Should medication be taken with food?

From the Guidelines

Medication should not be taken with food, at least for levodopa-containing medications, as it can interfere with absorption and efficacy.

Key Considerations

• Levodopa competes with dietary large neutral amino acids for intestinal absorption and transport across the blood-brain barrier, reducing its effectiveness when taken with meals 1.
• Patients are advised to take levodopa-containing medications at least 30 min before meals to avoid interactions and maximize absorption and efficacy 1.
• A protein-redistribution dietary regimen, with low-protein breakfast and lunch and consumption of a second course with no quantitative restrictions in terms of protein only at dinner, can improve motor function and disability and increase the duration of the "ON" state in patients with motor fluctuations 1.
• Patients should undergo active monitoring when following a protein-redistribution dietary regimen to avoid potential complications, including weight loss, micronutrient deficits, hunger before dinner, and dyskinesias 1.

From the FDA Drug Label

Aripiprazole tablets can be taken with or without food. Aripiprazole can be administered with or without food Administration of a 15 mg aripiprazole tablet with a standard high-fat meal did not significantly affect the Cmax or AUC of aripiprazole or its active metabolite, dehydro-aripiprazole, but delayed Tmax by 3 hours for aripiprazole and 12 hours for dehydro-aripiprazole.

Medication Administration: Aripiprazole can be taken with or without food. The presence of food does not significantly affect the maximum concentration or area under the curve of aripiprazole, but may delay the time to reach maximum concentration by a few hours 2.

From the Research

Medication and Food Interactions

• Medications can interact with food, affecting their absorption, efficacy, and safety 3, 4, 5, 6
• Food-drug interactions can be classified into three types: pharmaceutical, pharmacokinetic, and pharmacodynamic 4
• The effects of food on medication can vary depending on the type of medication, the properties of the drug, and the individual's physiology 3, 5

Factors Influencing Food-Drug Interactions

• The type of meal, such as high-fat or standard meals, can affect the oral drug absorption rate and extent 3
• The timing of medication administration in relation to food intake can impact the efficacy and safety of the medication 5, 7
• Certain foods, such as grapefruit, dairy, and tyramine-containing foods, can interact with medications and affect their efficacy or increase the risk of adverse effects 4, 6

Recommendations for Medication Administration

• Some medications, such as opioids and nonsteroidal anti-inflammatory drugs (NSAIDs), can be taken without regard to food, while others may require administration with food to improve tolerability or reduce adverse effects 5
• Proton pump inhibitors, such as omeprazole and lansoprazole, are more effective when taken before a meal 7
• Patient counseling and collaboration between healthcare teams can help patients avoid food-drug interactions and optimize medication therapy 4, 6