Food Bioactive Compounds and Their Interference in Drug Pharmacokinetic/Pharmacodynamic Profiles.

Matteo Briguglio,Marco Malaguti,Mauro Porta,Silvana Hrelia,Roberto Canaparo,Giuseppe Banfi,Roberta Galentino,Sara De Michele,Carlotta Zanaboni Dina,Bernardo Dell’Osso,Loredana Serpe

doi:10.3390/pharmaceutics10040277

Abstract

Preclinical and clinical studies suggest that many food molecules could interact with drug transporters and metabolizing enzymes through different mechanisms, which are predictive of what would be observed clinically. Given the recent incorporation of dietary modifications or supplements in traditional medicine, an increase in potential food-drug interactions has also appeared. The objective of this article is to review data regarding the influence of food on drug efficacy. Data from Google Scholar, PubMed, and Scopus databases was reviewed for publications on pharmaceutical, pharmacokinetic, and pharmacodynamic mechanisms. The following online resources were used to integrate functional and bioinformatic results: FooDB, Phenol-Explorer, Dr. Duke's Phytochemical and Ethnobotanical Databases, DrugBank, UniProt, and IUPHAR/BPS Guide to Pharmacology. A wide range of food compounds were shown to interact with proteins involved in drug pharmacokinetic/pharmacodynamic profiles, starting from drug oral bioavailability to enteric/hepatic transport and metabolism, blood transport, and systemic transport/metabolism. Knowledge of any food components that may interfere with drug efficacy is essential, and would provide a link for obtaining a holistic view for cancer, cardiovascular, musculoskeletal, or neurological therapies. However, preclinical interaction may be irrelevant to clinical interaction, and health professionals should be aware of the limitations if they intend to optimize the therapeutic effects of drugs.

Highlights

Oral drug administration is easy, cost-effective, and often preferred by patients, because they are able to take medicine without assistance or a dedicated delivery device, assuming pharmacological therapy independently and at home
Drug efficacy may be modified by meals consumed concomitantly, as food matrices and bioactive compounds might interfere at different phases of the pharmacokinetic process
Food-drug interactions in the absorption phase of orally administered drugs are investigated by studies of food-effect bioavailability (BA) and fed bioequivalence (BE) [1], and proper information about the correct way of drug consumption should always be conveyed to the patient

Summary

Introduction

Oral drug administration is easy, cost-effective, and often preferred by patients, because they are able to take medicine without assistance or a dedicated delivery device, assuming pharmacological therapy independently and at home. The lack of information could be the basis of some cases of pharmacological inefficacy [6] Other effects of these overlooked food-drug interactions could be associated with unstable control of symptoms [7], or increased rates of side effects or occurrence of unexpected adverse events [8], for patients suffering from chronic diseases that require the use of multiple drugs. CAM approaches are often abused by patients who seek alternative therapies, possibly augmenting the risk of side effects and pharmacological opposition [10] Given this usage trend and variability in individual pharmacological therapies and dietary habits, an increase in potential food-drug interactions has recently appeared. A panorama of existing preclinical, clinical, and bioinformatic evidence is provided

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Conclusion