Food and drugs: risky interactions

If drugs and food are taken orally , there’s an increased chance that they interact in the digestive system. Some interactions can be extremely dangerous food items are actually capable of altering the metabolism and absorption of certain drugs , with potentially significant results.

Food and drugs can alter the effects of a variety of drugs, creating the vast variation in their concentration , which can result in dangerous adverse side negative effects. The mechanisms through which these happen are varied in that they slow the process of emptying the gastric as well as the solubilization process of the drug in gastric juices or food as well as the combination of the drug with certain ingredients in food, and modulation of enzymes that break down the drug through substances found in food items.

People who, due to their illnesses, need to use a variety of medications throughout the day are especially at risk. A significant portion of people over the age of 65 use non-steroidal anti-inflammatory medications, anti-hypertensives statins, anticoagulants, heart medications , and antidepressants all day. Of course, every day they drink and eat food and drinks and might also utilize herbs, natural products and phytotherapeutic supplements, exposing them to potentially harmful interactions. This are even more important due to the decreased effectiveness of a variety of bodily functions due to the aging process.

Food and drugs, issues of absorption

Certain drugs are especially vulnerable to an acidic atmosphere in the stomach. Certain antibiotics, such as penicillin G ampicillin, penicillin VK and penicillin are degraded by gastric secretions. It’s therefore advised to take them at least an hour prior or two hours following the meal. Other medications to take in between meals include captopril, a hypertensive drug, as well as indinavir which is a drug that is used in AIDS treatment.

Bisphosphonates are a class of drugs that is that are used to treat osteoporosis. The drugs alendronate and ibandronate and risedronate aren’t absorption-friendly when consumed alongside any drinks or food, with the exception of water. People who take these medications must take them 8-10 hours of fasting, and at least a half hour before eating food In the morning, prior to breakfast is the best time.

Antacids and supplements that contain significant amounts of iron or calcium can hinder the action of certain antibiotics, like ciprofloxacin or tetracycline. is best to be careful not to take both simultaneously.

Interactions with the acidic stomach environment can be positive or negative. Certain drugs’ lower gastric pH can aid in absorption. This is true for ketoconazole, an antimycotic of griseofulvin, an antimycotic, whose absorption is higher when combined with fats. Additionally, the absorption of lithium and lovastatin is greater when consumed with meals.

Certain medicines, such as ibuprofen the acid stomach’s environment reduces absorption, but does not affect its effectiveness, while at the same time, it decreases significantly the possibility of adverse consequences.


Certain foods contain substances that could interfere with the actions of specific medications. A lot of leafy vegetables as well as brassicas are rich in of Vitamin K. It is a chemical that is vital to the process of blood coagulation. Consuming a lot of these foods by people taking anticoagulant treatment with warfarin (Coumadin) will significantly diminish the effects of the drug, which can expose the patient to the danger of thrombosis.

A few monoamine antioxidants (MAOI) are antidepressant drugs while efficient, are less frequently used for oral administration because of potential interactions with endogenous amines that are present in certain foods such as old cheese, red wines and seafood, cured meats and ripe bananas, which are that can determine the trigger of severe hypertensive crises.

A diet that is high in protein may increase your absorption levels of propanolol an antihypertensive. Hesperidin that is found in orange juice could lower the absorption of another hypertensive agent, called celiprolol.

Levothyroxine (Euthyrox) is recommended to be consumed on an empty stomach to allow for better absorption the drug. Additionally, the patient should avoid intake of goitrogenic food items like the cabbage variety, Brussels sprouts, broccoli cauliflower beans, pearl millet. This can severely reduce the effectiveness of the medication because it reduces the amount of iodine available. Soy consumption can reduce the effectiveness of the drug due to a decline in digestion or directly interactions of isoflavones from soy with thyroid physiology.

Licorice has glycyrrhizin and Glycyrrhe acid, two chemicals that are known to interfere antihypertensive and antiarrhythmic medications.

Food and drugs are linked to cytochrome P450

The active ingredients in the drugs are xenobiotics. These are chemicals that the body is able to eliminate faster or slower through complicated reactions. Over 70% of substances that we consume are metabolized by enzymes that belong to the Cytochrome P450 family. Humans have around 60 genes that encode for various kinds of the enzyme and many of them play a role in the process of detoxification. There is a wide variation in the reaction of individuals that are using the same medication and this is due to a distinct speed of metabolization owing to the genetic variations of cytochromes. Rapid metabolizers remove drugs quickly which could reduce any effects caused by the substance however, in slow metabolizers, drugs are eliminated slow, with the potential for overdose.

The varieties of the cytochrome P450 used to aid in detoxification of drug include CYP3A4, CYP2D6, CYP2C9, CYP1A2, and CYP2E1 (CYP is the acronym used to describe the family of enzymes that comprise this group). Certain substances in food items can disrupt the actions of these enzymes. They can cause extremely consistent changes, of up to 10 times in the concentration of some drugs. The consequences could be extreme.


Cytochrome CYP3A4 – taurochenodeoxycholate 6alpha-hydroxylase for the more adventurous – is the most active enzymatic form and alone plays an important role in the metabolization of about 50% of drugs. The enzyme is found primarily inside the liver, and the small intestinal tract, which suggests it developed specifically to guard against gastric system from xenobiotics absorbed through the diet. In fact, the function of CYP3A4 is greatly affected by the food ingredients that are present.

There are many foods that hinder the function in the enzyme a prominent place is given to the grapefruit juice, which due its presence in furanocoumarins like dihydroxybergamottin as well as bioflavonoids, such as naringin quercetin and naringenin, is a potent inhibitor and an inactivator of Cytochrome. Its effects are already evident when you consume just a small amount of juice, but it can grow substantially with regular consumption. It is worth noting that the inhibitory effect of grapefruit juice may last for as long as a couple of days, so it’s not advised to consume the drug within a few hours of having consumed the juice. It is recommended to be stopped a few days prior to. Pomelo and Seville oranges also contain significant amounts of these substances that have inhibition properties. Certain substances found in wine been shown to have an inhibitory effect on the enzyme, in vitro. the results in vivo are uncertain, but they do suggest that the beverage may slow the metabolism of certain medications. Additionally, inhibitors of this enzyme are also found in the juice of raspberries, white and black Mulberry juice, and the juice of pomegranate, however no significant in vivo effects were observed.


The inhibition of CYP3A4 decreases the speed of certain drugs being removed in the body. This can lead to an increase in the amount of the drug by taking a series of doses, which can be combined to create an overdose. Consider the extensive usage of statins and the risk of overdose for those who use statins in conjunction with a drinking grapefruit juice. It is commonly emphasized by its purported slimming properties.

St. John’s Wort is one of the most commonly used medicinal plants which is utilized to combat depression. St. John’s wort is a traditional, natural remedy however, as with many other plants used for medicinal purposes, it’s a potent source of xenobiotics which can trigger significant interactions with drugs. This is compounded by the fact that products can vary in a meaningful way in terms of the quality and amount of active components, exposing users to serious dangers. Actually, St. John’s wort contains ingredients that trigger the actions of CYP3A4. The current belief in hypericum in conjunction with certain drugs may increase the rate of elimination of drugs which can lead to an overdose that could have devastating consequences. Among the substances metabolized by this enzyme are the cyclosporines, which are used to decrease the possibility of rejection organ transplants. A too rapid removal of cyclosporins, as well as St. John’s Wort can result in a decrease in the average amount for the medication by approximately 50%, and may cause rejection of the organ that was transplanted. Some oral contraceptives may be eliminated too quickly through using St. John’s wort, and the contraceptive effect is completely lost. effectiveness. Beware!

In the list of drugs whose action alters when combined with the consumption of grapefruit, or in the opposite direction and in the opposite direction, by the st. John’s wort we’ll mention the most commonly used:

Anxiolytics: Diazepam

Antiarrhythmics: Carvedilol, Amiodarone, Propafenone, Quinidine

Antibioticsinclude: Erythromycin, Ciprofloxacin and Clarithromycin

Antihistamines: Terfenedine, Fexofenadine, Montelukast

Antifungals: Itraconazole and Fluconazole

Antihypertensives: Losartan and enalapril

Calcium channel blockers: Felodipine, Amlodipine, Diltiazem, Verapamil

Corticosteroids: Prednisone, Progesterone

The NSAIDs include Meloxicam as well as Mefenamic Acid

Immunodepressants: Cyclosporine, Tacrolimus

The Proton Pump inhibitors: Esomeprazole, Omeprazole

Neurological: Carbazepamine, Imipramine, Bupropion

Hormonal: Finasteride, Anastrzol

Statins: Lovastatin, Atorvastatin, Simvastatin

Treatments for impotence Sildenafil (Viagra) and the tadalafil (Cialis) Vardenafil (Levitra)

Cytochrome CyP1A2 is primarily found in the liver. It is involved in the metabolism of caffeine , theophylline fluvoxamine, clozapine and imipramine. The consumption of a large amount of caffeine-which includes tea, coffee and chocolatecould increase the amount of enzymes in the body, as can the consumption of brassicaceous foods like cabbage broccoli, brussels sprouts, and brussels swissand barbecued meats which is why the activity of CYP1A2 can be enhanced due to an increase in the rate of elimination of prescribed drugs. However the typical grapefruit juice as well as Jufeng grape juices are inhibitory in nature. In addition, due to the sensitive nature of the drugs involved, care must be taken in the consumption of certain foods.

Cytochromes CYP2E1, CYP2C9, and CYP2D6 play a role in the function of metabolism for ethanol the enflurane and halothane compounds, ibuprof and diclofenac, warfarin proguanil and omeprazole. Drinking alcohol can boost CYP2E1 activity and increase the rates of elimination of certain substances. When people consume high amounts of alcohol, paracetamol and alcohol are common signs of hepatotoxicity. This is because of the excessive accumulation in the liver of various metabolites from the drug.

Consuming alcohol in conjunction with drugs can be very dangerous. The alcohol in drinks could alter the supply of drugs . Certain drugs could alter the metabolism processes that enable removal of alcohol. which is a toxic substance specifically for the part that is related to Cytochrome CYP2E1. Alcohol can cause dangerous interactions with antidepressants opioids, benzodiazepines and anticonvulsants stimulants, antihypertensives analgesics and anti-inflammatory drugs. The most frequent symptoms include tachycardia, sedation and an increase in alcohol-related intoxication that can occur with the consumption of alcohol. Because of the high danger of interactions, the broad range of substances involved, and the potential consequences that could be directly or indirectly fatal It is always advisable to avoid drinking substances and alcohol in the same moment. In Hollywood they can but it’s inside the movie. Life is not the same and it’s best not to experiment with some very hazardous mixtures.

If you’re worried after reading this article I would like be sure to inform you that every label on every drug will also mention the possible interactions with food. that research on this subject is extremely active and meticulous and that the regulatory bodies follow strict guidelines in the study of interactions between food and drugs. If you are unsure when you are considering taking a medicine discuss it with your doctor or consult an expert trained in the field. Always be aware.


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