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.
Similar content being viewed by others
References
Stein BE. Avoiding drug reactions: seven steps to writing safe prescriptions. Geriatrics 1984; 49(9): 28–36
Ahronheim J. Practical pharmacology for older patients: avoiding adverse drug effects. Mt Sinai J Med 1993; 60(6): 497–501
Johnson JC. General concepts of geriatric medicine. Clin Podiatr Med Surg 1993; 10(1): 23–33
Roe DA. Medications and nutrition in the elderly. Prim Care 1994; 21(1): 135–47
Aparasu RR, Fliginger SE. Inappropriate medication prescribing for the elderly by office-based physicians. Ann Pharmacother 1997; 31: 823–9
Carlson JE. Perils of polypharmacy: 10 steps to prudent prescribing. Geriatrics 1996; 51(7): 26–35
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
Munro HN, Suter PM, Russell RM. Nutritional requirements of the elderly. Annu Rev Nutr 1987; 7: 23–49
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
Yamreudeewong W, Henann NE, Fazio A, et al. Drug-food interactions in clinical practice. J Fam Pract 1995; 40(4): 376–84
Kirk JK. Significant drug-nutrient interactions. Am Fam Physician 1995; 51(5): 1175–82
Randle NW. Food or nutrient effects on drug absorption: a review. Hosp Pharm 1987; 22: 694–697, 718
Smith CH, Bidlack WR. Dietary concerns associated with the use of medications. J Am Diet Assoc 1984; 84: 901–14
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
Thomas JA. Drug-nutrient interactions. Nutr Rev 1995; 53: 271–82
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
Hurwitz A, Brady DA, Schaal SE et al. Gastric acidity in older adults. JAMA 1997; 278(8): 659–82
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
Tsuji A, Tamai I. Carrier-mediated intestinal transport of drugs. Pharm Res 1996; 13(7): 963–77
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
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
Welling PG. Effects of food on drug absorption. Annu Rev Nutr 1996; 16: 383–415
Hoyumpa AM, Schenker S. Major drug interactions: effect of liver disease, alcohol, and malnutrition. Annu Rev Med 1982; 33: 113–49
Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Fam Physician 1991; 44(5): 1651–8
Hammerlein A, Derendorf H, Lowenthal DT. Pharmacokinetic and pharmacodynamic changes in the elderly. Clin Pharmacokinet 1998; 35(1): 49–64
Michalets E. Update: clinically significant cytochrome P-450 drug interactions. Pharmacotherapy 1998; 18: 84–112
Steffens DC, Ranga Rama Krishnan K. Metabolism, bioavailability and drug interactions. Clin Geriatr Med 1998; 14(1): 17–31
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
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
Roe DA. Therapeutic significance of drug-nutrient interactions in the elderly. Pharmacol Rev 1984; 36(2 Suppl.): 109S–22S
Cardinale V. Stemming the tide of polymedicine. Drug Topics 1988; 132: 36–41
Lamy PP. Effects of diet and nutrition on drug therapy. J Am Geriatric Soc 1982; 30(11 Suppl.): S99–S112
Moorandian AD. Nutritional modulation of life span and gene expression. Ann Intern Med 1988; 109: 891–2
Nordin B. Calcium and Osteoporosis. Nutrition 1997; 13: 664–86
Guttman P. Patterns of legal drug use by older Americans. Addict Dis 1978; 3: 337–56
Ouslander JG. Drug therapy and the elderly. Ann Intern Med 1981; 95: 711–22
Roe DA. Drug and nutrient interactions in the elderly diabetic. Drug Nutr Interact 1988; 5: 195–203
Susman JL, Helseth LD. Reducing the complications of type II diabetes: a patient-centered approach. Am Fam Physician 1997; 56: 471–8
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
Roe DA. Interactions between drugs and nutrients. Med Clin North Am 1979; 63: 985–1007
Tschanz C, Stargel WW, Thomas JA. Interactions between drugs and nutrients. Adv Pharmacol 1996; 35: 1–26
Spencer CM, Markham A. Troglitazone. Drugs 1997; 54(1): 89–101
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
Stiefeld SM, Graziani AL, MacGregor RR, et al. Toxicities of antimicrobial agents used to treat osteomyelitis. Orthop Clin North Am 1991; 22: 439–65
Hulin B. New hypoglycemic agents. Prog Med Chem 1994; 31: 1–58
Roe DA. Drug and nutrient interactions in elderly cardiac patients. Drug Nutr Interact 1988; 5: 205–12
Bennett WM. Drug interactions and consequences of sodium restriction. Am J Clin Nutr 1997; 65Suppl. 2: 678S–81S
Diaz MN, Frei B, Vita JA, et al. Antioxidants and atherosclerotic heart disease. N Engl J Med 1997; 337(6): 408–16
Lee M, Schwartz RN, Sharifi R. Warfarin resistance and vitamin K. Arch Intern Med 1981; 94: 140–1
Wells PS, Holbrook AM, Crowther NR, et al. Interactions of warfarin with drugs and food. Ann Intern Med 1994; 121: 676–83
Harris JE. Interaction of dietary factors with oral anticoagulants: review and applications. J Am Diet Assoc 1995; 95(5): 580–4
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
Nordin BEC. Calcium and osteoporosis. Nutrition 1997; 13(7/8): 664–86
Bronner F. Intestinal calcium absorption: mechanisms and applications. J Nutr 1987; 11: 1347–1352
D’Arcy PF, McElnay JC. Drug interactions in the gut involving metal ions. Rev Drug Metabol Drug Interact 1985; 5: 83–99
Perlia CP, Gubisch NJ, Wolter J, et al. Mithramycin treatment of hypercalcemia. Cancer 1970; 25: 389–94
Guillaume M, Björntorp P. Obesity in children: environmental and genetic aspects. Horm Metab Res 1996; 28: 573–81
Rosenbaum M, Leibel RL, Hirsch J. Obesity. N Engl J Med 1997; 337(6): 396–407
Guerciolini R. Mode of action of orlistat. Int J Obes 1997; 21Suppl. 3: S12–23
Goldman P. Olestra: assessing its potential to interact with drugs in the gastrointestinal tract. J Clin Pharm Ther 1997; 61; 613–8
Author information
Authors and Affiliations
Corresponding author
Rights 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
Published:
Issue Date:
DOI: https://doi.org/10.2165/00002512-199813030-00003