Food-drug Interactions Research Articles

Impact of fresh grape juice on the pharmacokinetics of omeprazole: results of a food-drug interaction study.

Grapes have been widely used for dietary ailments due to their attributed pharmacological activities. Resveratrol, the chief constituent of grapes, is responsible for their pharmacological benefits. However, apart from their beneficial effects, grapes have also recently been considered in drug interaction studies. This study investigated the pharmacokinetic profile of omeprazole administered alone compared to omeprazole administered with grape juice, with a prior intake of grape juice, for 1 continuous week. The study was conducted on two groups of healthy male volunteers [n = 12]. One group was orally administered 40mg of omeprazole alone, while the other group was administered omeprazole with grape juice. Blood samples were analyzed for omeprazole concentration by a reverse-phase HPLC method. Co-administration of 40mg omeprazole with grape juice significantly decreased the AUC0-t and Cmax by 32% and 34%, respectively, suggesting a role being played by grapes in the activation of P-glycoprotein and omeprazole metabolizing enzymes, including CYP3A4 and CYP2C19. In conclusion, the addition of grapes as a dietary supplement in patients taking omeprazole for the management of peptic ulcer symptoms may lead to a higher required dose of omeprazole.

Polysaccharides from Ziziphus jujuba prolong lifespan and attenuate oxidative stress in Caenorhabditis elegans via DAF-16 and SKN-1

Jujube is a commonly consumed traditional Chinese medicine (TCM) food-drug interaction. Recent evidence revealed crude polysaccharides of jujube extract (CPJE) exhibited bioactive properties in vitro; however, its antioxidant capacity in vivo remains unknown. The objectives of this study were to evaluate the effects of CPJE on growth, locomotion, reproduction, lifespan, and antioxidant defense system using Caenorhabditis elegans. Results showed CPJE were not toxic to C. elegans with no effects on bacterial growth. Compared to control, CPJE significantly increased body length and width, head thrashes, body bends, and brood size of nematodes. In addition, CPJE at higher concentrations significantly increased pharyngeal pumping of the nematodes. Moreover, CPJE at 0.25, 0.5, and 1 mg/mL promoted lifespan by 17.9 %, 34.7 % and 46.3 %, respectively. CPJE at higher concentrations reduced level of ROS, increased activities of SOD, CAT, and GSH. CPJE also upregulated the expression of daf-16, skn-1, sod-3, and gcs-1 in N2 nematodes. Meanwhile, results from studies with nematode mutants also suggested that improved stress resistance of CPJE was due to modulation of daf-16 and skn-1. Overall, our results suggest CPJE promote longevity and reduce oxidative stress via DAF-16 and SKN-1. Our findings shed a new light on the utilization of CPJE to attenuate oxidative stress.

The use of population pharmacokinetics to extrapolate food effects from human adults and beagle dogs to the pediatric population illustrated with ibuprofen as a case

Oral drug administration is the most convenient route of administration in the pediatric population. However, children are often not fasted when drugs are orally administered, hence potential food-drug interactions might occur. Most of these interactions are extrapolated from studies performed in human adults where a recommended high-fat, high-calorie meal is administered prior to drug dosing. As the recommended protocols are based on studies in support of adult drug development, these studies do not mimic the meal composition administered to the pediatric population, especially the very young ones, which renders food-drug interactions in this population understudied. Therefore, it was evaluated to what extent population pharmacokinetics could reliably extrapolate food effects from human adults and beagle dogs to mimic the real-life situation in the pediatric population. Eight human adults and six beagle dogs received ibuprofen under different dosing conditions (fasted, reference meal fed condition, infant formula fed condition). Population pharmacokinetic analysis was performed to derive the pharmacokinetic parameters to be scaled to pediatric ages. For both species, a one-compartment model best described the data, where in human adults a dual-input function to capture the double absorption peak significantly improved the model fit. Simulations for a virtual pediatric population demonstrated that the predictive ability of human adults and beagle dogs to inform absorption effects under different dosing conditions using population pharmacokinetic modeling appeared to be reasonable. However, to be able to fully validate the predictability of both species for ibuprofen, additional studies in the pediatric population are required to generate more informative data.

Evaluating Pharmacists' Knowledge of Food-Drug Interactions in Croatia: Identifying Gaps and Opportunities.

Food-drug interactions (FDIs) are pharmacokinetic or pharmacodynamic changes in drug effects caused by the presence of specific foods. To identify and prevent FDIs, pharmacists, alongside other healthcare professionals, should possess a certain level of knowledge. This study aimed to assess knowledge of FDIs among Croatian pharmacists. A total of 206 participants were included in this cross-sectional study. The median knowledge score among Croatian pharmacists was 69.44%, with an interquartile range of 19.44. Croatian pharmacists most commonly recognized FDIs involving theophylline, warfarin, and tetracycline, while the lowest rate of correct answers was observed with digoxin interactions. Future studies should evaluate pharmacists' clinical practice concerning FDIs. Additionally, more research is needed to develop educational programs on this topic, either at the university level or for continuing education.

Direct Oral Anticoagulants: Quick Primer on When to Use and When to Avoid.

Direct oral anticoagulants (DOACs) have transformed the landscape of antithrombotic therapy in the past two decades. However, there is uncertainty about when they should or should not be used for treatment or prevention of thromboembolic events. DOACs have largely replaced warfarin for many patients with atrial fibrillation or venous thromboembolism who require anticoagulant therapy. In addition to noninferior efficacy, fewer drug-drug and food-drug interactions and improved convenience; DOACs have been shown to reduce the risk of intracranial hemorrhage. They have also received new indications compared with warfarin, such as cardiovascular risk reduction in patients with stable atherosclerotic diseases. However, there are some scenarios in which DOACs are associated with inferior efficacy or worse safety compared with standard treatment, such as warfarin. These include patients with mechanical heart valves, thrombotic antiphospholipid syndrome, and others. Although DOACs offer a streamlined and convenient option for the management of many patients with or at risk of thromboembolic events, their use should be avoided in certain high-risk scenarios. This minireview summarizes such conditions and those in which there is uncertainty for use of DOACs for particular diseases or particular patient subgroups.

Limited Sampling Strategy for Predicting the Area under Plasma Concentration–Time Curve of Nadolol in Healthy Subjects

AbstractNadolol is a hydrophilic β‐adrenoceptor blocker with a relatively long half‐life and negligible metabolism. It is a substrate of P‐glycoprotein and organic anion transporting polypeptide 1A2, and may serve as an in vivo probe drug for the assessment of drug–drug and food–drug interactions mediated by these transporters. In the present study, we aimed to develop limited sampling strategy (LSS) models for predicting the area under the plasma concentration–time curve (AUC0‐∞) of nadolol. Plasma concentration data (Ct) in healthy volunteers reported in four previous studies were randomly divided into a training dataset for model development (n = 15) and a test dataset for model validation (n = 16). By multiple linear regression analysis, we confirmed that four out of the eight models using two time points and all models using three time points met the acceptable criteria. In particular, the three time point models using (C3, C6, and C24) and (C4, C8, and C24) showed better predictive performances with r2 values of 0.983 and 0.980, respectively. In drug interaction studies of nadolol with itraconazole, rifampicin, grapefruit juice, and green tea extract, both LSS models accurately predicted the AUC0‐∞ with percent mean absolute error ≤11% and percent root mean square error ≤12%. In addition, using digitized pharmacokinetic data of nadolol, both LSS models were further validated by predicting the AUC0‐∞ in different doses. The results suggest that the LSS models using three time points allow a reliable prediction of AUC0‐∞ of nadolol in healthy individuals.

A Prospective study on Impact of Nutritional Counseling for Maintenance Hemodialysis patients

Background: Patients with End-Stage Kidney Disease (ESKD) have complex medication regimens and specific food recommendations. Dietary restrictions and medication burden places dialysis patients at risk for drug-disease, food-disease, drug-food and drug-drug interactions and more. Ideal nutritional practices are challenging in maintenance hemodialysis (HD) patients, yet it has been found to be crucial in obtaining positive clinical and health outcomes. This study was to evaluate the impact of counseling by a clinical pharmacy researcher on ideal dietary practices and assess the food-drug and drug-drug interactions within this patient population. Methods: The study was a pre-post intervention design that included patients undergoing maintenance hemodialysis in a United Arab Emirates tertiary-level care hospital. The study adopted a population-based approach and involved counseling conducted by a clinical pharmacy researcher with the help of nutritionist in the study site. Data was processed using SPSS version 26 for descriptive analysis. Results: Data of 47 participants were analyzed. A significant improvement in ideal dietary practices were reported by the study participants after counseling compared to their practices before counseling (P 0.001). Food-drug interactions were significantly higher than drug-drug interactions and a significant association between food-drug interactions and malnutrition symptoms were found (P 0.001). Conclusion: Nutritional counseling to maintenance HD patients by a pharmacy professional improved patient reported ideal nutritional/dietary behaviors. This illustrates the importance of clinical pharmacy reinforcement to nutritionist services for patient care. Pharmacy professionals can integrate drug counseling with nutritional counseling in addition to nutritionist counseling.

Predicting Food-Drug Interactions between Piperine and CYP3A4 Substrate Drugs Using PBPK Modeling.

Piperine has been reported to inhibit the enzyme activity of cytochrome P450 (CYP) 3A4. The aim of this study was to develop and validate a physiologically based pharmacokinetic (PBPK) model for piperine and to predict potential food-drug interactions (FDIs) between piperine and CYP3A4 substrate drugs using these models. The PBPK model for piperine was successfully developed and validated. Using this model, FDIs with ten CYP3A4 substrate drugs were simulated. The predicted area under the curve (AUC) ratios (with and without piperine, following a 7-day intake of 20 mg/day) for six drugs were found to exceed 1.25, with significant increases in AUC observed for ritonavir (31%), nifedipine (34%), cyclosporine (35%), triazolam (36%), alfentanil (39%), and simvastatin (59%) in humans. These findings suggest that caution should be exercised when consuming amounts of black pepper equivalent to a daily intake of 20 mg piperine during treatment with CYP3A4 substrate drugs, as it may significantly alter their pharmacokinetics.

Kinetics of the inhibition of CYP3A4 and CYP2C19 activity by jabara juice and identification of the responsible inhibitory components

Some citrus fruits are known to cause clinically significant drug interactions by inhibiting intestinal cytochrome P450 (CYP) enzymes. This in vitro study aimed to investigate the kinetics of the inhibition of CYP3A4 and CYP2C19 by the juice of jabara, a Japanese citrus fruit that does not contain furanocoumarins such as 6′,7′-dihydroxybergamottin, and to identify the inhibitory compound(s).CYP3A4 and CYP2C19 activity levels were determined in vitro using recombinant CYP preparations and their respective substrates. The ethyl acetate extract (EAE) of jabara juice was separated to isolate and identify the compound(s) that inhibited CYP3A4. Then, the time-dependent kinetics of the inhibition of CYP3A4 and CYP2C19 by the EAE and its inhibitory compound(s) were analyzed.The EAE of jabara juice was found to inhibit CYP3A4 in a time-dependent manner. Two flavonoids, 3,3′,4′,5,6,7,8-heptamethoxyflavone (HpMF) and 3,3′,4′,5,6,7-hexamethoxyflavone (HxMF), were identified as the responsible compounds. HpMF and HxMF inhibited CYP3A4 activity in a concentration- and time-dependent manner, with inhibition constants (KI) of 10.0 and 7.90 µM and maximal inactivation rate constants (kinact,max) of 0.00856 and 0.0134 min−1, respectively. The EAE did not inhibit CYP2C19, even when preincubation was employed. These findings imply that jabara juice may cause food-drug interactions via time-dependent inhibition of intestinal CYP3A4.

Thyroxine Replacement Therapy during Ramadan Fasting: A Narrative Review

Abstract Introduction Ramadan fasting-induced changes in eating and sleeping patterns pose a risk of influencing thyroid hormone levels. There is a recognition of the potential impact of fasting and feasting on levothyroxine (L-T4) absorption. Materials and Methods A narrative, nonsystematic literature review from two major medical online databases (PubMed and Google Scholar) from their inception to the search day (February 22, 2024). A relevant combined search term was used. The retrieved literature is narrated in a concise account. Results There is a relationship between metabolism and thyroid-stimulating hormone (TSH). This relationship contributes to transient metabolic disturbances that influence the pharmacodynamics and pharmacokinetics of various drugs, adding complexity to the management of hypothyroidism during Ramadan fasting. Several observational studies have studied the changes in thyroid function levels during unmodified L-T4 regimens. Experimental trials explored the impact on body weight, well-being, and thyroid functions when the timing of L-T4 administration changes. Findings are far from homogeneous due to different study protocols. A recent meta-analysis demonstrated a significant post-Ramadan increase in TSH levels among euthyroid patients. L-T4 timing points, encompassing pre-Iftar, post-Iftar, and pre-Suhoor, are associated with elevated TSH levels after Ramadan fasting. The emphasis on individualized L-T4 regimens during Ramadan fasting is underscored, with recommendations for patients to refrain from food for at least 3 hours before and 30 minutes after L-T4 intake to ensure optimal compliance by most experts. The association between adherence to L-T4 during Ramadan fasting and maintaining euthyroid status is highlighted, encouraging patients to follow prescribed regimens diligently. Modified dosing frequencies, such as weekly regimens, exhibit promising results, especially in patients grappling with compliance issues. Proactive consultations with physicians before Ramadan are needed to review the latest thyroid function test and make possible dose adjustments. Conclusion Managing hypothyroidism during Ramadan necessitates an understanding of medication timing, food-drug interactions, and prior regimens. Adherence, facilitated by flexibility, plays a critical role in achieving euthyroid status.

Clinically important interactions of macrolides and tetracyclines with dietary interventions-a systematic review with meta-analyses.

Effective management of drug-food interactions is crucial for enhancing antibiotics' efficacy/safety. Adhering to PRISMA guidelines, we conducted a systematic review to assess the impact of dietary interventions on the bioavailability of 15 macrolides and 10 tetracyclines. We included studies examining the influence of food, beverages, antacids, and mineral supplements on the pharmacokinetic parameters of orally administered macrolides and tetracyclines. We searched Medline (via PubMed), Embase and Cochrane Library databases up to December 2022. Risk of bias was assessed using Cochrane and NIH tools. Quantitative analyses were conducted if two or more comparable food-effect studies were available; otherwise, a qualitative summary was provided. We included 120 studies from 97 reports. Meta-analyses were conducted for 8 macrolides and 4 tetracyclines, with qualitative synthesis for 10 and 9, respectively. About 64% of the studies were open-label, crossover designs. Our assessment found that 37% of the studies had a high risk of bias, while only 6% had low risk. Food significantly affected 10 of 13 macrolides (77%) and 6 of 7 tetracyclines (86%). High positive effects on bioavailability were seen with extended-release azithromycin and clarithromycin, and erythromycin estolate. High negative impacts were observed with erythromycin propionate and stearate, azithromycin capsules, demeclocycline and omadacycline. Antacids and mineral supplements significantly decreased tetracyclines absorption. Milk and grapefruit juice showed variable impacts on absorption. Interactions depend on antibiotics' physicochemical characteristics, intervention type, drug formulation and potential patient factors. The quality of evidence was rated low due to outdated studies, methodological diversity and unequal data availability.

DDInter 2.0: an enhanced drug interaction resource with expanded data coverage, new interaction types, and improved user interface.

Drug interactions pose significant challenges in clinical practice, potentially leading to adverse drug reactions, reduced efficacy, and even life-threatening consequences. As polypharmacy becomes increasingly common, the risk of harmful drug interactions rises, underscoring the need for comprehensive and user-friendly drug interaction resources to ensure patient safety. To address these concerns and support healthcare professionals in optimizing drug therapy, we present DDInter 2.0, a significantly expanded and enhanced update to our drug interaction database. This new version incorporates additional interaction types, including drug-food interactions (DFIs), drug-disease interactions (DDSIs), and therapeutic duplications, providing a more complete resource for clinical decision-making. The updated database covers 2310 drugs, with 302 516 drug-drug interaction (DDI) records accompanied by 8398 distinct, high-quality mechanism descriptions and management recommendations. DDInter 2.0 also includes 857 DFIs, 8359 DDSIsand 6033 therapeutic duplication records, each supplemented with detailed information and guidance. Furthermore, the enhanced user interface and advanced filtering options in this second release facilitate easy access to and analysis of the comprehensive drug interaction data. By providing healthcare professionals and researchers with a more complete and user-friendly resource, DDInter 2.0 aims to support clinical decision-making and ultimately improve patient outcomes. DDInter 2.0 is freely accessible at https://ddinter2.scbdd.com.

Uncovering the Knowledge Landscape of Food-Drug Interactions Among Medical Professionals

Background: Drug-food interactions (DFIs) can alter drug pharmacokinetics and pharmacodynamics, impacting patient outcomes. Health care professionals (HCPs) play a critical role in managing these interactions. Specific Background: Despite their significance, the awareness of DFIs among Iraqi medical professionals is inadequately documented. Knowledge Gap: There is a lack of comprehensive studies evaluating the knowledge of DFIs among medical professionals in Iraq, which is crucial for improving patient care and therapeutic efficacy. Aims: This study aimed to evaluate the knowledge of food-drug interactions among Iraqi medical professionals, including medical students, newly graduated doctors, and junior doctors. Methods: A cross-sectional study was conducted using a self-administered questionnaire with 20 questions evaluating knowledge on common DFIs. Results: The study revealed a concerning lack of knowledge about DFIs among participants, with junior doctors scoring an average of 7.1 out of 15, newly graduated doctors 6.38, and sixth-grade medical students 5.27. Only 13% felt knowledgeable about DFIs, while 31.7% acknowledged their insufficient understanding. Notably, knowledge on interactions such as tyramine-rich foods with antidepressants and grapefruit juice with statins was limited. Novelty: This study provides the first comprehensive assessment of DFI knowledge among Iraqi medical professionals, highlighting significant gaps and educational needs. Implications: The findings underscore the necessity for enhanced educational programs targeting DFIs in medical curricula, ensuring HCPs are equipped to counsel patients effectively, thereby improving patient safety and therapeutic outcomes. These results emphasize the importance of targeted educational interventions to bridge the knowledge gap, ultimately contributing to better health outcomes and informed patient care in Iraq. Highlights: Knowledge Gaps: Iraqi medical professionals lack understanding of common food-drug interactions. Education Needed: Enhanced training on interactions is essential in medical curricula. Patient Safety: Improving knowledge will lead to better patient outcomes. Keywords: Food–Drug Interactions, Knowledge, Drug Interaction, Medical Students

Food-drug interactions risk management: An emergent piece of pharmacovigilance systems.

Food-drug interactions risk management: An emergent piece of pharmacovigilance systems.

Knowledge of Food-Drug Interactions among Medical University Students.

Food-drug interactions (FDIs) may alter drug pharmacokinetics and pharmacodynamics, modifying the whole therapy's effectiveness. Some of them cause the attenuation of drug effects, while others inhibit the medicines' metabolism resulting, in too high concentrations of the medicine in the body. Thus, some healthcare professionals-doctors, pharmacists or dieticians-should be aware of the possibility of food-drug interactions. This study aimed to assess knowledge of food-drug interactions among students of pharmacy, medicine, stomatology, medical analysis and dietetics and students of the college of further medical education for pharmacy technicians. Students (n = 820) completed a custom-made questionnaire. The relationships between the continuous variables were analysed on the basis of Pearson's correlation coefficient. To verify the predictors of objective students' knowledge about food-drug interactions, a multiple linear regression model with analysis of covariance (ANCOVA) was used. The Kruskal-Wallis test was performed to compare the total scores the respondents received for questions assessing their objective knowledge of FDI. Students' objective knowledge of FDIs correlated positively with their year of study and their self-evaluation of it. It was also significantly influenced by the field and mode of studies and by the fact that the issue had been discussed during the courses. Most students of the medical university had serious deficiencies in their knowledge of food-drug interactions. This is of particular concern for future doctors and dentists. Among the respondents, pharmacy students stood out, as their FDI knowledge was greater. The issue of food-drug interactions should be more widely taught at medical universities, which was emphasised by the respondents themselves.

Assessing knowledge and awareness of Food and Drug Interactions among nutrition sciences students: Implications for education and clinical practice.

Chronic diseases and polymedication increase the risk of food-drug interactions (FDIs) among the population, negatively impacting health. Nutritionists, as responsible for dietary planning, have a key role in preventing these events. To assess the knowledge about FDIs among a sample of Nutrition Sciences Bachelor students. A descriptive cross-sectional observational study was conducted, involving 44 students from the 3rd and 4th academic years of different Portuguese universities during the 2023/2024 academic year. Participants completed a self-reported questionnaire, covering general and specific FDIs knowledge, academic background, and perceptions regarding FDIs importance and training adequacy. Results revealed a general lack of FDIs knowledge among participants, particularly in identifying specific interactions and appropriate dietary management. While half of the students reported exposure to a subject dedicated to FDIs, only 18.18% considered the knowledge acquired sufficient. Nearly all participants (93.18%) expressed the need for further training in FDIs during their undergraduate course. Furthermore, none of the participants had received additional training or attended workshops on FDIs. Specifically, participants struggled to identify appropriate dietary choices in conjunction with certain medications. Moreover, only a minority of participants demonstrated awareness of the ideal timing for medication intake relative to food consumption. Despite these knowledge gaps, participants recognized the importance of FDIs knowledge for future clinical practice. Bridging these knowledge gaps through targeted educational interventions and interdisciplinary collaboration is essential to ensure future nutrition professionals are equipped to address the complex challenges posed by FDIs in professional practice.

Knowledge and Awareness Towards Food Drug Interaction Among Pharmacists in Erbil City

In the evolving landscape of healthcare, understanding the potential interactions between pharmaceutical drugs and food is imperative yet often overlooked. This study aimed to assess pharmacists' knowledge of food-drug interactions (FDI) in Erbil city, focusing on comprehension, risk factors, counseling practices, and familiarity with drug databases. Conducted through a survey-based approach, the research involved 100 pharmacists from varying educational backgrounds, sampled purposively from Doctors Street in Erbil. Data collection occurred over two months via a self-administered questionnaire comprising 34 questions covering basic FDI awareness and advanced topics. Results indicate a correlation between higher education levels and a deeper understanding of FDI, particularly in recognizing specific drug-nutrient interactions. Nonetheless, knowledge gaps persist, underscoring the complexity of FDI comprehension. Intriguingly, pharmacists with institute certificates exhibited nuanced understanding in certain scenarios, challenging assumptions about the linear relationship between education and awareness. The study emphasizes the necessity for targeted interventions in pharmaceutical education to address these nuances effectively. These findings contribute to the growing body of knowledge on FDI awareness among pharmacists, highlighting the importance of continuous education to ensure optimal patient care, treatment efficacy, and safety.

Bioequivalence and Food Effect Assessment of Eltrombopag Olamine Tablets in Healthy Chinese Subjects: An Open, Randomized, Single-Dose, and Two-Period Crossover Study.

Eltrombopag, a nonpeptide thrombopoietin receptor agonist, is primarily used for treating immune thrombocytopenic purpura. The aim of this study was to investigate the pharmacokinetic profile and food-drug interaction of test and reference eltrombopag olamine tablets among healthy Chinese volunteers. An open, randomized, single-dose, 2-period crossover design was employed, involving fasting and fed conditions with a 10-day washout period. Ninety-six healthy volunteers received a single oral dose of 25mg of the 2 eltrombopag formulations, with 48 participants in each group: fasting volunteers and those consuming a high-fat, low-calcium meal. Plasma eltrombopag concentrations were analyzed using liquid chromatography-tandem mass spectrometry, and pharmacokinetic parameters were derived from the concentration-time profiles. The geometric mean ratios, with 90% confidence intervals, for the maximum plasma concentration, area under the concentration-time curve from time 0 to the last measurable concentration, and area under the concentration-time curve from time 0 to infinity fell within the bioequivalence acceptance criteria (80%-125%) under both fasting and fed conditions, indicating bioequivalence between the test and reference formulations. Administration of eltrombopag with a high-fat, low-calcium diet reduced the net systemic exposure by approximately 40%. Adverse events were recorded, and no serious adverse events were observed in either fasting or fed conditions. In conclusion, eltrombopag is well tolerated and exhibits a favorable safety profile in the Chinese population. The achievement of bioequivalence under fasting and fed conditions supports the demonstration of biosimilarity between the test and reference formulations.

Awareness of Food, Supplement, and Drug Interactions among Oncology Patients on Oral Chemotherapy

Abstract Background Food-drug interactions (FDIs) are very common, but under-reported due to a lack of proper history or lack of knowledge and limited research. Our study highlights the knowledge gap among oncology patients treated with capecitabine regarding food-oral chemotherapy interactions. Method A cross-sectional study was conducted among 110 breast and colon cancer patients, purposively sampled from the chemotherapy outpatient clinic from June 2021 to December 2021. A structured questionnaire and interviews were used to collect data, we asked them about the information they had received from the doctor and the way they were taking the medicine. Data were analyzed using SPSS, and the p-value of p < 0.05 was considered significant. Results Regarding the sociodemographic and clinical data of participants, their ages widely ranged from 20-83 years old, and their mean age was 54.78±13.18. The majority of participants were females 81(73.6%), non-employed 86(78.2%), colon cancer 72(65.5%) and received ≤4 cycles 66 (60%). Still, there is poor awareness concerning FDI among oncology patients and most participants were unaware of the possible interactions of capecitabine with grapefruits, vitamins, herbs, and antioxidants, but the majority 92 (83.6%) were taking their medication correctly concerning meal recommendations and only 18(16.4% )were not taking capecitabine within 30 minutes of meals. The current study showed that patients’ knowledge was not associated with age, sex, education, marital status, or occupation. The main factors that affected knowledge in the current study were the cancer site and the number of treatment cycles, as colon cancer patients and those who have received four or fewer cycles had better doctor-patient communication. Conclusion There is a lack of awareness about interactions between oral chemotherapy and various nutrients and supplements among patients in the current study. Patient education and better doctor-patient communication are recommended to ensure optimal oral chemotherapy intake and patient safety.

A Survey of Knowledge About the Interaction Between Food and Drugs Among the Syrian Population

This study aimed to evaluate the knowledge and awareness of food-drug interactions among the general public in Syria. A questionnaire was distributed at Tishreen University and published on social media between October and November 2023. A total of 419 responses were collected. 83.3% know that food can affect the effectiveness of medications. 85.2% think that food can increase or slow down the effects of medications. 77.6% believe that the effect of food-drug interactions varies depending on dose, age, and health status. 68.5% believe that food-drug interactions may lead to serious side effects. 45.8% believe that food-drug interactions can lead to death. 49.2% chose that the age group of patients at highest risk for food-drug interactions should be over 60 years of age. The questionnaire results showed that the level of knowledge and awareness of participants about food-drug interactions was good because the overall average of the number of participants who answered correctly was 63.34%.