Combining medicines with the right food could improve the effectiveness of drugs and dramatically lower the rapidly rising costs of treating patients, experts say.
University of Chicago oncologists Mark Ratain, MD, and Ezra Cohen, MD, have released their expert comments after examining research that showed taking a breast cancer drug with fatty food, rather than on an empty stomach, enhanced absorption of the drug.
Previously experts have warned of the potential dangers of interactions between food and drugs i.e. they could lead to drugs becoming toxic, or less effective.
But Ratain and Cohen argue that results like this one should point researchers toward a partial solution, a novel way to decrease medication costs while increasing benefits from these effective but expensive drugs.
The study found that taking the drug with a meal increased the bioavailability of the drug by 167 percent. Taking the drug with a high-fat meal boosted levels by 325 percent.
"Simply by changing the timing, taking this medication with a meal instead of on an empty stomach, we could potentially use 40 percent (or even less) of the drug. Since lapatinib costs about $2,900 a month, this could save each patient $1,740 or more a month," Ratain said.
He added that drinking grapefruit juice, which is known to boost the rate at which some drugs enter the blood stream, at the same time could increase these savings to 80 percent.
"We expect the one 250 mg lapatinib pill accompanied by food and washed down with a glass of grapefruit juice may yield plasma concentrations comparable to five 250 mg pills on an empty stomach," Ratain said.
And eating such "value meals" at the same time as taking drugs could have other benefits too, the authors add.
For example, the major toxicity associated with lapatinib is diarrhea, probably caused by unabsorbed drug. So taking a lower dose with food should "reduce the amount of unabsorbed drug, and therefore theoretically also reduce the frequency and severity of diarrhea."
But the authors warned patients against trying these experiments on their own, calling instead for more research to gauge the effects of drug-combinations on patients.
"The one thing that should not be anticipated is an efficacy study by lapatinib's sponsor," the authors write.
They are currently conducting such a study of their own, testing the consequence of combining a drug with grapefruit juice, and have called for more such studies to be carried out.