An Introduction to Drug–Nutrient Interactions

Boullata, Joseph I.

doi:10.1007/978-1-60327-362-6_1

Cited by 16 publications

(24 citation statements)

References 115 publications

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“…Drug-nutrition interactions result from physical, chemical, physiological or pathophysiological relationships not only between a drug and a nutrient but also between a drug and multiple nutrients, food in general, specific foods or components, or nutrition status. 1,2 The combined or reciprocal action of a drug with any of these other elements requires that one is a precipitating factor to and the other an object of the interaction. The precipitant may be any of these (i.e.…”

Section: Commentmentioning

confidence: 99%

Drug and nutrition interactions: not just food for thought

Boullata

2013

J Clin Pharm Ther

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Summary What is known and objective The management of drug‐drug interactions – from recognition of the interaction potential, to addressing the negative consequences – are well‐recognized and avoided, or rapidly addressed when identified clinically. Drug‐nutrition interactions are no less important than drug‐drug interactions in patient care. Unfortunately, beyond those caused by food, these interactions are less commonly recognized or identified and managed. This article will re‐introduce the topic of drug‐nutrition interactions to clinicians. Comment Although many clinicians are acutely aware of and vigilant for potential drug‐drug interactions, most are less aware of the possibility of drug‐nutrition interactions beyond classic food‐drug interactions. Interaction can occur between a drug and a nutrient, multiple nutrients, food in general, specific foods or components, or nutrition status. An interaction is considered clinically significant if it alters therapeutic drug response and/or compromises nutrition status. Mechanistically the interactions may be physicochemical reactions, actions at membrane transporters or metabolizing enzymes, or an influence on physiologic function. Appreciating the many types of drug‐nutrition interactions will aid the clinician and have the potential to influence patient outcome. What is new and conclusion Ongoing advances in knowledge about drug and nutrition interactions have potential to improve patient care. Drug‐nutrition interactions need to be better recognized, understood on a mechanistic basis, predicted, and managed as necessary.

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Section: Commentmentioning

confidence: 99%

Drug and nutrition interactions: not just food for thought

Boullata

2013

J Clin Pharm Ther

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“…Much of this historic view has been described elsewhere (13). More contemporary reviews and compilations of DNIs have reframed the subject, allowing for a more systematic approach to identifying and evaluating them (14)(15)(16)(17). Despite some advances in recognizing DNIs and understanding some of the mechanisms, data on how best to manage individual DNIs still remain inadequate at this time.…”

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confidence: 97%

Drug–Nutrient Interactions: A Broad View with Implications for Practice

Boullata¹,

Hudson²

2012

Journal of the Academy of Nutrition and Dietetics

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“…[14][15][16] Mechanism-based inhibition (MBI) of CYP3A4 is characterized by nicotinamide adenine dinucleotide phosphate (NADPH)-, time-, and concentration-dependent enzyme inactivation that occurs when some substrates are converted by CYPs into reactive metabolites. 17) Several phytochemicals, including GF-I-1 (4-[ [6-hydroxy-7 [1] benzopyran-7-one) furanocumarins from grapefruit, 18) rutaecarpine and limonene from Evodia rutaecarpa, 19) methylenedioxyphenyl lignans from Piper, 20) kaempferol from Zingiber aromaticum, 21) 5-methoxypsoralen from Foeniculum vulgare, 22) and lignans from Phyllanthus amarus, 23) have all been shown to be responsible for MBI of CYP3A4. Moreover, interactions between these compounds and therapeutic drugs could occur in vivo.…”

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confidence: 99%

Mechanism-Based Inhibition of Recombinant Human Cytochrome P450 3A4 by Tomato Juice Extract

Sunaga

Ohkawa

Nakamura

et al. 2012

Biological & Pharmaceutical Bulletin

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This study investigates whether tomato juice can inhibit cytochrome P450 (CYP) 3A4-mediated drug metabolism. Three commercially available, additive-free tomato juices, along with homogenized fresh tomato, were analyzed for their ability to inhibit testosterone 6β-hydroxylation activity using human recombinant CYP3A4. Results were compared to that of grapefruit juice. Ethyl acetate extracts of the tomato juices moderately reduced residual activity of CYP3A4 testosterone 6β-hydroxylation activity by 19.3-26.2% with 0-min preincubation. Residual activity was strongly reduced by 69.9-83.5% at 20-min preincubation, a reduction similar to that of grapefruit juice extract, known to contain constituents of mechanism-based inhibitors. One juice extract (tomato juice C) showed irreversible dose-and preincubation time-dependent and partial nicotinamide adenine dinucleotide phosphate (NADPH)-dependent inhibition of CYP3A4 activity. Furthermore, we examined whether the CYP3A4 inhibitory effect of tomato juice was substrate dependent by examining midazolam 1′-hydroxylation activity and nifedipine oxidation activity, in addition to testosterone 6β-hydroxylation activity. Tomato juice showed a potent inhibitory effect on nifedipine oxidation activity, which was comparable to that on testosterone 6β-hydroxylation activity; however, it showed a weak inhibitory effect on midazolam 1′-hydroxylation activity. We conclude that tomato juice contains one or more mechanism-based and competitive inhibitor(s) of CYP3A4. Additionally, significant CYP3A4 inhibitory activity did not result from lycopene, a major compound in tomato. Although the active compound was uncertain, a strong CYP3A4 inhibitory activity was observed in other solanaceous plants, i.e., potato, eggplant, sweet pepper, and capsicum. Therefore, responsible compounds in tomato are likely commonly shared among solanaceous vegetables.Key words tomato juice; mechanism-based inhibition; food-drug interaction; human recombinant cytochrome P450 3A4 Many foods and/or beverages have recently been found to influence drug metabolism or transport, sometimes resulting in clinically important drug interactions. This food-drug interaction is a critical aspect of pharmacotherapy. Food-drug interaction can be viewed in terms of pharmacokinetics and pharmacodynamics. Pharmacokinetic interactions can involve enzymes and transporters that are implicated in drug absorption, distribution, metabolism, or excretion. Pharmacodynamic interactions involve the pharmacological effect of a drug or physiologic effect of a dietary constituent. 1)Foods that inhibit drug metabolism enzymes, such as cytochrome P450 (CYP), elevate the blood concentration of co-administered drugs, resulting in a food-drug interaction, which sometimes causes adverse effects. [2][3][4] In vitro screening assays with beverages and foods such as beer, red wine, black and herbal tea, garlic, spices, mace, nutmeg, fruits, and fruit juices have all shown the ability to inhibit enzyme-mediated drug metabolism. [5][6][7][8][9][10] CYP...

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An Introduction to Drug–Nutrient Interactions

Cited by 16 publications

References 115 publications

Drug and nutrition interactions: not just food for thought

Drug and nutrition interactions: not just food for thought

Drug–Nutrient Interactions: A Broad View with Implications for Practice

Mechanism-Based Inhibition of Recombinant Human Cytochrome P450 3A4 by Tomato Juice Extract

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