Introduction
According to the US-Food and Drug Administration (FDA), the interaction between drugs and food or beverages can mainly affect the activity of drugs, either by increasing or decreasing their medicinal effects, causing unexpected side effects, or leading to the development of a new pharmacological effects that drugs would not produce originally (1-3).
Many people all over the world are used to taking their drugs with food, beverages, or herbs (4). For example, approximately, one in five Asian people take their medications concurrently with herbal products and juices (4). These products may contain chemicals that interfere with the prescribed drugs leading to changes in their bioavailability and alteration of their pharmacokinetic properties (5). People usually take their drugs with herbs or beverages such as juices seeking for health benefits or to taste-mask the bitterness of some drugs (6).
Some plants or herbs are well known for their ability to interact with drugs (5). The most common example is St. John’s wort (Hypericum perforatum ), which is used for mild depression and known for its interactions with various drugs (7). Examples of these drugs include antidepressants like serotonin reuptake inhibitors, immunosuppressants such as ciclosporin and tacrolimus, human immunodeficiency virus( HIV) medications, and hormonal contraceptives (2, 7). Ginkgo (Ginkgo biloba ), usually used to improve memory and blood circulation, can inhibit platelet-activating factor; thus, it is well-known for its interaction with warfarin resulting in an increased risk of bleeding (2, 8). In addition, since the discovery of grapefruit juice interaction with felodipine; an antihypertensive medication, many studies were conducted on other juices to investigate their tendency to perpetrate potential food-drug interaction (9-11).
Numerous patients do not mention the concurrent administration of their medications with food, beverages, or herbs to their physicians or pharmacists due to many reasons (5). Firstly, physicians do not usually ask their patients about their method of drug administration and the intake of other health products such as herbs or over-the-counter (OTC) drugs, as they usually focus on the patients’ conventional drugs (12). Secondly, physicians do not have enough knowledge about herbal remedies uses, side effects and drug interactions (13-15). Thirdly, either patients or their healthcare providers, do not consider natural products an important thing to mention (8). Finally, patients fear the potential disapproval of their healthcare providers regarding their use of non-prescribed drugs and herbs (16, 17). As a result, patients have fewer opportunities to learn about potential interactions with their drugs or other herbal products (5, 18).
Several studies were conducted to assess the awareness of healthcare professionals about simultaneous intake of food, beverages and herbal products with drugs (19, 20), However, there are a limited number of studies investigating the awareness of the public community toward such practice (21, 22), which can have serious health repercussions on individuals (23-25).
This is the first study assessing the extent of perception and use of food, beverages, and herbs alongside conventional drugs among Jordanian society.