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NUTRIENT-DRUG INTERACTIONS

BY: BROOKE KOPACZ, WENDY BARTH, AND HAYDEN KUSILEK


WHAT IS A NUTRIENT-DRUG INTERACTION?
Definition: Drug-nutrient interactions are defined as physical, chemical, physiologic, or pathophysiologic
relationships between a drug and a nutrient.
Not Drug-Drug Interactions
The Interactions between Drugs and Nutrients
Hundreds of drugs and nutrients interact, and these interactions can lead to nutrient imbalances or interfere
with drug effectiveness. Different ways foods and drugs interact:
◼ Drugs can alter food Intake and absorption, metabolism, and excretion of nutrients.

◼ Foods and nutrients can alter the absorption, metabolism, and excretion of nutrients of drugs.

◼ Combinations can be toxic!


DRUGS ALTER FOOD INTAKE

Suppress appetite, alters taste sensations, induce nausea or vomiting, cause mouth dryness, or create
inflammation or lesions (mouth stomach, or intestinal lining).
◼ Side effects
◼ abdominal discomfort, constipation, and diarrhea
◼ If not resolved, will cause weight loss or malnutrition
◼ Can also cause weight gain
◼ Avoid treatment
◼ Appetite advancers prescribed in certain cases
DRUGS ALTER NUTRIENT ABSORPTION

◼ Some medications bind to nutrients in the GI tract, preventing their absorption.


◼ bile & acid binders (cholestyramine, Questran) used to lower cholesterol also bind to fat-soluble
vitamins (A, D, E, K)

◼ Some antibiotics bind to calcium in foods & supplements, which reduces absorption of both
substances.
◼ iron, magnesium, & zinc may also bind to antibiotics
◼ dairy and supplements hours after medication

◼ Medications that reduce stomach acidity may interfere with absorption of vitamin B12, folate, & iron.
◼ Several drugs interfere with intestinal metabolism or transport into mucosal cells.
DIET-DRUG TOXICITIES
◼ Warfarin (Coumadin) - Vitamin K
◼ Coumadin - foods that affect blood
viscosity
◼ Insulin, Oral Diabetic Agents, - Alcohol
◼ Digoxin, High-Fiber Diets, and Herbs
◼ Statins - grapefruit
◼ Calcium Channel Blockers - grapefruit
◼ Erectile Dysfunction Drugs - grapefruit
◼ Acetaminophen - alcohol
◼ Antibiotics - dairy products
◼ MAOIs and Tyramine - Containing
Foods
◼ Antithyroid Drugs and Iodine-Rich
Foods
THE INACTIVE INGREDIENTS IN DRUGS

Sugar, sorbitol and lactose


◼ Used for taste
◼ Watched closely for diabetics
◼ problems for lactose intolerant patients
◼ Sodium
◼ some medications may take up entire daily sodium limit
◼ Alka-Seltzer
◼ Antacids
◼ Could reduce absorption of nutrients
Research Article- Effect of Grapefruit Juice on Bioactivation Prasugrel

◼ Grapefruit juice reduces the bioactivation of prasugrel, but it has a limited effect on the antiplatelet
effect of the drug.
◼ prasugrel: acts as a platelet inhibitor, and is used to prevent blood clotting.
Food-Drug Interactions: Barbara Mendez. R. Ph. M.S. Registered
Pharmacist & Nutritionist
References
◼ Barbara Mendez (2015, May 18). YouTube Retrieved from https://www.youtube.com/watch?v=8WwHOqmXozo

◼ Bushra, R., Aslam, N., & Khan, A. Y. (2011). Food-drug interactions. Oman Medical Journal, 26(2), 77–83. doi:10.5001/omj.2011.21
◼ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191675/

◼ Holmberg, M. T., Tornio, A., Hyvärinen, H., Neuvonen, M., Neuvonen, P. J., Backman, J. T., & Niemi, M. (2015). Effect of grapefruit
juice on the bioactivation of prasugrel. British Journal of Clinical Pharmacology, 80(1), 139–145. doi:10.1111/bcp.12581

◼ RD, C. M. B. (2016). Dangerous food-drug interactions. December 12, 2016, Today’s Geriatric Medicine,
http://www.todaysgeriatricmedicine.com/archive/101308pe.shtml

◼ Whitney, E. N., & Rolfes, S. R. (2007). Understanding nutrition, ISE (11th ed.). United States: Thomson Higher Education.