engleski

Food-drug interactions: focus on fruit juices

Fruit juices contain numerous phytochemicals and bioactive compounds, which, in combination with certain drugs (fooddrug interactions), can pose a risk for human health and have unwanted effects on the desired pharmacological outcome. Depending on the nature, such interactions are categorised as pharmacokinetic or pharmacodynamic. In other words, drug activity is changed due to a change in absorption, distribution, metabolism, and elimination of a certain drug, or due to a change at its site of action. In most cases, the mechanisms behind food-drug interactions are related to fruit juice interference with the activity of cytochrome P450 metabolising enzymes (CYPs) or drug transporters, whereas phytochemicals can act as inhibitors (or inducers). The clinical relevance of food-drug interactions precipitated by fruit juices is especially important with drugs that have a narrow therapeutic index, as relatively small changes in the drug plasma concentrations can lead to adverse effects, i.e. drug toxicity. Unfortunately, the potential for food-drug interactions caused by fruit juices, in addition to clinical relevance, cannot be easily predicted. However, examples of potentially relevant drug-fruit juice interactions with suggested/known mechanism in humans noted so far would be presented. By summarising, the best advice is to take the prescribed medication with water, and/or consult a specialised healthcare professional about the correct administration of drugs.

adverse events ; CYP enzymes and drug transporters ; inhibition and induction

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