Clinical studies have found that up to 93% of oral medications are affected by the type of food. Reasonable diet during the period of taking the drug not only helps the absorption and distribution of the drug, but also enhances the therapeutic effect and effectively avoids or reduces adverse toxic and side effects.
For patients with chronic hepatitis, liver cirrhosis, other cardiovascular and cerebrovascular diseases, diabetes and other patients who need to take medication for a long time, it is particularly important to understand the interaction between food and drugs.
Although doctors often emphasize paying attention to diet when prescribing and in the instructions of medicines, it is often vague and confusing. This article will detail how to maximize the efficacy of drugs and avoid adverse effects through a reasonable diet.
Do you know about food?
The concept of food is very broad, and everything that can be brought into the mouth and swallowed can be classified as food. (e.g. meals, fruits, beverages, various liquors, food additives, etc.)
Generally speaking, the interaction between drugs and food is mainly manifested in four aspects: irrelevant, reduced efficiency, increased efficiency, and increased adverse reactions, and sometimes the latter two coexist.
In most cases, when a drug meets food, it may only appear as an unrelated effect, and if it is not specifically indicated in the drug label, it can often be considered as an unrelated effect.
Pay attention to these foods while taking the drug
For people with liver disease, certain food-drug interactions require special attention to avoid reducing the effectiveness of the drug or increasing adverse effects.
1. High-fat foods
High-fat foods promote the absorption of fat-soluble drugs, such as vitamins A, D, E, and K. However, when taking certain drugs, such as griseofulvin, high-fat foods should be avoided to avoid increased adverse effects due to high blood levels.
Patients with liver disease should avoid foods that are too oily when taking iron supplements, so as not to affect the absorption of iron.
2. High-protein foods
During the use of adrenocorticosteroids, high-protein foods can help prevent other pathologies caused by protein deficiency, but for patients with liver disease, high-protein intake should be moderate and follow the doctor's instructions to avoid increasing the burden on the liver.
3. Specific Foods
Some components contained in tangerines can inhibit the activity of cytochrome oxidase and P-glycoprotein, enhance the effect of nifedipine and digoxin, and increase adverse reactions.
Certain components in tomatoes can affect the activity of liver enzymes, which can enhance the effect of phenytoin (an antiepileptic drug) and increase the chance of adverse effects.
Grapefruit juice (grapefruit) interacts with hundreds of medications, and it is recommended that you avoid grapefruit/grapefruit juice during oral medications. Other grapefruit fruits, such as ordinary grapefruits, and even oranges that are adjacent to them, should also be taken with caution during medication.
If you have a habit of eating grapefruit or other fruits, but are not sure whether you can eat them, be sure to consult your doctor/pharmacist.
4. Tea and coffee
For patients with chronic liver disease with stable liver function, moderate consumption of tea or coffee usually does not have adverse effects on the liver.
However, when taking hepatoprotective drugs, especially antiviral drugs, it is recommended to avoid taking them with tea and coffee, and the drinking time between the two should be more than 2 hours apart to prevent the efficacy of the drug from being affected.
In addition, in the case of decompensated liver cirrhosis, varicose veins of the esophagus or gastric mucosa, gastritis, ascites, etc., as well as when using other drugs that have greater damage to the liver, it is not advisable to drink a large amount of tea or coffee, but it is not absolutely contraindicated.
5. Alcohol
Long-term alcohol consumption can induce liver microsomal oxidase, accelerate drug metabolism, and affect the efficacy of drugs. People with liver disease should strictly abstain from alcohol! No matter how much you drink, drinking red/white/beer is a worse blow to the liver that is affected by the liver disease virus.
The best time to take common medications
In order to minimize undesirable interactions between medications and foods, care should be taken to adjust the timing of meals while taking the following medications:
Take before meals
The absorption and onset of proton pump inhibitors such as omeprazole, lansoprazole, and pantoprazole are easily disturbed by gastric contents, so it is recommended to take them on an empty stomach before breakfast and dinner to exert their best efficacy.
Compound azinamide, multi-enzyme tablets, pepsin and other digestive aids are mostly digestive juice components, or substances that promote the secretion of digestive juices, and it is recommended to take them immediately before meals or with meals, so as to facilitate the immediate decomposition and absorption of the drug and take effect.
Take during meals
The hepatitis B antiviral drugs tenofovir, tenofovir alafenol and emitenofovir need to be taken during or immediately after meals for the best absorption, blood concentration and efficacy.
Acarbose should be chewed with the first bite of food to reduce irritation of the gastrointestinal tract; Some antineoplastic drugs, such as imatinib, need to be synchronized with meals and drink plenty of fluids to reduce the risk of gastrointestinal irritation caused by the drug.
Meal between meals
Entecavir, an antiviral drug for hepatitis B, is susceptible to eating and should be taken about 2 hours between meals or on an empty stomach.
Gastric mucosal protective drugs such as sucralfate suspension and teprenone capsules can form a protective barrier for the stomach, strengthen its own defense and repair effect, and take it on a full stomach due to excessive gastric contents, which will reduce the concentration of the drug and affect the efficacy, but on the other hand, there is a certain amount of gastric contents, but it can slow down the rate of the lower gastric discharge of the drug, so that the duration of the protective barrier formed is prolonged, so it is recommended to take it between meals.
Take after meals
Bacillus subtilis, Enterococci double viable bacteria enteric-coated capsules, Bacillus licheniformis live bacteria capsules and other drugs to adjust the gastrointestinal flora mostly restore the internal environment by supplementing the normal flora in the gastrointestinal tract, and it is best to take it with warm water or milk below 40 °C after meals.
In daily medication, foods can interact with medications, affecting efficacy or increasing risk.
For middle-aged and elderly patients with chronic digestive system lesions or other underlying diseases, especially those with liver disease who need to take long-term medication, they should be more vigilant about these interactions.
Understanding some necessary drug knowledge, taking precautions, and preventing potential risks is the only way to reduce toxicity and improve efficiency, and achieve long-term stability.
About author丨Cheng Shuquan, Chief Physician of the Third Central Hospital of Guilin
(Medical science is universal, not as a diagnosis and treatment opinion, if you have personalized needs, it is recommended that you consult a doctor.) ）
