Drug and nutrition interactions: not just food for thought

J Clin Pharm Ther. 2013 Aug;38(4):269-71. doi: 10.1111/jcpt.12075. Epub 2013 May 27.

Abstract

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.

Keywords: drug interactions; food; nutrient; nutrition; safety.

MeSH terms

  • Food*
  • Food-Drug Interactions / physiology*
  • Humans
  • Nutritional Status / physiology
  • Pharmaceutical Preparations / metabolism*

Substances

  • Pharmaceutical Preparations