The influence of food on the absorption and metabolism of drugs: an update

Abstract

Food-drug interactions can lead to a loss of therapeutic efficacy or toxic effects of drug therapy. Generally, the effect of food on drugs results in a reduction in the drug's bioavailability; however, food can also alter drug clearance. The benefits of considering metabolism and pharmacokinetic information in the drug discovery process have been highlighted by Humphrey and Smith (79) and the process of rational drug design should include considerations of the chemistry, pharmacology and pharmacokinetics of the drug (80) and the impact of diet on these parameters.

Comparative effect of different types of food on the bioavailability of cefaclor extended release tablet

“…The low-fat non-vegetarian diet showing little food effect may be due to adsorption of cefaclor to the non-vegetarian content (meat). The significant increase in C max with highfat non-vegetarian diet may be due to decrease in adsorption of cefador to meat in the presence of fat and an increase in release of cefador from the extended release formulation produced by fat induced increase in biliary secretion as reported by Williams et al (24). The increase in C max however, is not relevant to the pharmacodynamic effect (efficacy) of cefador since it is a time-dependent antibiotic.…”

“…Rosen et al (23) while studying the role of milk protein in food drug interactions concluded that milk protein such as casein could alter the dissolution rate, saturation solubility, concentration of free drug in solution and also physicochemical properties of the system. All these factors could account for the effect of food on phenytoin absorption (24). In case of cefaclor, which is also a sparingly soluble drug like phenytoin, the protein may have similar effects.…”

Effects of Food on Drug Absorption

“…The extent of food-drug interactions is dependent on factors such as the physicochemical properties of the drug, formulation, type and size of the meal, the order in which food and drug are ingested, and the time interval between the administration of food and drug (Welling, 1984;Williams et al ., 1996). The physiological changes following food intake in the stomach, intestine, and circulation affect drug absorption.…”

“…The amount of drug that enters the systemic circulation is a function of presystemic clearance (Welling, 1996). The increased splanchnic blood flow after meal may influence the absorption of extensively metabolized drugs as a result of changes in the clearance of a drug during the first pass through the liver (Welling, 1977;Williams et al ., 1996). After a meal, a larger fraction of the drug, for example, propranolol, bypasses the liver because of the increased splanchnic blood flow and therefore resulting in increased bioavailability (Melander and McLean, 1983;Welling, 1996).…”

Therapie gastroenterologischer Krankheiten

“…Die meisten Interaktionen, die während der enteralen Ernährungsphase zwischen Arznei-und Nährstoffen auftreten, sind auf eine einzige der nachfolgend aufgeführten Inkompatibilitäten zurückzufüh- [Klang 2000;Williams 1996]. Deshalb ist bei der Verabreichung von Medikamenten während einer enteralen Ernährung Vorsicht geboten.…”