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

B126, 84

B1270

folate1, 2

Nausea8, 41, 98

Vomiting8, 41, 98

Constipation8, 41, 98

Diarrhoea8, 41, 98

­­­Inc Weight8, 41, 98

­Dec Appetite8, 41, 98

Altered taste8, 41

Dry mouth1, 2

Dysphagia8, 41, 98

hypoalbuminaemia8, 41

anaemia8, 41, 98

hypoglycaemia1

hyperglycaemia2

hypokalaemia8, 41

hypocalcaemia8, 41, 98

hypophosphataemia8, 41, 98

hyperthyroidism41

hypercholesterolaemia41

Nutritional care

Pharmacokinetics

  • Binding of drug to plasma proteins ~ 96%8, 41.
  • Associated with cytochrome P450 pathway, isozyme 3A48, 41, 98.
  • Can be administered before meals or with meals, however choice must remain consistent8, 41.
  • Associated with altered thyroid function41, 369, and diabetes41.

Drug Food Interactions

  • Grapefruit and grapefruit juice contra-indicated8, 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 transporter11, 12, 13, 15, 16, 17, 18 that can also transport choline11, 13, 19, 20 and tyramine11, 12, from the portal vein into liver hepatocytes11, 13, 15, 17, 19, 21, 22.
  • Drug is a BCRP substrate (can be carried by the transporter)8. BCRP substrates include riboflavin30, 31, folic acid31, 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 broken8, 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 broken8, 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.

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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.

Change isn't easy to recognise as it arrives,

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

Seth Godin

Visionary

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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