Tips for Celiacs – Poison in the Medicine Cabinet
When people take medicine, they do so with the intention of improving their health or maintaining good health. They certainly do not expect to poison themselves with it, yet if celiacs take medicine that is not gluten free, the medicine can act as poison to their bodies just as surely as gluten-bearing foods can. Drugs and vitamin/mineral supplements, whether prescription or over-the-counter (OTC), are composed of active and inactive ingredients. Active ingredients, the chemical components that we consume in order to improve or maintain health, generally are not sources of gluten. However, inactive ingredients, also called “excipients,” used as binders, fillers, carriers, and dusting powders may contain gluten. Therefore, it is imperative that celiacs be diligent to verify that all prescription medicines, over the counter drugs, and vitamin/mineral supplements that they take are gluten free.
Admittedly, it is a bit of a chore to have to research everything that one eats, but in the case of drugs, the matter is complicated by the fact that ingredients often have unfamiliar chemical names, such as “carboxymethylcellulose” and “sodium starch glycolate.” Furthermore, there is no assurance that the manufacturer did not use a gluten-containing dusting powder on the conveyor belts or on the drugs themselves, as there is no regulation requiring dusting powders to be listed as ingredients. The situation is made worse by the fact that the rules that apply to food ingredients do not necessarily apply to drugs and supplements. For instance, US regulations require that the word “starch“ when used without modifiers refers only to cornstarch in foods. The regulation does not apply to “starch“ in pharmaceuticals. In spite of these difficulties, however, it is possible to determine if medications and food supplements are gluten free.
In the case of vitamin and/or mineral supplements and OTC drugs, the simplest way to determine if a particular product is gluten free is to contact the manufacturer by phone, by e-mail, or through the manufacturer's Web site. Most brand name products have a toll-free phone number printed on the package; some also list a Web address where one may be able to find gluten information. A manufacturer's statement that a product is gluten free not only provides the consumer with assurance that the ingredients themselves are gluten free, but it is also an assurance that the product is free from other forms of gluten contamination.
For prescription drugs, contacting the manufacturer directly may not be a simple solution. For one thing, if the drug is generic, the celiac will first have to find out which company manufactured it. Whether the drug is brand name or generic, the celiac will need to find the pharmaceutical company's phone number, and he should also obtain the drug's lot number and expiration date in case that information is needed to check the product's gluten-free status. Even when the celiac patient is armed with all of this information, he may call and discover that the pharmaceutical company representatives will speak only with pharmacists. Therefore, it is often easier to enlist the aid of the dispensing pharmacist from the start, asking him or her to contact the pharmaceutical company to determine whether a medication is gluten free. A Pharmaceuticals Guide will help in communicating the celiac patient's needs to the pharmacist.
It is possible for medications and food supplements to contain gluten. Therefore, it is important for celiacs to review all prescription medications, OTC drugs, and food supplements that they take to make sure they are all gluten free. These include analgesics (aspirin, baby aspirin, acetaminophen, and ibuprofen products), cough/cold/allergy/flu preparations, gastrointestinal relief products (for heartburn, diarrhea, constipation, etc.), and all vitamins and minerals (multi-vitamins, vitamin C, calcium, and so on).
Are there poisons in your medicine cabinet?
For more information, the article “Gluten in Pharmaceutical Products” by Sister Jeanne Patricia Crowe, Pharm.D., R.Ph. and Nancy Patin Falini is available online at http://www.medscape.com/viewarticle/406948.
