Tuesday, May 22, 2012

FOOD-DRUG INTERACTIONS


Ada sesetengah ubatan yang diambil boleh berinteraksi dengan makanan yang diambil..jadual dibawah menunjukkan jenis ubatan dan food interaction.

 TABLE 1: FOOD-DRUG INTERACTIONS
Disease
Types
of Drugs
Food
Interactions
Examples of
Drug (Brand Name)
AllergiesAntihistaminesTake without regard of food. Bioavailabilty decreases with apple, orange, grapefruit juice.
  • Diphenhydramine
    (BENADRYL)
  • Loratadine
    (CLARITYNE)
  • Cetrizine
    (ZYRTEC)
Arthritis/PainAnalgesicsTake on empty stomach for rapid relief
  • Paracetamol
    (PANADOL)
Arthritis/PainNon-Steroidal Anti Inflammatory Drugs (NSAIDs)Take with food or milk to decrease stomach upset
  • Aspirin
  • Ibuprofen
    (Brufen)
Arthritis/PainCorticosteroidsTake with food or milk to decrease stomach upset
  • Prednisolone
AsthmaBronchodilatorsHigh fat meals may increase the amount of theophylline in the body, while high carbohydrate meals decrease it. Avoid eating / drinking large amounts of caffeine - containing food, drinks.
  • Theophylline
  • Salbutamol
Cardio-Vascular DisordersDiureticsTake on empty stomach/with milk to decrease stomach upset.
  • Frusemide
  • Bumetanide
  • Hydrochlorothiazide
Cardio-Vascular DisordersBeta BlockersTake with food to increase bioavailability.
  • Atenolol
  • Metoprolol
  • Propranolol
Cardio-Vascular DisordersNitratesTake on empty stomach.
  • IsosorbideDinitrate
    (ISORDIL)
  • Nitroglycerin
Cardio-Vascular DisordersAngiotensin Coverting EnzymesTake on empty stomach. Ensure adequate fluid intake.
  • Captopril
  • Perindopril
  • Lisinopril
Cardio-Vascular DisordersInhibitors (ACEi)Avoid salt substitutes.
  • Enalapril
Cardio-Vascular DisordersMNG-CoA Reductase inhibitors (Statins)Avoid grapefruit / related citrus. Avoid high fibre meals. Best taken before bedtime.
  • Atorvastatin
    (LIPITOR)
  • Simvastatin
    (ZOCOR)
Cardio-Vascular DisordersAnticoagulantsLimit food high in Vitamin K such as broccoli, leafygreens, cauliflower as it produces blood - clotting substances that may reduce effectiveness of the drug. Vitamin E (400IU or more) may prolong clotting time leading to bleeding.
  • Warfarin
InfectionsPenicillin/Quinolones /CephalosporinsTake on empty stomach 1 hour before or 2 hours after unless it upsets stomach, take with food but not with dairy or calcium - fortified food.
Quinolone: Avoid caffeine as it increase excitability & nervousness
  • Penicillin:Penicillin V,
    Amoxicillin
  • Quinolones:Ciprofloxacin,
    Ofloxacin
  • Cephalo: Cephalexin,
    Cefuroxime
InfectionsMacrolidesMay take with food if GI distress.
Avoid citrus food, carbonated drinks and citrus juices
  • Azithromycin
  • Erythromycin
  • Clathromycin
InfectionsSulfonamidesTake with food and at least with 8 ounces of water.
  • Sulfamethoxazole/
    Trimethoprim
    (BACTRIM)
InfectionsTetracyclineTake with food and at least with 8 ounces of water. Avoid taking it with dairy products, antacids, vitamin supplements containing iron as it can interfere with drug’s effect.
  • Tetracycline
  • Doxycycline
InfectionsNitromidazoleMay take with food to decrease GI distress.
  • Metronidazole
    (FLAGYL)
InfectionsAntifungalsTake with food to increase absorption. Do not take itraconazole with citrus.
  • Fluconazole
  • Ketoconazole
  • Itraconazole
Mood DisordersMonoamine Oxidase (MAO) InhibitorsDo not take foods or alcoholic beverages containing tyramine (eg.cheese, tapai, soy sauce, tofu, bananas, raisins, caffeine) while taking this drug and for 2 weeks after discontinuation.
  • Selegiline
Mood DisordersAnti-AnxietyMay take with food to decrease GI distress. Caffeine may cause excitability and lessen the anti-anxiety effect of the drug.
  • Alprazolam
  • Diazepam
Mood DisordersAntidepressantTo be taken with or without food.
  • Sertraline
    (ZOLOFT)
  • Fluoxetine
    (PROZAC)
Stomach ConditionsHistamine BlockersTo be taken with or without food. Caffeine may irritate stomach.
  • Cimetidine
    (TAGAMET)
  • Ranitidine
    (ZANTAC)

TABLE 2: HERBS/SUPPLEMENTS-DRUG INTERACTION
Herbs Supplements
Interacting Drug
Possible Effects
Ginseng
to stimulate adrenal gland which increases energy and reduce blood glucose
Warfarin
May decrease drug’s effectiveness
CorticosteroidsMay potentiate drug and increase side effects
AntihypertensiveMay increase blood pressure
MAOIsMay increase insomnia, headache, tremulousness
Gingko Biloba
for the treatment of dementia & to improve memory
Aspirin
Bleeding
WarfarinHaemorrhage
ThiazideHypertension
Garlic
to lower blood pressure & cholesterol
WarfarinIncreased effectiveness of warfarin, leads to bleeding
Ginger
for nausea & bowel spasms
WarfarinIncreased effectiveness of warfarin, leads to bleeding
Dong Quai
for menopausal symptom control
WarfarinMay increase the effect of this drug which can lead to bleeding
St. John’s wort
a natural anti –depressant for mild to moderate depression.
AmitriptylineWorsen depression as it reduces concentration of the drug in the blood
DigoxinDecrease digoxin concentration leading to reduce efficacy of digoxin
Theophylline
Worsen signs & symptoms of asthma as it reduces concentration of the drug in the blood
OestrogenCauses breakthrough bleeding
Green Tea
as an antioxidant
CalciumDecreases calcium absorption
WarfarinWarfarin activity might be lowered due to high level of vitamin K in herb
Turmeric
as an anti inflammatory, to treat digestive and liver problems, skin diseases, wounds
NSAIDsMay increase bleeding and gastrointestinal irritation
Warfarin, AspirinMay increase the effect of this drug which can lead to bleeding
Ranitidine,Omeprazole
May increase production of stomach acid
AzadirachtaIndica (Neem)
antiseptic, antiviral, antipyretic, anti-inflammatory, anti-ulcer
Insulin
May decrease glucose level further
Immunosuppressants (eg:Cyclosporine Azathioprine)
May increase immune’s system which leads to decrease of medications efficacy.
Ocimumtenuiflorum
(tulasi)
for common colds, headache
Anticoagulants,antiplatelets
May slow blood clot which leads to increase bleeding and bruising
Eurycomalongifolia (Tongkat Ali)
to stimulate male hormones, increase libido
ImmunosuppressantsMay further weaken immune system

Mechanism Of Food – Drug Interaction
mekanisma terbahagi kepada dua jenis iaitu Pharmacokinetic dan pharmacodynamic
Sesetengah pharmacokinetic mechanisms akan ada/wujud apabila berkurang atau meningkatnya
  • Penyerapan drug oleh badan
  • Pengagihan drug dalam badan
  • Metabolisma drug
  • Penyingkiran drug dari badan

Medication Safety Measures
( tips untuk elakkan food-drug interaction:
  • Sentiasa baca label preskripsi dan juga pamplet yang disertakan bersama ubatan (directions, warnings, interaction precautions) 
  • Ikut arahan cara pengambilan ubatan yang diarahkan oleh doktor.
  • Ambil ubatan dengan air putih.Elakkan mengambil dengan air panas kerana kepanasan kadangkala mengurangkan keberkesanan ubatan.
  • Jangan campurkan dengan makanan keculi jika diarahkan.
  • Jangan ambil ubatan herba atau supplement dalam masa yang sama anda mengambil ubatan.
  • Jangan minum alkohol semasa anda mengambil ubatan.
  • Beritahu doktor atau farmasi ubatan yang sedang diambil atau herba yang dimakan.
  • Beritahu Doktor tentang perubahan dalam gaya hidup kebelakangan ini (exercise, diet, alcohol intake).
  • Jika ada sebarang keraguan tentang ubatan,rujuk doktor atau farmasi.

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3 comments:

Assalamualaikum..
no harsh words please...
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