Table 1 Circadian variations in pharmacodynamics and pharmacokinetics as well as drug–food interactions of commonly prescribed MS drugs

Baclofen

No effect [37].

Dantrolene

No effect [38].

Pregabalin

Consuming with food decreased C_maxby 25–30% and delayedt_maxby ≈3h [39].

Tizanidine

Simultaneous food intake with a tizanidinecapsule reduced C_maxand AUC_o–t by <20% and extendedt_max from 0.75 h to 1.5 h.

Extent of absorption is increased ≤20% relative to administration of the tizanidine capsule under fasted conditions.

In contrast,simultaneous food consumption with a tizanidinetablet increased C_max and AUC_o–t by22.6% and 45.2%, respectively [40].

The dosage forms of the tablet and capsule were not bioequivalent if administered with food.

Food increasedthe t_max and the extent of absorption for the tablet and capsule. However, the C_maxvalues of tizanidine achieved if administered with food were increased by 30% for the tablet but decreased by 20% for the capsule. Under fed conditions, the capsule was ≈80% bioavailable relative to the tablet.

Using tizanidine together with caffeine is, in general, not recommended. Combining these medications may significantly increase the blood levels and effects of tizanidine.

Gabapentin

High-protein food increased the AUC and C_maxby 26% and 32%, respectively [41].

Take extended release tablet with evening meal. Swallow whole; do not chew, crush, or split.

No significant effects on the rate or extent of absorption of the immediate-release tablet were noted. The rate and extent of absorption of the extended-release tablet was increased.

Carbamazepine

Serum levels of carbamazepine may be increased if taken with food and/or grapefruit juice.

Extended-release tablets should be administered with meals; swallow whole, do not crush or chew.

SSRIs

Paroxetine: peak concentration is increased, but bioavailability is not significantly altered by food.

Sertraline: average peak serum levels may be increased if taken with food.