Skip to main content
Log in

Drug-Food Interactions in Hospitalised Patients

Methods of Prevention

  • Leading Article
  • Published:
Drug Safety Aims and scope Submit manuscript

Summary

Drug-food interactions in hospitalised patients may result in decreased drug efficacy or increased drug toxicity. The increasing complexity of drug therapy regimens has increased the potential for drug-food interactions to occur, reinforcing the need to develop methods to prevent clinically significant drug-food interactions.

Before selecting the optimal method, in terms of feasibility of implementation and successful outcome, drugs with the potential for clinically significant interactions with food must be identified. From an analysis of the literature, 6 methods to prevent drug-food interactions have been suggested as useful tools. Each method has its own advantages and disadvantages. Most have been developed in response to guidelines from the most well recognised agency for quality review in the US, the Joint Commission on Accreditation of Healthcare Organisations (JCAHO). Based on those recommendations, an ideal programme to prevent drug-food interactions would be a combined patient counselling and label system to select the most appropriate drug administration times and increase nurse and patient awareness of the potential for drug-food interactions. However, because of time constraints and limited resources, a label system or the provision of a drug-food interaction pamphlet to the patient before discharge would be a more practical method. Newsletters and educational inservices combined with patient counselling or a label system would be a valuable method to prevent drug-food interactions in hospitalised patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Neuvonen PJ, Kivisto KT. The clinical significance of food-drag interactions: a review. Med J Aust 1989 Jan 2; 150: 36–40

    PubMed  CAS  Google Scholar 

  2. Thomas JA. Drug-nutrient interactions. Nutr Rev 1995 Oct; 53(10): 271–82

    Article  PubMed  CAS  Google Scholar 

  3. Yamreudeewong W, Henann NE, Fazio A, et al. Drug-food interactions in clinical practice. J Fam Pract 1995 Apr; 40(4): 376–84

    PubMed  CAS  Google Scholar 

  4. Kirk JK. Significant drug-nutrient interactions. Am Fam Phys 1995 Apr; 51(5): 1175–82

    CAS  Google Scholar 

  5. Accreditation Manual for Hospitals. Chicago: Joint Commission on Accreditation of Hospitals, 1997

  6. Williams L, Davis JA, Lowenthal DT. The influence of food on the absorption and metabolism of drags. Med Clin North Am 1993 Jul; 77(4): 815–29

    PubMed  CAS  Google Scholar 

  7. Welling PG. Interactions affecting drug absorption. Clin Pharmacokinet 1984; 9: 404–34

    Article  PubMed  CAS  Google Scholar 

  8. Illingworth DR. Comparative efficacy of once versus twice daily mevinolin in the therapy of familial hypercholesterolemia. Clin Pharmacol Ther 1986; 40: 338–43

    Article  PubMed  CAS  Google Scholar 

  9. Hopkin S. Clinical toleration and safety of azithromycin. Am J Med 1991; 91 Suppl. 3A: 40S–5S

    Article  Google Scholar 

  10. Neuvonen PJ, Kivisto KT, Lehto P. Interference of dairy products with the absorption of ciprofloxacin. Clin Pharmacol Ther 1991 Nov; 50(5): 498–502

    Article  PubMed  CAS  Google Scholar 

  11. Fagan TC, Walle T, Oexmann MJ, et al. Increased clearance of propranolol and theophylline by high-protein compared with high-carbohydrate diet. Clin Pharmacol Ther 1987; 41: 402–6

    Article  PubMed  CAS  Google Scholar 

  12. Scott AK. Warfarin usage. Can safety be improved? Pharmacol Ther 1989; 42: 429–57

    CAS  Google Scholar 

  13. Karlson B, Leijd B, Hellstrom K. On the influence of vitamin K-rich vegetables and wine on the effectiveness of warfarin treatment. Acta Med Scand 1986; 220(4): 347–50

    Article  PubMed  CAS  Google Scholar 

  14. Lippman S. Monoamine oxidase inhibitors. Am Fam Phys 1986; 34(1): 113–9

    Google Scholar 

  15. Artymowicz RJ, James VE. Atovaquone: a new antipneumocystis agent. Clin Pharm 1993; 12: 563–70

    PubMed  CAS  Google Scholar 

  16. Mantyla R, Mannisto PT, Vuorela A, et al. Impairment of Captopril bioavailability by concomitant food and antacid intake. Int J Clin Pharmacol Ther Toxicol 1984; 22: 626–9

    PubMed  CAS  Google Scholar 

  17. Singhvi SM, McKinstry DN, Shaw JM, et al. Effect of food on the bioavailability of Captopril in healthy subjects. J Clin Pharmacol 1982; 22: 135–40

    PubMed  CAS  Google Scholar 

  18. Gupta SK, Manfro RC, Tomlanovich S, et al. Effect of food on the pharmacokinetics of cyclosporine in healthy subjects following oral and intravenous administration. J Clin Pharmacol 1990; 30: 643–53

    PubMed  CAS  Google Scholar 

  19. Hartman NR, Yarchoan R, Pluda JM, et al. Pharmacokinetics of 2′,3′-dideoxyinosine in patients with severe human immunodeficiency infection: II. The effect of different oral formulations and the presence of other medications. Clin Pharmacol Ther 1991; 50: 278–85

    Article  PubMed  CAS  Google Scholar 

  20. Rodin SM, Johnson BF. Pharmacokinetic interactions with digoxin. Clin Pharmacokinet 1988; 15: 227–44

    Article  PubMed  CAS  Google Scholar 

  21. Lomaestro BM, Bailie GR. Quinolone-cation interactions: a review. DICP Ann Pharmacother 1991; 25: 1249–58

    CAS  Google Scholar 

  22. Mannisto P, Mantyla R, Kilnge E, et al. Influence of various diets on the bioavailability of isoniazid. J Antimicrob Chemother 1982; 10: 427–34

    Article  PubMed  CAS  Google Scholar 

  23. Nutt JG, Woodward WR, Hammerstad JP, et al. The ‘on-off’ phenomenon in Parkinson’s disease. Relation to levodopa absorption and transport. N Engl J Med 1984; 310: 483–8

    Article  PubMed  CAS  Google Scholar 

  24. Baruzzi A, Contin M, Riva R, et al. Influence of meal ingestion time on pharmacokinetics of orally administered levodopa in parkinsonian patients. Clin Neuropharmacol 1987; 10: 527–37

    Article  PubMed  CAS  Google Scholar 

  25. Richter WO, Jacob BG, Schwandt P. Interaction between fibre and lovastatin [letter]. Lancet 1991; 338: 706

    Article  PubMed  CAS  Google Scholar 

  26. Karim A, Rozek LF, Smith ME, et al. Effect of food and antacid on oral absorption of misoprostol, a synthetic prostaglandin El analog. J Clin Pharmacol 1989; 29: 439–43

    PubMed  CAS  Google Scholar 

  27. Bailey DG, Munoz C, Spence JD, et al. Interaction of citrus juices with felodipine and nifedipine. Lancet 1991; 337: 268–9

    Article  PubMed  CAS  Google Scholar 

  28. Soll AH, Weinstein WM, Kurata J, et al. Nonsteroidal anti-in-flammatory drugs and peptic ulcer disease. Ann Intern Med 1991; 114; 307–19

    PubMed  CAS  Google Scholar 

  29. Longe RL, Smith OB. Phenytoin interaction with an oral enteral feeding results in loss of seizure control. J Am Geriatr Soc 1988; 36: 542–4

    PubMed  CAS  Google Scholar 

  30. Baurer LA. Interference of oral phenytoin absorption by continuous nasogastric feedings. Neurology 1982; 32: 570–2

    Article  Google Scholar 

  31. Leyden JJ. Absorption of minocycline hydrochloride and tetracycline hydrochloride: effect of food, milk, and iron. J Am Acad Dermatol 1985; 12: 308–12

    Article  PubMed  CAS  Google Scholar 

  32. Jonkman JH. Food interactions with sustained-release theophylline preparations: a review. Clin Pharmacokinet 1989; 16: 162–79

    Article  PubMed  CAS  Google Scholar 

  33. Lewis CW, Frongillo EA, Roe DA. Drug-nutrient interactions in three long-term-care facilities. J Am Diet Assoc 1995 Mar; 95(3): 309–15

    Article  PubMed  CAS  Google Scholar 

  34. Franse VL, Stark N, Powers T. Drug-nutrient interactions in a Veterans Administration Medical Center teaching hospital. Nutr Clin Pract 1988; 3: 145–7

    Article  PubMed  CAS  Google Scholar 

  35. Garabedian-Ruffalo SM, Syrja-Farber M, Lanius PM, et al. Monitoring of drug-drug and drug-food interactions. Am J Hosp Pharm 1988 Jul; 45: 1530–4

    PubMed  CAS  Google Scholar 

  36. Gauthier I, Malone M, Lesar TS. Comparison of programs for preventing drug-nutrient interactions in hospitalized patients. Am J Health Syst Pharm 1997 Feb 15; 54: 405–11

    PubMed  CAS  Google Scholar 

  37. Poirier TI, Gludici RA. Evaluation of drug-food/nutrient interactions microcomputer software programs. Hosp Pharm 1991 Jun; 26: 533–40

    PubMed  CAS  Google Scholar 

  38. Jones CM, Reddick JE. Drug-nutrient interaction counseling programs in upper midwestern hospitals: 1986 survey results. J Am Diet Assoc 1989 Feb; 89(2): 243–5

    PubMed  CAS  Google Scholar 

  39. Wix AR, Doering PL, Hatton RC. Drug-food interaction counseling programs in teaching hospitals. Am J Hosp Pharm 1992 Apr; 49: 855–60

    PubMed  CAS  Google Scholar 

  40. Teresi ME, Morgan DE. Attitudes of healthcare professionals toward patient counseling on drug-nutrient interactions. Ann Pharmacother 1994 May; 28: 576–80

    PubMed  CAS  Google Scholar 

  41. Laswell AB, Loreck ES. Development of a program in accord with JCAHO standards for counseling on potential drug-food interactions. J Am Diet Assoc 1992 Sep; 92(9): 1124–5

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Isabelle Gauthier.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gauthier, I., Malone, M. Drug-Food Interactions in Hospitalised Patients. Drug-Safety 18, 383–393 (1998). https://doi.org/10.2165/00002018-199818060-00001

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00002018-199818060-00001

Keywords

Navigation