Drug-nutrient interaction: Scientific backing is key to quelling concerns

17 Oct 2018 --- Growing consumer and industry awareness of potential drug-nutrient interactions is creating both challenges and opportunities for dietary ingredients companies. With chronic diseases on the rise and consumers keen to boost their diets with supplementation, suppliers have the opportunity to take a key position in providing the right scientific backing and information.

Drug-nutrient interactions are defined as physical, chemical, physiological or pathophysiological interactions between a drug and a nutrient. In some cases, the use of medication can cause certain deficiencies, which necessitate the supplementation of nutrients, but in other examples, dietary supplementation may bring about adverse effects to medication use.

“Drug-nutrient interaction is an important area, both for patients and doctors. Today we are experiencing a dramatic rise in the number of chronic [disease] patients, because big pharma was innovating over the past 30 years, creating a lot of life-saving drugs,” Araksya Topchyan, DSM Global Marketing Manager Pharma, tells NutritionInsight at CPhI Global in Madrid, Spain.

“A lot of patients have taken the same medicine day after day for 20 years, sometimes even 30 years. Some of the actions of these drugs, such as [creating] a deficit of vitamins and other nutrients, are only now reaching their clinical manifestation. This means that doctors are only now starting to observe these effects,” she adds.

A pertinent example are anti-diabetic products that can create vitamin B12 deficiencies. Following the first scientific publication of this effect in 2010, the scientific community has seen a sharp rise in the number of publications and clinical case studies.

“The US Diabetes Council paid attention to this problem for the first time last year and even revised their guide stating that patients taking metformin should also be observed for B12 deficiency. This is important because when we talk about diabetes and the low level of vitamin B12, we talk about diabetic neuropathy, a serious complication,” she notes.

“Spreading awareness of the prophylactic use of vitamin B12 or chronic use of anti-diabetic medications is important as this is how we prevent serious complications of this disease.”

Case examples of launched products building on the positive aspects of drug-nutrient interactions include Beyaz, which comprises contraceptive and folic acid, key to avoiding folate deficiency.

However, she notes, such examples as Beyaz are not that great in number and thus a fertile ground for industry cooperation and innovation.

“DSM today has a chance to use its cooperation with leading clinics and researchers, and pool these into vitamin research. Our focus is on vitamins and the interactions between common drugs and vitamins. We look forward to partnering with leading pharmaceutical players, [in health areas] where you have stated and proven science that the chronic use of the drug brings on a vitamin deficit,” she concludes.

Scientific backing
Speaking to NutritionInsight at CPhI Global, Cosimo Palumbo, Marketing Director at Indena, explains that suppliers must provide adequate information and scientific backing on their ingredients to support consumers looking to use supplementation while on medication.

“There is growing concern among consumers, particularly regarding those supplements that need to be taken on a continuous basis. An example would be turmeric, which is among the top five categories worldwide in terms of dietary supplement consumption,” explains Palumbo.
 
“The first question [for many consumers] is, if I am taking medications, will it be a concern? Can I take my medications and turmeric? In the case of Indena’s Meriva, since we claim a superior efficacy, we also wanted to create scientifically-based proof that you can take it in conjunction with the top classes of medications, such as anti-platelet agents as well as anti-coagulant agents, replacement therapy for hormones and some anti-diabetic medications. We are probably the first company, and the first brand with Meriva, to add particular evidence for our consumers and partners, to introduce this new element of substantiation,” he explains.

For particular classes of compounds that need to be taken on a continuous or prolonged basis to have an effect, supplement manufacturers should ensure additional safety documentation and guarantees, he notes. 

“We believe it’s important for supplement manufacturers to continue creating evidence of efficacy with human studies and evidence on safety. Safety needs to be taken a step ahead,” he concludes.

By Lucy Gunn