Drug-mineral interactions: a new responsibility for the hospital dietitian

Recent hospital accreditation guidelines encourage hospital dietitians to monitor patient drug therapy and provide education regarding drug-food interactions. However, information concerning these interactions is lacking, even though they can occur frequently. Minerals in foods can complex with drugs and/or alter the gastrointestinal environment to affect the normal absorption processes of drugs and minerals. There are three types of drug-mineral interactions: (a) malabsorption of the mineral and/or drug; (b) mineral depletion and retention; and (c) drug-mineral interactions induced by simultaneous antacid ingestion. It is recommended that oral drugs be administered on an empty stomach 1 hour before or 2 hours after a meal and at least 2 hours before or after antacid use. A small snack of refined carbohydrates with low nutrient density can be consumed with drugs that cause gastric upset when given on an empty stomach.