A Review of Food–Drug Interactions on Oral Drug Absorption

Abstract

Food effect, also known as food-drug interactions, is a common phenomenon associated with orally administered medications and can be defined as changes in absorption rate or absorption extent. The mechanisms of food effect and their consequences can involve multiple factors, including human post-prandial physiology, properties of the drug, and how the drug is administered. Therefore, it is essential to have a thorough understanding of these mechanisms when recommending whether a specific drug should be taken with or without food. Food-drug interactions can be clinically relevant, especially when they must be avoided to prevent undesirable effects or exploited to optimize medication therapy. This review conducts a literature search that examined studies on food effect. We summarized the literature and identified and discussed common food effect mechanisms. Furthermore, we highlighted drugs that have a clinically significant food effect and discussed the corresponding mechanisms. In addition, this review analyzes the effects of high-fat food or standard meals on the oral drug absorption rate and absorption extent for 229 drugs based on the Biopharmaceutics Drug Disposition Classification System and demonstrates an association between Biopharmaceutics Drug Disposition Classification System class and food effect.

pH-dependent spontaneous hydrolysis rather than gut bacterial metabolism reduces levels of the ADHD treatment, Methylphenidate

“…Reports on the pharmacokinetics of MPH comparing fed and fasting conditions are scarce and reveal contradictory results [31,32]. Although food intake tends to increase luminal pH of the gut [33], not enough information is available regarding the pH levels in the small intestine in fed or fasting conditions and how this could affect the bioavailability of MPH.…”

Effects of Food and Gender on Pharmacokinetics of Rosuvastatin in a Chinese Population Based on 4 Bioequivalence Studies

“…These studies have suggested that dose adjustment may be required in a fasted or fed condition as well as for change of gender. 19 Several clinical trials also found that the plasma concentrations of other statins are lower in the fed state; however, no effect on overall LDL-C lowering was observed. Therefore, we investigated the effect of food and gender on rosuvastatin pharmacokinetics in healthy All values are expressed as mean ± SD except t max values, which are median (range).…”

“…18 Many drugs have demonstrated statistically significant food effects, but only a few have significant clinical relevance. 19 Several clinical trials also found that the plasma concentrations of other statins are lower in the fed state; however, no effect on overall LDL-C lowering was observed. 20,21 The main action site of statins is in the liver; therefore, the high liver uptake is important for a lipid-lowering effect.…”

Effect of Food on the Pharmacokinetics of Quizartinib

“…16 Food effects can be a complex aspect of drug development. 16 Food effects can be a complex aspect of drug development.…”

“…Food-drug interactions or differences in absorption of a drug when administered with and without food are a common occurrence with many orally administered medications. 16 Food effects can be a complex aspect of drug development. Exposure to several oral tyrosine kinase inhibitors is affected by the presence of food, necessitating guidance regarding whether to dose these medications with or without food.…”