Assessment of Drug-Food Interactions Knowledge among Pharmacy Students at AL-Muthanna University in Iraq
Downloads
Drug-food interactions (DFIs) are a critical yet often underrecognized factor in medication safety and therapeutic efficacy. Despite their significance, pharmacy students' knowledge regarding DFIs remains insufficiently explored, particularly in Iraq. This study aimed to assess the awareness and understanding of DFIs among undergraduate pharmacy students at Al-Muthanna University through a descriptive cross-sectional online survey conducted in August 2024. The questionnaire covered demographic data and evaluated knowledge across multiple DFI scenarios. Results from 94 participants revealed that while the majority demonstrated good awareness of common interactions—such as those involving tetracycline and dairy, or grapefruit and CYP3A4 substrates—knowledge gaps were evident in areas like warfarin and dietary vitamin K, or digoxin and fiber. These findings emphasize the necessity of integrating structured DFI education into the pharmacy curriculum to enhance future pharmacists’ competency in reducing food-related medication errors and improving patient counseling.
Frankel EH. (2003). Basic Concepts. In: Hand book of food-drug Interactions, McCabe BJ, Frankel EH., Wolfe JJ (Eds.) pp. 2, CRC Press, Boca Raton, 2003.
Won CS, Oberlies NH, Paine MF. Mechanisms underlying food–drug interactions: inhibition of intestinal metabolism and transport. Pharmacol Ther. 2012;136(2):186–201. doi:10.1016/j.pharmthera.2012.08.001.
Ayo JA, Agu H, Madaki I. Food and drug interactions: its side effects. Nutr Food Sci 2005;35(4):243-252.
Kirby BJ, Unadkat JD. Grapefruit juice, a glass full of drug interactions? Clin Pharmacol Ther 2007 May;81(5):631-633.).
Li P, Callery PS, Gan LS, Balani SK. Esterase inhibition by grapefruit juice flavonoids leading to a new drug interaction. Drug Metab Dispos 2007 Jul;35(7):1203-1208.
Li Y, Jiang X, Lan K, Zhang R, Li X, Jiang Q. Pharmacokinetic properties of rosuvastatin after single-dose, oral administration in Chinese volunteers: a randomized, open-label, three-way crossover study. Clin Ther 2007 Oct;29(10):2194-2203.
Bushra, Rabia, Nousheen Aslam, and Arshad Yar Khan. "Food-drug interactions." Oman medical journal 26.2 (2011): 77.
Ased, Sumaya, et al. "Clinically significant food-drug interactions." The Consultant Pharmacist® 33.11 (2018): 649-657.
De Castro WV, Mertens-Talcott S, Derendorf H, Butterweck V. Grapefruit juicedrug interactions: Grapefruit juice and its components inhibit P-glycoprotein (ABCB1) mediated transport of talinolol in Caco-2 cells. J Pharm Sci 2007 Oct;96(10):2808-2817.
McCabe BJ, Frankel EH, Wolfe JJ. (2003). Monitoring nutritional status in drug regimens. In: Hand book of food-drug Interactions, McCabe BJ, Frankel EH., Wolfe JJ (Eds.). CRC Press, Boca Raton. pp 73-108.
Genser D. Food and drug interaction: consequences for the nutrition/health status. Annals of Nutrition and Metabolism. 2008; 52(Suppl. 1):29–32.
Sathyanarayana TR, Yeragani VK. Hypertensive crisis and cheese. Indian journal of psychiatry. 2009; 51(1):65–6., Ngo AS-Y, Ho RY, Olson KR. Phenelzine-induced myocardial injury: a case report. Journal of medical toxicology. 2010; 6(4):431–4.
Boullata JL, Hudson LM. Drug-nutrient interactions: a broad view with implications for practice. J Acad Nutr Diet 2012;112:506-17.
Syed Faisal, Aman, et al. "Studies of food drug interactions." (2010): 313-320.
Coreg (carvedilol) package insert. Research Triangle Park, NC: GlaxoSmithKline; December 2008.
Boullata JL, Hudson LM. Drug-nutrient interactions: a broad view with implications for practice. J Acad Nutr Diet 2012;112:506-17.
Shils ME, Shike M. Modern nutrition in health and disease. Lippincott Williams & Wilkins; 2006.
Gosney M, Tallis R. Prescription of contraindicated and interacting drugs in elderly patients admitted to hospital. Lancet. 1984;324(8402):564–7.
Benni, Jyoti M., et al. "Knowledge and awareness of food and drug interactions (FDI): a survey among health care professionals." International journal of Pharmacology and Clinical Sciences 1.4 (2012).
Zaidi, Syed Faisal, et al. "A questionnaire-based survey to assess the level of knowledge and awareness about drug–food interactions among general public in western Saudi Arabia." Pharmacy 9.2 (2021): 76.
Degefu, Natanim, Melaku Getachew, and Firehiwot Amare. "Knowledge of drug–food interactions among healthcare professionals working in public hospitals in Ethiopia." Journal of Multidisciplinary Healthcare (2022): 2635-2645.
Alhubail, Sarah Abdullah, et al. "Healthcare Professionals and Undergraduate Students’ Knowledge Toward Drug-Food Interactions in the Eastern Region of Saudi Arabia." Journal of Multidisciplinary Healthcare (2023): 2883-2892.
Smith, Cole. "Food/Drug Interactions: Assessing student knowledge before and after viewing an interactive educational website." (2016).
Abualhasan, Murad, et al. "Pharmacists' knowledge of drug food administration and their appropriate patient counseling a cross-sectional study from Palestine." Journal of Health, Population and Nutrition 42.1 (2023): 99.
Smith, Cole. "Food/Drug Interactions: Assessing student knowledge before and after viewing an interactive educational website." (2016).
Alhubail, Sarah Abdullah, et al. "Healthcare Professionals and Undergraduate Students’ Knowledge Toward Drug-Food Interactions in the Eastern Region of Saudi Arabia." Journal of Multidisciplinary Healthcare (2023): 2883-2892.
Ghoneim MM, Hinrichs JV, Chiang CK, Loke WH. Pharmacokinetic and pharmacodynamic interactions between caffeine and diazepam. J Clin Psychopharmacol. 1986 Apr;6(2):75-80. PMID: 3517081.
Bailey DG, Dresser G, Arnold JM. Grapefruit-medication interactions: forbidden fruit or avoidable consequences? CMAJ. 2013 Mar 5;185(4):309-16. doi: 10.1503/cmaj.120951. Epub 2012 Nov 26. PMID: 23184849; PMCID: PMC3589309.
Hanley MJ, Cancalon P, Widmer WW, Greenblatt DJ. The effect of grapefruit juice on drug disposition. Expert Opin Drug Metab Toxicol. 2011 Mar;7(3):267-86. doi: 10.1517/17425255.2011.553189. Epub 2011 Jan 22. PMID: 21254874; PMCID: PMC3071161.
Agbabiaka, Taofikat B., et al. "Prevalence of drug–herb and drug–supplement interactions in older adults: a cross-sectional survey." British Journal of General Practice 68.675 (2018): e711-e717.
Boullata, J. I., and V. T. Armenti. "Handbook of Drug‐Nutrient Interactions." Nutrition & Food Science 41.6 (2011): 448-448.).
Radwan, Asma, et al. "Evaluation of community pharmacists’ knowledge and awareness of food–drug interactions in Palestine." International journal of clinical pharmacy 40 (2018): 668-675.
Syed Snr, Wajid, Adel Bashatah, and Mahmood Basil A Al-Rawi. "Evaluation of knowledge of food–drug and alcohol–drug interactions among undergraduate students at king Saud University–an observational study." Journal of Multidisciplinary Healthcare (2022): 2623-2633.
Degefu, Natanim, Melaku Getachew, and Firehiwot Amare. "Knowledge of drug–food interactions among healthcare professionals working in public hospitals in Ethiopia." Journal of Multidisciplinary Healthcare (2022): 2635-2645
Ismail, Mohammed Yahya Mohammed, and M. Yaheya. "Drug-food interactions and role of pharmacist." Asian J Pharm Clin Res 2.4 (2009): 1-10.
Zawiah, Mohammed, et al. "Food-drug interactions: Knowledge among pharmacists in Jordan." PloS one 15.6 (2020): e0234779.

