Interactions between foods, nutritional supplements and drugs
I. INTRODUCTION Food-drug interactions can be the result of different mechanisms and may lead to a decrease in drug efficacy or increases in toxicity. There have been a number of very informative recent reviews on food-drug interactions (15,27,42,51,52,56, 60,62). In addition, several recent reviews pertaining to food-drug interactions have focused on specialized conditions such as in the elderly (53), in the critically ill (54), in hospitalized patients (18) and in patients receiving specialized nutritional support (35). Unfortunately, despite efforts to clearly define the actual incidence of food-drug interactions, it has been difficult to define the magnitude of the problem, which will most likely expand as the population ages. It is estimated that two-thirds of patients aged 65 years and older use one or more drugs daily (50). Furthermore, older patients experience adverse drug reactions more frequently than do younger adults (2). Not only has the incidence of drug-food interactions increased in older patients, but generally drugs have become more potent. Along with the increased use of specialized nutritional support in patients requiring multiple medications, there is a concern about the possibility for pharmacologic-nutritional interactions, and the consequences of therapeutic outcomes (35,42). It is known that the frequency of drug interactions is higher in the critically ill patient simply because of the larger number of drugs they receive (45).