Interactions Among Drugs, Food, Beverages, Alcohol, Herbs, Phytochemicals, Nutraceuticals, and Micronutrients: A Current and Updated Review.

Abstract

Introduction: Alterations in the pharmacokinetics or pharmacodynamics of a drug could be the result of interaction with nutritional elements or due to the nutritional status of patients. This review summarizes the findings of previous studies on the interaction between the most prescribed drugs and food variables.

Methods: From the commencement of databases related to the topic of interest to January 2024, all relevant articles were searched in PubMed, Scopus, and Web of Science.

Results: Milk, grapefruit juice, or alcohol could lead to specific food-drug interactions. Patients who require surgery should refrain from using ginseng for at least a week prior to the operation. The interaction of drugs, such as carbamazepine with capsaicin, saquinavir with garlic, and warfarin with ginkgo biloba, needs vigilant attention. Among epileptic patients, in those taking phenobarbital and phenytoin, due to an increase in the metabolism of vitamin D, supplementation of vital minerals might be optional. The curcumin's effect in patients with doxorubicin, due to the modulation of cellular pathways (P-glycoproteins, other ABC transporters), could be complex.

Discussion: Interactions between drug and food variables could cause an alteration in drug efficiency or toxicity due to changes in drug transporters. Attention to the induction or inhibition of cytochrome P450 by food content could help mitigate the risk of unwanted side effects.

Conclusion: The population of elderly, patients on drugs with patients on drugs with a narrow therapeutic window, pregnant women, and children needs more attention. To better assess the benefit-risk relationship, a full and comprehensive dietary recall, including simultaneous intake of drugs and food, is recommended.