Comprehensive and reliable information on drug-nutrient and drug-food interactions

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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.

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Medications & Nutrition

comprehensive and reliable information, easy-to-use

So many people have asked us for advice on how to apply the information in a clinically-useful manner, so we developed 3 resources based on our trials and experience for you to download and adapt to your requirements.

Explanatory tips on the layout of the database

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Suggestions for applying the information

Outlines formats for integrating pharmaconutrition into clinical assessments

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Expandable tables to present summary information

Click image to either open or download

How to integrate medications and nutrition into your clinical practice flowchart

The best sequence for applying the information