Beverage Effects on drug disposition

Fluid intake
                       Drug absorption is affected by fluid intake. The rate of drug absorption may be decreased by intake of large volume of fluids such as soft drinks. Colas containing phosphate and sugar may decrease the rate of drug absorption because they delay the rate of stomach emptying. However, the efficiency of drug absorption may be increased by concurrent intake of beverages. Reasons include speedier dissolution of the drug, osmotic effects, or change in the surface area of the intestinal mucosa to which the drug molecules are exposed. Further, the temperature, composition and volume of beverage may also effect its absorption.

Milk and Milk Formulas
                                           Ingestion of milk has long been known to interfere with the absorption of tetracycline because insoluble chelates are formed between the drug and the calcium present in the beverages (Neuvonen et al. 1971). It has also been shown that milk decreases the bioavailability of the beta adrenergic blocking agent sotalol. It has been suggested that this effect may also be due to an interaction with calcium. In premature infants, a milk feed does not influence the total amount of theophylline absorbed, but decreases the rate of absorption, probably because of effects of the milk on stomach emptying. (Heiman et al. 1982)

Caffeine Containing Beverages

                                                    Caffeine is consumed not only in coffee but also in other beverages, including tea, colas, and other sodas. Monks et al. showed at elimination of methylxanthines, such as caffeine, from the diet led to faster and more extensive metabolism of theophylline. However, addition of extra methylxanthines to the diet did not significantly alter the disposition of theophylline. It has been suggested that even if there was a significant effect of caffeine on theophylline disposition, it may not be therapeutically important because most people do not materially change the caffeine content of their diet in an abrupt manner. Many who may change the caffeine content of their diets in the pursuit of general health as well as for the management of peptic ulcer, gastritis, rosacea and headaches.

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