Food-Drug Interactions: Types, Causal Mechanisms, Potential Consequences, and Preventive Strategies

Classification And Causal Mechanisms Of Food-Drug Interactions

Physico-chemical or biological interplay between a dietary ingredient and a drug is referred to as a food-drug interaction. Since the outcome of a food-drug interaction arises either in terms of pharmacokinetic or pharmacodynamic variations, thus similar to drug-drug interactions and drug-herb interactions, the food-drug interactions are also broadly classified into two major types of pharmacokinetic food-drug interactions and pharmacodynamic food-drug interactions. Certain food products can modulate the biological effects of drugs via interfering with their physico-chemical properties or mechanisms of action. Such type of interactions involving the alteration of mode of action or biological effect of drug(s), by the concurrently used food item(s) are known as pharmacodynamic food-drug interactions. For instance, the anticoagulant effect of warfarin is reversed by the concurrent use of vitamin K₁-containing green leafy vegetables. Likewise, potassium-containing fruits including banana and orange may potentiate the hyperkalemic effect of renin-angiotensin-aldosterone system blockers and consequently lead to myocardial arrhythmia and even cardiac arrest (Choi & Ko, 2017).