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

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How to integrate medications and nutrition into your clinical practice flowchart

The best sequence for applying the information

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