Drug side effects and toxicity and often the drug efficacy are highly dependent on drug metabolism
determining the activation and/or elimination of the respective compound. In humans, cytochromes
P450 are the most important drug metabolizing enzymes of the first phase of drug
biotransformation. Their activity can vary due to interindividual genetic differences, but it can be
changed also by inhibition or induction of the enzymes by their substrates or other compounds that
are not only drugs themselves and/or drugs taken concomitantly. Often, influence on drug
metabolism by compounds that occur in the environment, most remarkably in the food, is forgotten.
Some commonly used herbs, fruits as well as e.g. alcohol may cause failure of the therapy up to
serious alterations of the patient’s health. This review presents a brief overview of potentially
dangerous nutrition factors including herbs (incl. teas, infusions) that should be considered when
indicating individual drug therapy. Examples include primarily grapefruits, pomelo, star fruit,
pomegranates and some other fruits, St John’s Wort (Hypericum perforatum), caffeine, as well as
alcohol and cigarette smoking.
cytochrome P450 – CYP – food – interaction – drug