Designing experiments for food-drug synergy: Health aspects

The prevalence of food-drug synergy that occurs in the hospital or at home is unknown. However, with over 80% of the U.S. adult population consuming at least one prescription drug, herb, supplement, or over-the-counter drug during the previous week, and 50% consuming at least one prescription drug per week,1 the concern is raised about the increasing potential occurrence of adverse food-drug synergy. In this chapter, “food-drug synergy” refers to the interaction of a food (or food components) and a specific drug (or drugs) conferring a greater health benefit or adverse reaction than either the food (or food component) or drug alone. However, other chapters in this book expand this definition to include additive effects of multiple foods, or foods and drugs, to result in a health benefit; or the ability of a food or drug to attenuate an adverse effect of a food or drug. The majority of these interactions are pharmacokinetic interactions, such that a single food or beverage or combination of foods may change the absorption, bioavailability, or metabolism of a drug resulting in its decreased effectiveness or enhanced absorption, which may or may not be desirable. Furthermore, individual characteristics, such as age, gender, weight, and health status, may also change the action of a consumed food and/or drug. Thus, in addition to the individual characteristics, a significant adverse or beneficial health outcome may potentially occur when a food or beverage and drug are consumed together.