Effect of Fruit/Vegetable-Drug Interactions on CYP450, OATP and p-Glycoprotein: A Systematic Review|
Mallhi, Tauqeer Hussain; Sarriff, Azmi; Adnan, Azreen Syazril; Khan, Yusra Habib; Qadir, Muhammad Imran; Hamzah, Azhar Amir & Khan, Amer Hayat
Purpose: To review the concomitant use of certain drugs with fruit/vegetable juices that may lead to
drug-juice interactions resulting in medication-related problems.
Method: In this systematic review, online databases (PubMed, Google Scholar and Science Direct)
were searched for information on juices derived from fruits and vegetables that are reported to have
inhibitory effects on cytochrome P450, p-glycoprotein and organic anion transporting polypeptides
Results: Fruits can inhibit CYP1A1, CYP1A2, CYP1A4, CYP3A1, CYP3A4, CYP2C6, CYP2C9,
CYP2E1 and drug transporters (P-glycoprotein, OATP). On the other hand CYP1A1, CYP1A2,
CYP2A2, CYP3A1, CYP1B1, CYP2B1, CYP2B2, CYP2C1, CYP2C6, CYP2E1 can be inhibited by some
vegetables. Antihypertensives, antidiabetics, statins, analgesics and antipsychotics were the most
common drugs interacting with fruits and vegetables. The inhibition of their metabolism by fruits and
vegetables can cause serious toxic effects, e.g., hypertension, poor glycemic control, rhabdomyolosis
and drug overdose-related toxic effects. Overall, active components of fruits and vegetables can interact
with many drugs leading to adverse effects.
Conclusion: Screening of fruits/vegetables for possible risk of interaction, and patient counseling are
some effective strategies for preventing such interactions for optimal patient care.
Fruits and vegetables; Cytochrome P450; Drug interactions; p-Glycoprotein; Organic anion transporting polypeptides