Pharmacol Res. 2016 Sep 28. pii: S1043-6618(16)30991-4. doi: 10.1016/j.phrs.2016.09.038. [Epub ahead of print]
- 1UMR-S1144, Faculté de Médecine Paris-Diderot, 10 avenue de Verdun 75010 Paris, France;
Département de Médecine Interne, Assistance Publique-Hôpitaux de Paris,
Hôpital Lariboisière, 2 rue Ambroise Paré ,75010 Paris, France. Electronic address: stephane.mouly@aphp.fr.
- 2UMR-S1144, Faculté de Médecine Paris-Diderot, 10 avenue de Verdun 75010 Paris, France;
Département de Médecine Interne, Assistance Publique-Hôpitaux de Paris,
Hôpital Lariboisière, 2 rue Ambroise Paré ,75010 Paris, France.
- 3Département de Médecine Interne, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, 2 rue Ambroise Paré ,75010 Paris, France.
Abstract
An
interaction of drug with food, herbs, and dietary supplements is
usually the consequence of a physical, chemical or physiologic
relationship between a drug and a product consumed as food, nutritional
supplement or over-the-counter medicinal plant. The current educational
review aims at reminding to the prescribing physicians that the most
clinically relevant drug-food interactions may not be strictly limited
to those with grapefruit juice and with the Saint John's Wort herbal
extract and may be responsible for changes in drug plasma
concentrations, which in turn decrease efficacy or led to sometimes
life-threatening toxicity. Common situations handled in clinical
practice such as aging, concomitant medications, transplant recipients,
patients with cancer, malnutrition, HIV infection and those receiving
enteral or parenteral feeding may be at increased risk of drug-food or
drug-herb interactions. Medications with narrow therapeutic index or
potential life-threatening toxicity, e.g., the non-steroidal
anti-inflammatory drugs, opioid analgesics, cardiovascular medications,
warfarin, anticancer drugs and immunosuppressants may be at risk of
significant drug-food interactions to occur. Despite the fact that
considerable effort has been achieved to increase patient' and doctor's
information and ability to anticipate their occurrence and consequences
in clinical practice, a thorough and detailed health history and dietary
recall are essential for identifying potential problems in order to
optimize patient prescriptions and drug dosing on an individual basis as
well as to increase the treatment risk/benefit ratio.
Copyright © 2016 Elsevier Ltd. All rights reserved.
KEYWORDS:
Clinical practice; Cytochrome P450 3A4; Drug-food interactions; Grapefruit juice; P-glycoprotein; Saint-John’s Wort
