Comprehensive and reliable information on drug-nutrient interactions

"The nutritional ramifications of pharmaceuticals in the human body"

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Sample Page below.

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Sample page

Brand name:  Pastiche (mix)

Generic name: Sample

Function/Action: XXXX

Nutrients affected

Adverse reactions

Biochemical factors


B126, 84


folate1, 2

Nausea8, 41, 98

Vomiting8, 41, 98

Constipation8, 41, 98

Diarrhoea8, 41, 98

­­­Inc Weight8, 41, 98

­Dec Appetite8, 41, 98

Altered taste8, 41

Dry mouth1, 2

Dysphagia8, 41, 98

hypoalbuminaemia8, 41

anaemia8, 41, 98



hypokalaemia8, 41

hypocalcaemia8, 41, 98

hypophosphataemia8, 41, 98



Nutritional care


  • Binding of drug to plasma proteins ~ 96%8, 41.
  • Associated with cytochrome P450 pathway, isozyme 3A48, 41, 98.
  • Can be administered before meals or with meals, however choice must remain consistent8, 41.
  • Associated with altered thyroid function41, 369, and diabetes41.

Drug Food Interactions

  • Grapefruit and grapefruit juice contra-indicated8, 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 transporter11, 12, 13, 15, 16, 17, 18 that can also transport choline11, 13, 19, 20 and tyramine11, 12, from the portal vein into liver hepatocytes11, 13, 15, 17, 19, 21, 22.
  • Drug is a BCRP substrate (can be carried by the transporter)8. BCRP substrates include riboflavin30, 31, folic acid31, 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 broken8, 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 broken8, 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

Explains data layout

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Suggestions for applying the information

Outlines formats for integrating pharmaconutrition into clinical assessments

Click image to view and download

Click image to view and download

Expandable tables to present summary information

Useful tables guide cover

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
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