Skip to main content
Log in

Important Drug-Nutrient Interactions in the Elderly

  • Review Article
  • Clinical Pharmacology
  • Published:
Drugs & Aging Aims and scope Submit manuscript

Abstract

Several drug-nutrient interactions can occur, but their prevalence may be accentuated in the elderly. Geriatric patients may experience age-related changes in the pharmacokinetics of a drug — absorption, distribution, metabolism and excretion. When drug-nutrient interactions occur, they usually affect absorptive processes more frequently. Specific transporter systems facilitate the absorption of many drugs. Little is known about how these transporter systems are affected by aging. Co-existing disease states in the elderly may exaggerate the action of a drug and represent a confounding factor in drug-nutrient interactions. While several different drug-nutrient interactions are important in the elderly, those affecting the cardiovascular system warrant special attention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Stein BE. Avoiding drug reactions: seven steps to writing safe prescriptions. Geriatrics 1984; 49(9): 28–36

    Google Scholar 

  2. Ahronheim J. Practical pharmacology for older patients: avoiding adverse drug effects. Mt Sinai J Med 1993; 60(6): 497–501

    PubMed  CAS  Google Scholar 

  3. Johnson JC. General concepts of geriatric medicine. Clin Podiatr Med Surg 1993; 10(1): 23–33

    PubMed  Google Scholar 

  4. Roe DA. Medications and nutrition in the elderly. Prim Care 1994; 21(1): 135–47

    PubMed  CAS  Google Scholar 

  5. Aparasu RR, Fliginger SE. Inappropriate medication prescribing for the elderly by office-based physicians. Ann Pharmacother 1997; 31: 823–9

    PubMed  CAS  Google Scholar 

  6. Carlson JE. Perils of polypharmacy: 10 steps to prudent prescribing. Geriatrics 1996; 51(7): 26–35

    PubMed  CAS  Google Scholar 

  7. Chen LH, Liu S, Cook Newell ME, et al. Survey of drug use by the elderly and possible impact of drugs on nutritional status. Drug Nutr Interact 1985; 3: 73–86

    PubMed  CAS  Google Scholar 

  8. Munro HN, Suter PM, Russell RM. Nutritional requirements of the elderly. Annu Rev Nutr 1987; 7: 23–49

    Article  PubMed  CAS  Google Scholar 

  9. Smith CH. Drug-food/food-drug interactions. In: Morley JE, Glick Z, Rubenstein LZ, editors. Geriatric nutrition: a comprehensive review. New York: Raven Press, 1990: 371–396

    Google Scholar 

  10. Yamreudeewong W, Henann NE, Fazio A, et al. Drug-food interactions in clinical practice. J Fam Pract 1995; 40(4): 376–84

    PubMed  CAS  Google Scholar 

  11. Kirk JK. Significant drug-nutrient interactions. Am Fam Physician 1995; 51(5): 1175–82

    PubMed  CAS  Google Scholar 

  12. Randle NW. Food or nutrient effects on drug absorption: a review. Hosp Pharm 1987; 22: 694–697, 718

    Google Scholar 

  13. Smith CH, Bidlack WR. Dietary concerns associated with the use of medications. J Am Diet Assoc 1984; 84: 901–14

    PubMed  CAS  Google Scholar 

  14. Garabedian-Ruffalo SM, Syria-Farber M, Lanius PM, et al. Monitoring of drug-drug and drug-food interactions. Am J Hosp Pharm 1988; 45: 1530–4

    PubMed  CAS  Google Scholar 

  15. Thomas JA. Drug-nutrient interactions. Nutr Rev 1995; 53: 271–82

    Article  PubMed  CAS  Google Scholar 

  16. Thomas JA, Tschanz C. Nutrient-drug interactions. In: Kotsonis FN, Mackey M, Hjelle JJ, editors. Nutritional toxicology, target organ toxicity series. New York: Raven Press, 1994: 139–48

    Google Scholar 

  17. Hurwitz A, Brady DA, Schaal SE et al. Gastric acidity in older adults. JAMA 1997; 278(8): 659–82

    Article  PubMed  CAS  Google Scholar 

  18. De Ponti F, Giaroni C, Cosentino M, et al. Adrenergic mechanisms in the control of gastrointestinal mortility: from basic science to clinical applications. Pharmacol Ther 1996; 69: 59–78

    Article  PubMed  Google Scholar 

  19. Tsuji A, Tamai I. Carrier-mediated intestinal transport of drugs. Pharm Res 1996; 13(7): 963–77

    Article  PubMed  CAS  Google Scholar 

  20. Mizuma T, Sakai N, Awazu S. Na+-dependent transport of aminopeptidase-resistant sugar-coupled tripeptides in rat intestine. Biochem Biophys Res Commun 1994; 203: 1412–6

    Article  PubMed  CAS  Google Scholar 

  21. Simanjuntak MT, Tamai I, Terasaki T, et al. Carrier-mediated uptake of nicotinic acid by rat intestinal brush-border membrane vesicles and relation to monocarboxylic acid transport. J Pharmacobiodyn 1990; 13: 301–9

    Article  PubMed  CAS  Google Scholar 

  22. Welling PG. Effects of food on drug absorption. Annu Rev Nutr 1996; 16: 383–415

    Article  PubMed  CAS  Google Scholar 

  23. Hoyumpa AM, Schenker S. Major drug interactions: effect of liver disease, alcohol, and malnutrition. Annu Rev Med 1982; 33: 113–49

    Article  PubMed  CAS  Google Scholar 

  24. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Fam Physician 1991; 44(5): 1651–8

    PubMed  CAS  Google Scholar 

  25. Hammerlein A, Derendorf H, Lowenthal DT. Pharmacokinetic and pharmacodynamic changes in the elderly. Clin Pharmacokinet 1998; 35(1): 49–64

    Article  PubMed  CAS  Google Scholar 

  26. Michalets E. Update: clinically significant cytochrome P-450 drug interactions. Pharmacotherapy 1998; 18: 84–112

    PubMed  CAS  Google Scholar 

  27. Steffens DC, Ranga Rama Krishnan K. Metabolism, bioavailability and drug interactions. Clin Geriatr Med 1998; 14(1): 17–31

    PubMed  CAS  Google Scholar 

  28. Bennett WM, Porter GA. Overview of clinical nephrotoxicity. In: Hook JB, Goldstein RS, editors. Toxicology of the kidney: target organ toxicity series. 2nd ed. New York: Raven Press, 1993: 61–97

    Google Scholar 

  29. Roe DA. Drug and food interactions as they affect the nutrition of older individuals. Aging Clin Exp Res 1993; 5(2 Suppl. 1): 51–3

    CAS  Google Scholar 

  30. Roe DA. Therapeutic significance of drug-nutrient interactions in the elderly. Pharmacol Rev 1984; 36(2 Suppl.): 109S–22S

    PubMed  CAS  Google Scholar 

  31. Cardinale V. Stemming the tide of polymedicine. Drug Topics 1988; 132: 36–41

    Google Scholar 

  32. Lamy PP. Effects of diet and nutrition on drug therapy. J Am Geriatric Soc 1982; 30(11 Suppl.): S99–S112

    CAS  Google Scholar 

  33. Moorandian AD. Nutritional modulation of life span and gene expression. Ann Intern Med 1988; 109: 891–2

    Google Scholar 

  34. Nordin B. Calcium and Osteoporosis. Nutrition 1997; 13: 664–86

    Article  PubMed  CAS  Google Scholar 

  35. Guttman P. Patterns of legal drug use by older Americans. Addict Dis 1978; 3: 337–56

    Google Scholar 

  36. Ouslander JG. Drug therapy and the elderly. Ann Intern Med 1981; 95: 711–22

    PubMed  CAS  Google Scholar 

  37. Roe DA. Drug and nutrient interactions in the elderly diabetic. Drug Nutr Interact 1988; 5: 195–203

    PubMed  CAS  Google Scholar 

  38. Susman JL, Helseth LD. Reducing the complications of type II diabetes: a patient-centered approach. Am Fam Physician 1997; 56: 471–8

    PubMed  CAS  Google Scholar 

  39. King H, Rewers M, World Health Organisation Diabetes Reporting Group. Global estimates for prevalence of diabetes mellitus and impaired glucose tolerance in adults. Diabetes Care 1993; (16): 157–77

    Article  PubMed  CAS  Google Scholar 

  40. Roe DA. Interactions between drugs and nutrients. Med Clin North Am 1979; 63: 985–1007

    PubMed  CAS  Google Scholar 

  41. Tschanz C, Stargel WW, Thomas JA. Interactions between drugs and nutrients. Adv Pharmacol 1996; 35: 1–26

    Article  PubMed  CAS  Google Scholar 

  42. Spencer CM, Markham A. Troglitazone. Drugs 1997; 54(1): 89–101

    Article  PubMed  CAS  Google Scholar 

  43. Shibata H, Kobayashi NS, et al. Phase I study of a new hypoglycemic agent CS-045 in healthy volunteers: safety and pharmacokinetics in single administration [in Japanese]. Rinsho Iyaku 1993; 9(7): 1503–8

    Google Scholar 

  44. Stiefeld SM, Graziani AL, MacGregor RR, et al. Toxicities of antimicrobial agents used to treat osteomyelitis. Orthop Clin North Am 1991; 22: 439–65

    PubMed  CAS  Google Scholar 

  45. Hulin B. New hypoglycemic agents. Prog Med Chem 1994; 31: 1–58

    Article  PubMed  CAS  Google Scholar 

  46. Roe DA. Drug and nutrient interactions in elderly cardiac patients. Drug Nutr Interact 1988; 5: 205–12

    PubMed  CAS  Google Scholar 

  47. Bennett WM. Drug interactions and consequences of sodium restriction. Am J Clin Nutr 1997; 65Suppl. 2: 678S–81S

    PubMed  CAS  Google Scholar 

  48. Diaz MN, Frei B, Vita JA, et al. Antioxidants and atherosclerotic heart disease. N Engl J Med 1997; 337(6): 408–16

    Article  PubMed  CAS  Google Scholar 

  49. Lee M, Schwartz RN, Sharifi R. Warfarin resistance and vitamin K. Arch Intern Med 1981; 94: 140–1

    CAS  Google Scholar 

  50. Wells PS, Holbrook AM, Crowther NR, et al. Interactions of warfarin with drugs and food. Ann Intern Med 1994; 121: 676–83

    PubMed  CAS  Google Scholar 

  51. Harris JE. Interaction of dietary factors with oral anticoagulants: review and applications. J Am Diet Assoc 1995; 95(5): 580–4

    Article  PubMed  CAS  Google Scholar 

  52. Fujimura A, Shiga T, Kumagai Y, et al. Effect of food intake on pharmacokinetics and effects of a new thromboxane A2 receptor antagonist. Euro J Clin Pharmacol 1996; 50(4): 311–4

    Article  CAS  Google Scholar 

  53. Nordin BEC. Calcium and osteoporosis. Nutrition 1997; 13(7/8): 664–86

    Article  PubMed  CAS  Google Scholar 

  54. Bronner F. Intestinal calcium absorption: mechanisms and applications. J Nutr 1987; 11: 1347–1352

    Google Scholar 

  55. D’Arcy PF, McElnay JC. Drug interactions in the gut involving metal ions. Rev Drug Metabol Drug Interact 1985; 5: 83–99

    Article  PubMed  Google Scholar 

  56. Perlia CP, Gubisch NJ, Wolter J, et al. Mithramycin treatment of hypercalcemia. Cancer 1970; 25: 389–94

    Article  PubMed  CAS  Google Scholar 

  57. Guillaume M, Björntorp P. Obesity in children: environmental and genetic aspects. Horm Metab Res 1996; 28: 573–81

    Article  CAS  Google Scholar 

  58. Rosenbaum M, Leibel RL, Hirsch J. Obesity. N Engl J Med 1997; 337(6): 396–407

    Article  PubMed  CAS  Google Scholar 

  59. Guerciolini R. Mode of action of orlistat. Int J Obes 1997; 21Suppl. 3: S12–23

    CAS  Google Scholar 

  60. Goldman P. Olestra: assessing its potential to interact with drugs in the gastrointestinal tract. J Clin Pharm Ther 1997; 61; 613–8

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to John A. Thomas.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Thomas, J.A., Burns, R.A. Important Drug-Nutrient Interactions in the Elderly. Drugs Aging 13, 199–209 (1998). https://doi.org/10.2165/00002512-199813030-00003

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00002512-199813030-00003

Keywords

Navigation