Medications & Nutrition is a subscription-based, online-only platform.
This resource lists a comprehensive range of drugs (~ 6,000) that are associated with the drug:nutrition interface i.e. drug effects on nutritional factors (drug-nutrient interactions, drug-food interactions) and the effects of nutritional factors on drug effects (eg malnutrition, weight change).
Available evidence relates to many of the following issues:
- Altered drug absorption dynamics. Examples include concurrent administration of calcium supplements with levodopa reduces availability of levodopa dose.
- Altered nutrient absorption dynamics. For example acid-inhibiting medicines alter gastric acidity and decrease absorption of vitamin C.
- Altered nutrient excretion dynamics. For example digoxin increases magnesium excretion via the kidneys.
- Impacts of side effects. For example some statins negatively impact appetite with ongoing loss of weight as the outcome.
- Impacts of specific nutrient supplements. For example iron supplements alter gut microbiota in favour of pathogens.
- Potential excipient harm. Excipients (the ingredients mixed with the active ingredient) may cause harm for those with specific food allergies and intolerances such as gluten, lactose, galactose, phenylalanine, etc.
- Non-compliance with pharmaceutical manufacturers’ administration recommendations. This is particularly relevant to those with impaired swallow reflex or for those requiring enteral feeding. Alteration in medicine form or delivery format potentially alters its rate of absorption and extent of effect.
- Nutrient derivatives as drugs . The impact of the nutrient-derivative medicines on their base nutrient status and metabolism remains unknown, and it is also unknown whether the base nutrients interact with the same medicines that the nutrient-derivative medicines interact with. For example methotrexate is a folic acid derivative – does folic acid interact with the same medicines as methotrexate? and if so are the interactions similar?
- Inconsistent drug-food interaction advice. Examples include advice to abstain from alcohol intake whilst consuming antibiotics and yet there is an extensive range of medicines whereby alcohol intake is contra-indicated and the advice to abstain is not highlighted; a low-salt diet is no longer advised if prescribed antihypertensives, and yet a low salt-diet is associated with a smaller drug dose and therefore fewer side effects and lower cost.
- Thiamine transporters and prescribed medicines. Which prescribed medicines can be transported by the thiamine transporters, and which ones inhibit the function of thiamine transporters? “Drug transporters” are in reality, physiological transporters that are being found to conveniently also transport certain drugs; this area of drug transport is currently undergoing significant research; the impact of nutrient displacement is not being similarly enthusiastically researched.