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Eur J Pharm Sci. 2019 Jun 15;134:31-59. doi: 10.1016/j.ejps.2019.04.003. Epub 2019 Apr 8.

The mechanisms of pharmacokinetic food-drug interactions - A perspective from the UNGAP group.

Author information

1
Department of Biopharmaceutics and Pharmaceutical Technology, University of Greifswald, Center of Drug Absorption and Transport, Felix-Hausdorff-Str. 3, D-17487 Greifswald, Germany.
2
Department of Health Sciences, University "Magna Græcia" of Catanzaro, Campus Universitario "S. Venuta", Viale Europa, 88100 Catanzaro, Italy; Net4Science Academic Spinoff, University "Magna Græcia" of Catanzaro, Campus Universitario "S. Venuta", Viale Europa, 88100 Catanzaro, Italy.
3
Drug Delivery and Disposition, KU Leuven, Herestraat 49, Gasthuisberg, O&N2, Box 921, 3000 Leuven, Belgium.
4
UCL School of Pharmacy, University College London, 29 - 39 Brunswick Square, London WC1N 1AX, United Kingdom.
5
NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, United Kingdom; Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom.
6
Medicines Evaluation Board in the Netherlands, PKPD Department, Utrecht, the Netherlands.
7
NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, United Kingdom; Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
8
Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland.
9
Charles University, Faculty of Pharmacy in Hradec Králové, Heyrovského 1203, 50005 Hradec Králové, Czech Republic.
10
Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia; ARC Centre of Excellence in Convergent Bio-Nano Science and Technology, Monash Institute of Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia.
11
Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 157 84 Athens, Greece.
12
Medicines Evaluation Board in the Netherlands, Quality Department, Utrecht, the Netherlands.
13
Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia.
14
Laboratory of Biotransformation, Institute of Microbiology, CAS, Vídeňská 1083, CZ-142 20 Prague, Czech Republic.
15
University of Zagreb, Faculty of Pharmacy and Biochemistry, A. Kovačića 1, 10000 Zagreb, Croatia.
16
NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, United Kingdom; Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, United Kingdom. Electronic address: maura.corsetti@nottingham.ac.uk.

Abstract

The simultaneous intake of food and drugs can have a strong impact on drug release, absorption, distribution, metabolism and/or elimination and consequently, on the efficacy and safety of pharmacotherapy. As such, food-drug interactions are one of the main challenges in oral drug administration. Whereas pharmacokinetic (PK) food-drug interactions can have a variety of causes, pharmacodynamic (PD) food-drug interactions occur due to specific pharmacological interactions between a drug and particular drinks or food. In recent years, extensive efforts were made to elucidate the mechanisms that drive pharmacokinetic food-drug interactions. Their occurrence depends mainly on the properties of the drug substance, the formulation and a multitude of physiological factors. Every intake of food or drink changes the physiological conditions in the human gastrointestinal tract. Therefore, a precise understanding of how different foods and drinks affect the processes of drug absorption, distribution, metabolism and/or elimination as well as formulation performance is important in order to be able to predict and avoid such interactions. Furthermore, it must be considered that beverages such as milk, grapefruit juice and alcohol can also lead to specific food-drug interactions. In this regard, the growing use of food supplements and functional food requires urgent attention in oral pharmacotherapy. Recently, a new consortium in Understanding Gastrointestinal Absorption-related Processes (UNGAP) was established through COST, a funding organisation of the European Union supporting translational research across Europe. In this review of the UNGAP Working group "Food-Drug Interface", the different mechanisms that can lead to pharmacokinetic food-drug interactions are discussed and summarised from different expert perspectives.

KEYWORDS:

Absorption; Drug release; Food effect; Food-drug interaction; Metabolism; Oral bioavailability; Oral drug delivery

PMID:
30974173
DOI:
10.1016/j.ejps.2019.04.003
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