Nutrient–drug interactions in nutritional support

Abstract Objective: To review the types and potential consequences of diet/nutrient–drug interactions that can occur in patients receiving nutritional support. Data sources: A literature review was performed using Ovid multi‐database searching including Medline, Agricola and Biosis. Summary: Although very little information is currently available that pertains specifically to veterinary patients, we know from the human experience that food intake and diet composition can affect the absorption, distribution, metabolism, efficacy and toxicity of a drug. Conversely, certain drugs can alter the absorption of nutrients when administered in conjunction with food or act to antagonize nutrient metabolism or function. The different ways that incompatibility can arise between food or nutrients and drugs in patients receiving nutritional support and strategies for avoiding these problems are discussed. Conclusions: The consequences of diet/nutrient–drug interactions include decreased tolerance of nutritional support, loss of feeding access, decreased drug efficacy, nutrient malabsorption or malassimilation, and risk of drug overdosage. Therefore, when patients receiving nutritional support experience these types of complications, a review of the diet, route of nutritional support, drugs, and timing of feeding and medication administration are indicated.