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Cairo University
Food Drug Interactions
By: Ayman M. A. Fkirin, Department of Pharmacology,
Fayoum University
Before Starting
Important Definition:
Drug-nutrient interaction:
the result of the action
between a drug and a
nutrient that would not
happen with the nutrient
or the drug alone
Food-drug interaction:
a broad term that
includes drug-nutrient
interactions and the effect
of a medication on
nutritional status
Mechanism:
Change PH
↑ Digestive secretions
Alter rate of Absorption
Bind to drug
Compete for absorption site.
Dilution of drug particles.
Formation of physical barrier.
Absorption
1) Grapefruit:
- Can cause more of a drug to be absorbed from intestine, even
toxic levels. (new Concern)*
- Active ingredient*:
1) Naringen.
2) Furano-coumarins Examples
3) Bergamot-tin
2) Orange juice:
- Should not consumed with antacid contains AL.
- ↓ bioavailability of some antibiotics
3) Dairy products:
- Interfere with tetracycline, Antifungal
- Exogenous Progesterone may require dairy product to work!!
**
4) Soda pop or high acid fruit or vegetable juices **:
- It is not recommended to take drugs with them.
- Can cause excess stomach acidity.
*Food-Drug Interactions By: Kamal El din EL Tahir, College of Pharmacy, KSU, 2007
**Food Drug interaction, by: Dr. William Diehl-Jones, University of Manitobia, 2005
Distribution
-Affect Urinary pH
- Acidic Food ↑ excretion of basic drugs.
- Basic Food ↑ excretion of acidic drugs.
3) GINKGO **
- It interferes with platelets clotting
- Many experts recommend that ginkgo not be combined with
NSAID and MAO inhibitors
1) Absorption:
- Drug form complexes with food ↓ food absorption
- Drug alters gastric acidity.
- Drug damages mucosal surface.
- Alter gastric motility.
2) Distribution:
- Drug displace Nutrient from protein binding:
e.g. Aspirin displace folate
4) Excretion:
- Drug increases urinary excretion of nutrients.
e.g. Loop diuretics ↑ excretion of Na, K, Cl, Mg, Ca.
- Drug decreases urinary excretion of nutrients.
e.g. Thiazide diuretics ↓ excretion of Ca.
Doctors should know possible food interactions with the prescribed drug
i.e. from books, researches, web sites.
Summary
Many people eat foods that have hundred of active
substance
That may counteract or added to action of many drugs.
Food can affect all levels of drug kinetics and dynamic
Drugs can affect food kinetics and Nutritional state of
patients.
Doctors must take good nutritional history of patients of
non-compliance to drugs