SAINT LOUIS UNIVERSITY

SCHOOL OF NURSING

SUYAT, RAYMART LIM, MA. SOPHIA PAGUEL, MARIA CHLOE

CHANCOCO, KARYL MACARAEG, VILLAMIN, AZIZAH
MAE SAMANTHA

FOOD-TO-DRUG INTERACTION
FOOD + DRUG
1. Insulin, Oral Diabetic Agents + Alcohol
2. Digoxin + High Fiber Diet
3. Statins + Grapefruit
4. Antithyroid + Iodine-Rich Foods
5. Antibiotic tetracycline + Milk
INTERACTION
Alcoholic drink can or prolong the effects of
insulin/ oral diabetic leading to hypoglycaemia.
Digoxin is used to strengthen the contraction of the
heart muscle, slow the heart rate and promote
elimination of fluid from body tissue.
Drinking grapefruit juice/eating fresh grapefruit
can increase the amount of some statins in your
blood and lead to potentially greater side effects of
these drugs.
Antithyroid drugs interfere with the body’s
production of thyroid hormones there by reducing
the symptoms of hyperthyroidism and preventing
the effect of Iodine absorption in the stomach.
Tetracycline binds with foods/other drugs
containing calcium.

DRUG-TO-DRUG INTERACTION
DRUG + DRUG
1. Warfarin + Vit. K
2. Aspirin + Methotrexate
3. Fluoxetine + Phenelzine
4. Digoxin + Quinidine
5. Clonidine and Propranolol
INTERACTION
Warfarin is naturally an anti-coagulant and Vit. K
is the inhibit coagulation. Altered effectiveness of
the drug can lower the effect of one drug to another.
Aspirin is more competitive for the site of protein-
binding. Therefore, blocking the site for
methotrexate and increase toxicity to the tissue.
Results in a central serotonin syndrome. It can
develop quickly with only 1 or 2 doses of
fluoxetine when combined with phenelzine (mental
status changes, agitation, diaphotesis, tachycardia,
and death). It also increases the serotonin level.
Interaction can lead to a marked increase in plasma
concentration levels of digoxin. Effects can be
nausea and vomiting to death. Quinidine also
decreases renal and nonrenal excretion rates of
digoxin, which leads to increased steady-state
concentrations of the cardiac glycoside. Patients
taking digoxin should avoid the use of quinidine.
The combination may produce a mysterious
hypertension that is unrelated to the pharmacology
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SCHOOL OF NURSING

of either agent when administered independently.

A sudden withdrawal of clonidine from adjunctive
therapy with propranolol may cause fatal rebound
hypertension. This activity leads to a decrease in
the norepinephrine amounts available in the
synaptic cleft of the adrenergic neuron. When
clonidine is suddenly withdrawn, the result is a
large increase in norepinephrine in the synaptic
cleft of the adrenergic neuron.

GENETICS-TO-DRUGS INTERACTION
GENETICS + DRUGS
1. HIV + Antidepressant drugs
2. G6PD + Chloroquine/ Primaquine
3. CYP2C9
INTERACTION
One drug competes for excretion with the other
drug leading to accumulation and toxic effects of
one of the drug.
People with G6PD deficiency, some drugs (such
as chloroquine and primaquine, which are used to
treat malaria) destroy red blood cells and
cause hemolytic anemia.
Irbesartan is an angiotensin II antagonist indicated
for the treatment of hypertension. The major
elimination (CL) pathways involve N-
glucuronidation and oxidation via CYP2C9. The
CL of irbesartan is affected by the individual’s
CYP2C9 genotype. As an example, individuals
with a CYP2C9*1/*3 genotype had an irbesartan
CL of 12.99 + 3.12 L/hr compared with 21.40 +
5.98 L/hr for wild-type CYP2C9*1/*1
individuals.14 Here, an individual carrying the
variant *3 form of the CYP2C9 gene has decreased
CL due to the drug–gene interaction. The genotype
differences resulting in decreased CL impact the
response to irbesartan, as *1/*2 and *1/*3
individuals experience a greater response to the
drug compared with *1/*1 individuals, in this case
exhibited as a reduction in blood pressure.

References:

Gilchrist, A. (2015, Sept. 16). 5 Dangerous Food-Drug Interactions. Retrieved from

https://www.pharmacytimes.com/news/5-dangerous-food-drug-interactions
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SCHOOL OF NURSING

Burns, S., & Kelly, W. (2002, Nov. 1). 10 Drug Interactions Every Pharmacist Should Know. Retrieved
from https://www.pharmacytimes.com/publications/issue/2002/2002-11/2002-11-7010
SAINT LOUIS UNIVERSITY
SCHOOL OF NURSING
SAINT LOUIS UNIVERSITY
SCHOOL OF NURSING

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