Departments of Experimental Pharmacology and Toxicology and.
Clinical Pharmacy and Management, Faculty of Pharmaceutical Sciences, University of Port Harcourt, Rivers State, Nigeria.
Am J Ther. 2018 Jul/Aug;25(4):e423-e433. doi: 10.1097/MJT.0000000000000705.
Food/Herb-drug interactions have become a major problem in health care. These interactions can lead to loss of therapeutic efficacy or toxic effects of drugs.
To probe the clinical relevance of such interactions, the impact of food/herb intake on the clinical effects of drug administration has to be evaluated. Failure to identify and efficiently manage food-drug interactions can lead to serious consequences. A comprehensive knowledge of the mechanisms that underpin variability in disposition will help optimize therapy.
Electronic search of literatures from relevant databases were conducted. A total of 58 original scientific reports/review articles were obtained with the search strategy; of which 25 were found eligible to be included in the present review. Required data were extracted from these studies, and their methodologies were assessed.
This review updates our knowledge on clinical food-drug interactions with emphasis on mechanism and clinical implications. Results obtained from literature search identified interactions with selected foods/herbs generated from in vivo and in vitro studies. For example, interaction studies in humans revealed a reduction in the bioavailability of mercaptopurine when taken concurrently with substances containing xanthine oxidase (eg, cow milk); a reduction in the bioavailability of quinine with Garcinia kola; increased bioavailability/toxicity of felodipine, nifedipine, saquinavir, sildenafil with grape juice; increased bioavailability of felodipine, cisapride with red wine and diminished bioavailability of fexofenadine with apple. Pharmacokinetic and/or pharmacodynamic mechanisms are implicated in many of these interactions. By evaluating the dietary patterns of patients and use of prescribed medications, health professionals will be well informed of potential interactions and associated adverse effects.
食物/草药-药物相互作用已成为医疗保健中的一个主要问题。这些相互作用可能导致药物治疗效果丧失或产生毒性作用。
为了探究这些相互作用的临床相关性，必须评估食物/草药摄入对药物给药临床效果的影响。未能识别和有效管理食物-药物相互作用可能会导致严重后果。全面了解药物处置变异性的机制将有助于优化治疗。
通过相关数据库的电子检索进行文献搜索。通过该搜索策略共获得了 58 篇原始科学报告/综述文章；其中有 25 篇被认为符合纳入本综述的条件。从这些研究中提取所需数据，并评估其方法学。
本综述更新了我们对临床食物-药物相互作用的认识，重点关注机制和临床意义。文献搜索结果确定了来自体内和体外研究的选定食物/草药的相互作用。例如，人类的相互作用研究表明，当与含有黄嘌呤氧化酶的物质（如牛奶）同时服用时，巯嘌呤的生物利用度降低；与 Garcinia kola 同时服用时，奎宁的生物利用度降低；葡萄汁可增加非洛地平、硝苯地平、沙奎那韦、西地那非的生物利用度/毒性；红葡萄酒可增加非洛地平、西普拉的生物利用度，苹果可降低非索非那定的生物利用度。许多这些相互作用涉及药代动力学和/或药效学机制。通过评估患者的饮食模式和使用规定的药物，医疗保健专业人员将充分了解潜在的相互作用和相关的不良反应。
