Food-drug interactions precipitated by fruit juices other than grapefruit juice: An update review,Journal of Food and Drug Analysis

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Food-drug interactions precipitated by fruit juices other than grapefruit juice: An update review
Journal of Food and Drug Analysis ( IF 2.6 ) Pub Date : 2018-04-01 , DOI: 10.1016/j.jfda.2018.01.009
Meng Chen ₁ , Shu-Yi Zhou ₂ , Erlinda Fabriaga ₂ , Pian-Hong Zhang ₃ , Quan Zhou ₁

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This review addressed drug interactions precipitated by fruit juices other than grapefruit juice based on randomized controlled trials (RCTs). Literature was identified by searching PubMed, Cochrane Library, Scopus and Web of Science till December 30 2017. Among 46 finally included RCTs, six RCTs simply addressed pharmacodynamic interactions and 33 RCTs studied pharmacokinetic interactions, whereas seven RCTs investigated both pharmacokinetic and pharmacodynamic interactions. Twenty-two juice-drug combinations showed potential clinical relevance. The beneficial combinations included orange juice-ferrous fumarate, lemon juice-99mTc-tetrofosmin, pomegranate juice-intravenous iron during hemodialysis, cranberry juice-triple therapy medications for H. pylori, blueberry juice-etanercept, lime juice-antimalarials, and wheat grass juice-chemotherapy. The potential adverse interactions included decreased drug bioavailability (apple juice-fexofenadine, atenolol, aliskiren; orange juice-aliskiren, atenolol, celiprolol, montelukast, fluoroquinolones, alendronate; pomelo juice-sildenafil; grape juice-cyclosporine), increased bioavailability (Seville orange juice-felodipine, pomelo juice-cyclosporine, orange-aluminum containing antacids). Unlike furanocoumarin-rich grapefruit juice which could primarily precipitate drug interactions by strong inhibition of cytochrome P450 3A4 isoenzyme and P-glycoprotein and thus cause deadly outcomes due to co-ingestion with some medications, other fruit juices did not precipitate severely detrimental food-drug interaction despite of sporadic case reports. The extent of a juice-drug interaction may be associated with volume of drinking juice, fruit varieties, type of fruit, time between juice drinking and drug intake, genetic polymorphism in the enzymes or transporters and anthropometric variables. Pharmacists and health professionals should properly screen for and educate patients about potential adverse juice-drug interactions and help minimize their occurrence. Much attention should be paid to adolescents and the elderly who ingest medications with drinking fruit juices or consume fresh fruits during drug treatment. Meanwhile, more researches in this interesting issue should be conducted.

中文翻译：

由葡萄柚汁以外的果汁引起的食物-药物相互作用：更新回顾

本综述基于随机对照试验 (RCT) 讨论了由葡萄柚汁以外的果汁引起的药物相互作用。截至 2017 年 12 月 30 日，通过搜索 PubMed、Cochrane 图书馆、Scopus 和 Web of Science 确定了文献。在最终纳入的 46 项 RCT 中，6 项 RCT 仅涉及药效学相互作用，33 项 RCT 研究药代动力学相互作用，而 7 项 RCT 研究药代动力学和药效学相互作用。22 种果汁-药物组合显示出潜在的临床相关性。有益的组合包括橙汁-富马酸亚铁、柠檬汁-99mTc-tetrofosmin、石榴汁-血液透析期间的静脉铁、蔓越莓汁-幽门螺杆菌的三联疗法药物、蓝莓汁-依那西普、酸橙汁-抗疟药和小麦草汁-化疗。潜在的不良相互作用包括降低药物的生物利用度（苹果汁-非索非那定、阿替洛尔、阿利吉仑；橙汁-阿利吉仑、阿替洛尔、塞利洛尔、孟鲁司特、氟喹诺酮类、阿仑膦酸盐；柚子汁-西地那非；葡萄汁-环孢素），增加生物利用度（塞维利亚橙汁） -非洛地平，柚子汁 - 环孢菌素，含有抗酸剂的橙铝）。与富含呋喃香豆素的葡萄柚汁不同，葡萄柚汁主要通过强烈抑制细胞色素 P450 3A4 同工酶和 P-糖蛋白来促进药物相互作用，从而由于与某些药物共同摄入而导致致命的结果，而其他果汁不会沉淀严重有害的食物-药物相互作用尽管有零星的病例报告。果汁-药物相互作用的程度可能与饮用果汁的量、水果品种、水果的类型、果汁饮用和药物摄入之间的时间、酶或转运蛋白的遗传多态性以及人体测量学变量。药剂师和卫生专业人员应适当筛查和教育患者潜在的不良果汁-药物相互作用，并帮助最大限度地减少它们的发生。青少年和老年人在服药期间服用果汁或食用新鲜水果应引起高度重视。同时，应该对这个有趣的问题进行更多的研究。青少年和老年人在服药期间服用果汁或食用新鲜水果应引起高度重视。同时，应该对这个有趣的问题进行更多的研究。青少年和老年人在服药期间服用果汁或食用新鲜水果应引起高度重视。同时，应该对这个有趣的问题进行更多的研究。

更新日期：2018-04-01

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