Fig. 1.

Drug-nutrient interactions: influencing factors, possible pathways, and potential effects on the micronutrient balance. Risk for drug-nutrient interactions can be affected by many precipitating/influencing factors. These factors are related to individual characteristics (e.g., age, gender, medical history, genetic profile), remedies (pharmacokinetics, pharmacodynamics), and micronutrients properties (nutrikinetics, nutridynamics). Frequently, DNIs are bidirectional in their outcomes. Drugs can potentially influence the metabolism of micronutrients in multiple ways, from their intestinal absorption to their cell bioavailability. Intermediate pathways include a wide range of alterations in physiological processes such as increase in gastrointestinal motility (e.g., induced from metoclopramide, erythromycin, and cisapride) and thus limited absorption and increased nutrient loss. As a result, the micronutrient balance is affected and elimination may occur in severe and prolonged DNI, when a drug impairs/inhibits micronutrient absorption or metabolic functions