Food and Drug Interactions

Abstract

Natural foods and vegetal supplements have recently become increasingly popular for their roles in medicine and as staple foods. This has, however, led to the increased risk of interaction between prescribed drugs and the bioactive ingredients contained in these foods. These interactions range from pharmacokinetic interactions (absorption, distribution, metabolism, and excretion influencing blood levels of drugs) to pharmacodynamic interactions (drug effects). In a quantitative respect, these interactions occur mainly during metabolism. In addition to the systemic metabolism that occurs mainly in the liver, recent studies have focused on the metabolism in the gastrointestinal tract endothelium before absorption. Inhibition of metabolism causes an increase in the blood levels of drugs and could have adverse reactions. The food-drug interactions causing increased blood levels of drugs may have beneficial or detrimental therapeutic effects depending on the intensity and predictability of these interactions. It is therefore important to understand the potential interactions between foods and drugs should and the specific outcomes of such interactions.

Patterns and Characteristics of Polypharmacy Among Elderly Residents in Danish Nursing Homes

“…Only prescription medications were included in this study, even though herbal and dietary supplements (HDS) can interact with prescription-based drugs [ 87 , 88 ]. Food supplements are defined as ‘foodstuffs the purpose of which is to supplement the normal diet and which are concentrated sources of nutrients or other substances with a nutritional or physiological effect, alone or in combination, marketed in dose form’ (The European Commission [ 89 ]).…”

Food Bioactive Compounds and Their Interference in Drug Pharmacokinetic/Pharmacodynamic Profiles

“…Both positive and negative abovementioned results in clinical practice are due to the fact that foods and beverages affect the way medicines exert their effects through diverse mechanisms, which can be classified as pharmaceutical, pharmacokinetic, and pharmacodynamic food-drug interactions. This is tuned to give the broadest view to the readers by providing a comprehensive classification of the major site of food-drug interactions, as pharmaceutical interferences, blood protein disruptions, and direct pharmacodynamic interferences are usually disregarded [3,4,5,13]. Furthermore, for the first time, evidence from bioinformatic approaches have been integrated with the literature data.…”

“…However, the recent and increasing use of traditional medicine along with complementary and alternative medicine (CAM) approaches, such as dietary modifications and dietary supplements, overcomes the concepts of fed or fasting drug administration, as patients are exposed to novel foods and supplements that contain various food bioactive compounds, such as nutraceuticals or phytochemicals [2]. For instance, food molecules may interfere with proteins involved in drug metabolism, which in turn cause variable and limited drug bioavailability [3,4,5], even though precise and comprehensive reviews of practical implications are mostly unseen.…”

Food–Drug Interactions with Fruit Juices

“…Altogether, the clinical relevance of the CYP system and drug transporters is recognized in drug–drug interactions, but also in food–drug interactions, because different xenobiotics, including those from fruit juices, e.g., grapefruit juice, can influence their activity and thus have an impact on the systemic drug exposure; i.e., efficacy and toxicity ( Figure 1 ) [ 17 , 18 , 19 ]. More importantly, the reader should be aware that drug interactions shown in vitro does not necessarily mean they are also occurring in vivo.…”