Drug-food interactions in clinical practice

Drug-food interactions are a significant problem in clinical practice. Foods may alter the effects of drugs by interfering with pharmacokinetic processes, such as absorption and elimination. For example, absorption of tetracyclines is decreased when taken with milk or other dairy products. Pharmacologic and pharmacodynamic mechanisms also play an important role in drug-food interactions by altering drug effects. An example is the interaction of warfarin sodium with leafy green vegetables, whereby the hypoprothrombinemic effect of warfarin may be decreased and thromboembolic complications may develop. Similarly, certain drugs may have an effect on food intake, absorption, metabolism, and utilization. Numerous drugs, such as antineoplastic agents, have been shown to suppress appetite, resulting in decreased food intake and nutritional deficiency. It is important that health care providers, such as physicians, pharmacists, and dietitians, recognize and work as a team to prevent significant drug-food interactions. Minimizing adverse drug-food interactions would improve patient care by optimizing therapeutic effects and maintaining proper nutritional status.