Medications and Nutrition

Empowering busy clinicians to enhance patient care by simplifying the complex world of drug-nutrition interactions

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We collate and curate drug-food and drug-nutrient interactions research for busy clinicians to easily integrate into their clinical practice with our subscription-based online platform Medications & Nutrition.

How well do you rate your awareness of the interactions between medications and nutrition?

Medications have profoundly and positively changed health outcomes however they do generally come with some nutritional harms. By identifying and addressing the nutritional harms, optimal health outcomes are closer to being achieved.

Innovative clinicians are always looking for new expertise and/or new skills and/or new knowledge so they can continue to provide their best service to the people in their care – are you an innovative clinician? Will you integrate pharmaconutrition into your daily clinical practice?

Medications and Nutrition is a comprehensive resource on interactions between prescribed medicines and nutrition

Our online portal lists a comprehensive range of drugs (~ 6,000) that are associated with the drug:nutrition interface i.e. drugs that alter nutritional factors (drug-nutrient interactions, drug-food interactions) and nutritional factors that alter drug effects (eg malnutrition, weight change).

Sample page

Brand name: Pastiche (mix)

Generic name: Sample

Function/Action: XXXX

Nutrients affected

Adverse reactions

Biochemical factors

Na¹⁴²

B1^{26, 84}

B12⁷⁰

folate^{1, 2}

Nausea^{8, 41, 98}

Vomiting^{8, 41, 98}

Constipation^{8, 41, 98}

Diarrhoea^{8, 41, 98}

Inc Weight^{8, 41, 98}

Dec Appetite^{8, 41, 98}

Altered taste^{8, 41}

Dry mouth^{1, 2}

Dysphagia^{8, 41, 98}

hypoalbuminaemia^{8, 41}

anaemia^{8, 41, 98}

hypoglycaemia¹

hyperglycaemia²

hypokalaemia^{8, 41}

hypocalcaemia^{8, 41, 98}

hypophosphataemia^{8, 41, 98}

hyperthyroidism⁴¹

hypercholesterolaemia⁴¹

Nutritional care

Pharmacokinetics

Binding of drug to plasma proteins ~ 96%^{8, 41}.
Associated with cytochrome P450 pathway, isozyme 3A4^{8, 41, 98}.
Can be administered before meals or with meals, however choice must remain consistent^{8, 41}.
Associated with altered thyroid function^{41, 369}, and diabetes⁴¹.

Drug Food Interactions

Grapefruit and grapefruit juice contra-indicated^{8, 41}.

Drug Nutrient Interactions

Concurrent administration with diuretic has a synergistic effect for hyponatraemia¹⁴².
Regular measurement of serum sodium levels recommended¹⁴².

Membrane transporters

Drug is an OCT1inhibitor (blocks transporter function)^{14, 57, 370}. OCT1 functions as a major thiamine transporter^{11, 12, 13, 15, 16, 17, 18} that can also transport choline^{11, 13, 19, 20} and tyramine^{11, 12}, from the portal vein into liver hepatocytes^{11, 13, 15, 17, 19, 21, 22}.
Drug is a BCRP substrate (can be carried by the transporter)⁸. BCRP substrates include riboflavin^{30, 31}, folic acid^{31, 32, 33}, vitamin K3³¹, pantothenate³⁴, and inhibitors include vitamin D2³⁵, and cranberry metabolites³⁶.
Drug is a P-gp substrate (can be carried by the transporter)⁸. P-gp substrates include pyridoxine³⁴, nicotinamide³⁴, pantothenate³⁴, cobalamin³⁷, vitamin D³⁸ and P-gp inhibitors includes vitamin A³⁹.

Non Oral Feeding

Tablets not to be crushed, chewed or broken^{8, 41}.
If jejunostomy then poor absorption of iron due to bypassing stomach (solubilizes iron) and duodenum (primary site of iron absorption)^{392, 393, 394}; jejunum is unable to upregulate iron absorption sufficiently to compensate for duodenal bypass³⁹².

Impaired Swallow

Tablets not to be crushed, chewed or broken^{8, 41}.

Note - superscripted numbers are reference numbers.

Medications & Nutrition - easy to use

Only look once for that prescribed medicine's information

Comprehensive range of prescribed medicines.

Each prescribed medicine's information is listed by brand name.

You can confirm the reliability of the information yourself

All entries referenced.

Not included - papers that contain a mismatch between data presented and conclusions.

Maintains currency of the information

Updated on a monthly basis.

No editorial

You form your own conclusions.

The data is objective therefore you will apply it based on your own experiences and clinical practice.

Medications & Nutrition enhances your clinical skills because ...

Once you identify an interaction then you can manage it

Includes interactions between prescribed medicines and foodstuffs, alcoholic beverages, some "drug" transporters, and vitamins and minerals.

Once you identify an issue then you can manage it

Also includes impacts on BSLs, binding to plasma proteins, adverse reactions (relating to nutritional impacts), impacted nutritional biochemical factors, non-oral feeding, impaired swallow reflex.

If you are interested then the next step is to subscribe -

Starter - if you are curious and cautious,

Health Professional - if you are committed and keen.

Introducing change is hard ... especially for busy clinicians

Introducing change is always difficult as your current habits and systems are well established ... inclusion of new stuff can be an inconvenience.

Initiating new "habits" or systems takes time as you ask questions such as how do we include this important information on our already-crowded assessment page, and/or how do we integrate this information into our clinical management strategies; it requires discussion and resolution.

You also have to decide whether the investment of your time, learning and testing provides a reasonable benefit to the people in your care.

As it is difficult to decide whether a resource like our Medications & Nutrition is worth your investment, this free Magazine was developed as a sample of the broad range of applicability of this field in your clinical practice.

Download MedNut Mag Issue 1 Now

Change isn't easy to recognise as it arrives,

but it's impossible to forget once it's here.

Seth Godin

Visionary

How to integrate medications and nutrition into your clinical practice flowchart

The best sequence for applying the information

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Medications & Nutrition

Helping busy clinicians access clinically-useful drug-nutrient and drug-food interactions research

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