Food and drug interaction: consequences for the nutrition/health status

Food-drug interactions are defined as alterations of pharmacokinetics or pharmacodynamics of a drug or nutritional element or a compromise in nutritional status as a result of the addition of a drug. Elderly patients are particularly at risk because more than 30% of all the prescription drugs are taken by this population. Failure to identify and properly manage drug-nutrient interactions can lead to serious consequences. For instance, drug-nutrient interactions can result in reduced absorption of certain oral antibiotics and may lead to suboptimal antibiotic concentrations at the site of infection. This predisposes the patient to treatment failure. Induction or inhibition of enzymes in the gut by nutrients may lead to a significant change in oral bioavailability of drugs or vice versa. For example, grapefruit juice is a selective intestinal CYP3A4 inhibitor. The overall exposure of some drugs can be increased by more than fivefold when taken with grapefruit juice and increase the risk of adverse effects. The use of certain drugs may affect GI tract function and may lead to a loss of bodily electrolytes and fluid. Limiting drug prescriptions to essential medications for as short a period as possible and periodic re-evaluations of the treatment chosen are essential to minimize adverse drug-nutrient interactions.