By: Shreya Sharma
While medicines can cure and treat many health issues, they must be taken appropriately to ensure safety and efficacy. The ideal drug should have a predictably specific, permanent effect, display linear potency and be non-toxic in any dosage. Of course, this is yet to be discovered, and in the meantime, medications have very complex interactions with the human body.
Drug interactions are scenarios in which another substance alters the drug’s activity, either by increasing or decreasing its effect, or producing a new effect entirely. Drug-drug interactions are typically the first to come to mind, which is why it is recommended to acquire all prescriptions from the same pharmacy. This allows for an accurate record of which medications were being taken and when. However, drug-herb and drug-food interactions also exist. These can occur due to unintentional misuse or due to unawareness of the active ingredients in the substances being consumed. In addition to drugs, food, and herbs, alcohol can also cause the medication to fail to work appropriately up to the point of serious health altercations.
Some foods can reduce or intensify drug effects by interfering with its pharmacodynamics, or the mechanisms of the drug’s actions. For example, warfarin is an anticoagulant which antagonizes the recycling of vitamin K1, which causes a depletion of the active form of vitamin K1. Certain combinations of foods and drugs can create hypertensive episodes that can be fatal if they become severe. Ingesting foods rich in tyramine (found in fermented foods such as cheese and wine) concurrently with monoamine oxidase inhibitors (MAOIs) can cause a severe increase in blood pressure. MAOIs are used to treat depression, but they also inhibit the breakdown of dietary and endogenous amines. They also decrease the breakdown of tyramine, a blood-pressure regulating amino acid, which can cause a hypertensive episode through vasoconstriction.
Pharmacokinetic interactions, or the movement of drugs through the body, can also be altered by different combinations of substances. Various physicochemical properties of foods can alter drug effects by chemically binding to the drug and turning it into an insoluble salt that can not be absorbed easily. For example, proteins found in foods can bind to phenytoin, an antiepileptic agent, and result in poor seizure control due to insufficient absorption. Comparatively, fat-rich foods can increase the solubility of lipid-soluble medications, such as antiretroviral protease inhibitors including
and saquinavir, increasing their absorption. Gastric emptying, bile stimulation, splanchnic circulation, GI pH and the gut microbiome can all also be physiologically or mechanically altered due to changes in drug absorption.
It is vital to consult healthcare professionals when prescribed or taking a new drug. Be sure to address all other over-the-counter drugs, supplements, vitamins, and other dietary concerns to mitigate the risk of adverse reactions. In particular, pharmacists are extensively knowledgeable about the effects, side effects, and interactions of a variety of drugs.
References
Aslam, N. (2011, March). Food-drug interactions. Retrieved April 24, 2021, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191675/
Center for Drug Evaluation and Research. (n.d.). Drug Interactions: What You Should Know.
Retrieved April 24, 2021, from
https://www.fda.gov/drugs/resources-you-drugs/drug-interactions-what-you-should-know
Publishing, H. (n.d.). 7 things you can do to avoid drug interactions. Retrieved April 24 2021,
from
https://www.health.harvard.edu/staying-healthy/7-things-you-can-do-to-avoid-drug-intera
ctions