Herb-food interactions

Herb-food interactions

Ø  A food – drug interaction  occurs when a food, or one of  its components, interferes with  the effects of a drug in the  body

Ø  The content of certain foods  interact with some drugs and  produce alterations in the  pharmacokinetics and pharmacodynamics of the drug

Adverse Drug-food interactions

Ø  Prevent the therapeutic effect of  a medicine

Ø  Exaggerate the therapeutic effect  of a medicine

Ø  Make a side effect worst

Ø  Cause a new side effect

Liquorice / Licorice

Ø  Common interactions with:

•       Antihypertensive, Digoxin, immunosuppressant's, (cyclosporine),   

     Diuretics

Ø  Results in:

•       Glycyrrhetinic  acid in licorice which blocks activity of 11B-hydroxsteroid dehydrogenase ultimately causing high blood pressure and  salt and water retention

•       It decreases antihypertensive effect

Ø  Solution:

•       Avoid licorice derivatives when suffering from Hypertension,  Conn’s Disease, and when using antihypertensive

Omega 3 rich fishes

Tuna, Sardine, Salmon, Mackerel, etc.

Ø  Common interactions with:

•       Antiplatelets and anticoagulants (aspirin, clopidogrel,  warfarin, heparin, alteplase, etc)

Ø  Results in:

Ø  Increased risk of bleeding

Solution:

•       Avoid concomitant use of omega 3 –  Containing foods with the above  Drugs

Caffeine Drinks

Coffee, tea, energy drinks, soft drinks, etc

Common interactions with:

Ø  Theophylline, Prednisolone, OCPs,  Ciprofloxacin, Cimetidine

Results in:

Ø  Inhibition of Theophylline metabolism with subsequent adverse effects of it. (Jitteriness, Insomnia, and Cardiac arrhythmias)

Ø  Reduced caffeine metabolism leads to subsequent  increased effects of caffeine

Grape Juice

Common interactions with:

Ø  Statins (increased risk of rhabdomyolysis), erythromycin, domperidone, amiodarone (increased risk for                QT prolongation), immuno suppressants (cyclosporine, Tacrolimus,, inhibiting its  metabolism with increased risk of nephrotoxity), opioids (fentanyl,  ketamine, oxycodone, inhibiting their metabolism with increased risk of  respiratory depression).

Vit K rich foods

Foods rich in Vit K - Kale, Collards, Spinach, Turnip greens, Brussels sprouts and Broccoli,  etc

Common interactions with:

Ø  Warfarin (Blood thinning agents that prevents blood clots)

Results in:

Ø  Increased intake of vit K foods - risk of thrombosis (blood clots).

Ø  Reduced intake  - increase risk of bleeding

Other Interactions

Ø  High Fat Meals may elevate the plasma levels of Griseofulvin. Patients should be instructed not  to take griseofulvin after a high-fat content meal

Ø  Protein Rich Foods may increase the bioavailability of Propranolol

Ø  Orange juice may interact with drugs like  Fexofenadine, Atenolol or Fluoroquinolones