Food-drug interactions precipitated by fruit juices other than grapefruit juice: An update review.
Food-drug interactions precipitated by fruit juices other than grapefruit juice: An update review.
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DOI：
10.1016/j.jfda.2018.01.009
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发表时间：
2018-04
影响因子：
3.6
通讯作者：
Zhou, Quan
中科院分区：
文献类型：
--
作者：
Chen, Meng;Zhou, Shu-yi;Fabriaga, Erlinda;Zhang, Pian-hong;Zhou, Quan
本文综述了基于随机对照试验（RCT）的葡萄柚汁以外的果汁引起的药物相互作用。通过检索PubMed、科克伦图书馆、Scopus和Web of Science识别文献，直至2017年12月30日。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研究了药代动力学相互作用，而7项RCT研究了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。有益的组合包括橙子汁-富马酸亚铁，柠檬汁-99 mTc-替曲膦，石榴汁-血液透析期间静脉内铁剂，蔓越莓汁-三联治疗药物。幽门螺杆菌，蓝莓汁-依那西普，酸橙汁-抗疟药，小麦草汁-化疗。潜在的不良相互作用包括药物生物利用度降低（苹果汁-非索非那定、阿替洛尔、阿利吉仑;橙子汁-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），生物利用度增加（塞维利亚橙子汁-非洛地平、柚子汁-环孢素、橙子-含铝抗酸剂）。富含呋喃香豆素的葡萄柚汁主要通过强烈抑制细胞色素P450 3A 4同工酶和P-糖蛋白而引起药物相互作用，因此与某些药物共同摄入会导致致命结果，而其他果汁则不同，尽管有零星的病例报告，但不会引起严重有害的食物-药物相互作用。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和人体测量变量有关。药剂师和卫生专业人员应适当筛查和教育患者有关潜在的不良果汁-药物相互作用，并帮助尽量减少其发生。青少年和老年人在药物治疗期间饮用果汁或食用新鲜水果应引起高度重视。同时，对这一有趣的问题还需要进行更多的研究。
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.
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