title: Is a flavonoid-rich diet with steamer cooking safe during calcineurin inhibitors therapy?
abstract: OBJECTIVE
  Dietary therapy is recommended for decreasing the symptoms of the metabolic syndrome and the risk of type 2 diabetes and cardiovascular diseases in subjects on calcineurin inhibitors. However, food-drug interactions may occur particularly with patients on such immunosuppressive therapy. This article comments on the benefit/risk assessment of a flavonoid-rich diet and steam-cooking of such food during calcineurin inhibitors therapy.
  
  
  CONCLUSIONS
  Patients are commonly advised against consuming citrus fruits and juices, grape juice and green tea. High vegetable intake may however increase the risk of food-diet interactions by inhibiting drug metabolic enzymes and transporters. Vegetable glucosinolates are potential interactants and may lead to adverse effects of drugs with narrow therapeutic indices and in the presence of genetic polymorphism. Examples of food components with potential drug interactants include all members of the Brassicaceae family.
  
  
  CONCLUSIONS
  The potential additive and synergistic effects of flavonoids with other molecules in interfering with drug bioavailability need to be taken into account. The risk is highest with drugs with a narrow therapeutic index and in subjects with genetic polymorphisms of proteins involved in the disposition of those drugs.
authors.affiliation: Department of Physiology and Pharmacology "V. Erspamer", "Sapienza" University of Rome, Rome, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Peluso
authors.forename: M
authors.initials: M
authors.lastname: Palmery
mesh_terms: D065095:Calcineurin Inhibitors / Q000378:metabolism*; D003296:Cooking; D004032:Diet; D005419:Flavonoids / Q000378:metabolism*; D018565:Food-Drug Interactions; D006801:Humans
chemical_list: D065095:Calcineurin Inhibitors; D005419:Flavonoids
keywords: calcineurin inhibitors; flavonoids; food-drug interactions; steamer