People with medical conditions such as celiac, non-celiac gluten sensitivity, or food allergies should know that they may not be sensitive or allergic to the medicine to which they reacted. Rather, their reactions may have been from the food contents in the drugs.
FDA regulations requiring the clear labeling of all food contents and elimination of food ingredients, where possible, in medication would be helpful to these populations.
Unfortunately, the Gluten in Medicine Identification Act of 2012 (HR 4972) failed, despite congressional offices receiving 6,200 letters in 72 hours to support the act, according to Marilyn Geller, chief operating officer/national executive director of the Celiac Disease Foundation. Despite that, she still has hope for legislation at a later date.
The Food Allergy Research and Education (FARE) continues to dialog with the FDA on labeling food allergens in medicine, according to spokesperson Veronica Brown. "This year, we are compiling data from families and health care providers on the scope of the problem," she says. Awareness of food in medicine among health care providers "varies tremendously," according to Brown.
Steven W. Plogsted, Pharm.D., of Glutenfreedrugs.com says that corn is the most popular starch in medicines, followed by potato. He says that gel capsules are predominantly made from an animal source, unless they are made kosher. Eggs can be a problem in both oral and injectable drugs, he notes.
Plogsted sent along an extract of a drug label for a progesterone prescription drug that showed peanut oil, gelatin, and soybean as ingredients.
Over-the-counter nutritional supplements present more of a problem because they often contain grasses, which may be processed in such a way that the finished product contains gluten, says Cynthia Kupper, executive director of the Gluten Intolerance Group (GIG) of North America.
Plogsted agrees that supplements, which are not regulated by the FDA in the same way that prescription medications are, pose a greater risk than prescription medications. With regard to medication, Plogsted says, "I have researched countless medications and the incidence of gluten contamination in medicines [is] extremely small."
But it may not be only gluten that causes gastrointesinal symptoms. "Artificial sweeteners in medications can sometimes cause digestive issues, which may mimic symptoms of celiac disease," says Alice Bast, founder and president of National Foundation for Celiac Awareness (NFCA).
"We need to know what's in our medication.. .and then we want it removed," says Bast.
As for the FDA, which continues to look into the problem of food in medicine, a spokesperson said:
Drug labeling identifies active ingredients and generally includes a list of inactive ingredients ... There are no special rules whereby substances that are also used as food ingredients need to be identified. Anyone sensitive to a particular ingredient should read the label and check with the drug's manufacturer if they have specific questions.
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