Fundamental Concepts of Interactions between Drugs and Foods or Nutrients

Abstract

Drug interactions are a critical factor directly associated with variability in therapeutic efficacy and the occurrence of adverse reactions to medication. Increasing attention is now being paid to interactions between drugs and foods, nutrients, dietary supplements, alcohol, and tobacco products. This review systematically examines drug-food interactions from pharmacokinetic and pharmacodynamic perspectives, focusing on their fundamental concepts, classification, and underlying mechanisms. Particular emphasis is placed on the effects of food intake on drug absorption and metabolism, interactions mediated by drug-metabolizing enzymes and transporters, and the understanding of food effects based on drug solubility and membrane permeability or metabolic characteristics, as outlined in the Biopharmaceutics Classification System and the Biopharmaceutics Drug Disposition Classification System. In addition, the bidirectional relationship between drugs and nutritional status is reviewed. Although evaluation of drug-food interactions is challenging due to the diversity of food components and interindividual variability in dietary habits, application of established frameworks for drug interaction assessment facilitates deeper understanding and appropriate risk evaluation. This review is expected to contribute to further research on drug-food interactions and to the optimization of pharmacotherapy.