is this Escitalopram gluten-free?

[windingshores]

My daughter has managed to avoid being glutened for 3 years. She has celiac and type 1.  She has had watery diarrhea for two and a half weeks, and that is the time frame for when her pharmacy switched the manufacturer of her Escitalopram. Could this have gluten in it? The ingredients all seem to check out! Thanks!  (ingredients below)

 

Escitalopram oxalate occurs as a fine, white to slightly-yellow powder and is freely soluble in methanol and dimethyl sulfoxide (DMSO), soluble in isotonic saline solution, sparingly soluble in water and ethanol, slightly soluble in ethyl acetate, and insoluble in heptane.

Escitalopram oxalate is available as tablets.

Escitalopram tablets, USP are film-coated, round tablets containing escitalopram oxalate in strengths equivalent to 5 mg, 10 mg, and 20 mg escitalopram base. The 10 and 20 mg tablets are scored. The tablets also contain the following inactive ingredients: croscarmellose sodium, microcrystalline cellulose, hypromellose, colloidal anhydrous silica, magnesium stearate and talc. The film coating contains hypromellose, titanium dioxide, and polyethylene glycol.

 

 

[cyclinglady]

It looks to be gluten free.  She could be reacting to any of the ingredients.  Notify the prescribing doctor.  She may need a different medication.  Also, when was the last time she had follow-up celiac disease testing?  This would help let you know if gluten was actually in her diet.  

[RMJ]

That does not read like information from a package insert or manufacturer.  Who is the actual manufacturer?  Many companies make the generic and they might not all use the same inactive ingredients.

[windingshores]

Accord Healthica. I have checked all the ingredients to the extent possible. This is in fact excerpted from the insert.

We are well aware that more than one company makes this and that they may used different ingredients. If that were not true, I would not have a question!

The drug store used a different manufacturer than she usually gets and her illness coincides with the dates she has used this med. We are actually hoping there WAS gluten to explain and address the symptoms.

 

 

Edited November 3, 2018 by windingshores
expanded

[RMJ]

You could try calling the manufacturer.  The ingredients look fine but there is always a chance for contamination. 
Accord Healthcare Inc,

1009 Slater Road, Suite 210-B,
Durham, NC 27703

(919) 941-7879
 

[windingshores]

Thanks, it is the weekend and things are getting a bit desperate. I will call the manufacturer but doubt they will admit to contamination! But thanks for the phone number.

[ravenwoodglass]

Call your doctor's office in the morning and tell them what is going on. The doctor can reissue the script and then contact the pharmacy and tell them that you need that med from the maker you used before.

It is also possible that she may have something else going on. Having watery D for that long is a concern. You want to be sure it was the med and not that she has food poisoning or something else going on. The doctor may want to see her to rule out other issues. I hope she improves soon.

[windingshores]

My daughter has already been to the pharmacy to get her old med, and has already been to the doctor for blood tests and stool samples.

No offense, but I was just thinking that maybe someone here recognized one of those ingredients as having caused trouble, regardless of info online. It was kind of a specific question.

Believe me, we are pretty sophisticated users of the health care system.

Thanks.

 

 

[cyclinglady]

I am sorry, but  I did not mean to say that she was getting gluten into her diet via food.    I meant that by testing her antibodies, you could confirm if she was having a gluten reaction.  Then that would help you determine if the medication might be the culprit if she has not made  any dietary changes.

One of the side effects reported from this drug (Drugs.com) is severe diarrhea.  So, again, the inert ingredients might be the culprit.  Personally, if I consumed polyethylene glycol which was in the ingredient list, I would have diarrhea.    It is the same ingredient found in Miralax which I will never take again (took it while My hubby was in the hospital) no matter how constipated I become.  

It is not common that pharmaceuticals contain gluten now.  I think more manufacturers are aware of celiac disease, but are not willing to test and insure they are gluten free.  They lobby hard in Washington DC.  It is the reason why it is safer to buy a Kraft or Nestle food product than a drug.  What is not being discussed is the source of raw materials and the actual manufacturing location of drugs.  About 60% of all generics are made in India and China.  Six hundred companies in India alone and only 23 FDA Inspectors.  Efficacy and safety is a huge concern, but no one is talking about it.  We all like our cheap generics.  

I had to verify every single drug that was given to my hubby with the hospital pharmacist.  It took a lot of time but they were great about it.   I knew more about gluten than they did.  

I do not mean to hyjack this thread with this topic though.

I can say from personal experience that I have been glutened a few times despite that I have managed this diet for 18 years. (Hubby gluten free 12 years before me).  Each time I suspect, like you either a new medication (in my case an antibiotic) or eating away from home which I rarely do as the risk is high.  I sincerely hope you figure it out and please, please, let us know the outcome.  It may help someone else.  

[windingshores]

Thank you so much for this response. My daughter checks with pharmacists before taking anything and has never been glutened by a medication (except in a ICU!). But the proplylene glycol is something I am sensitive to and is a good point. Contamination of the meds considering the source is also something to think about. She is going back to her MD and will ask about getting tested for exposure.

This watery diarrhea with food going through whole is what she has experienced in the past with gluten, and also an increase in migraine problems in the last 3 weeks. Very suspicious.

She has had blood work and almost did the stool samples at the MD's. She was ready but the nurse told her she was next in line and would have to wait to get a container. My daughter said "If I could wait for a container I wouldn't be here!" so she lost her chance. Tomorrow, we hope. She is a fashionable late 20 something and is wearing Depends.

I will certainly let this forum know what happens and hope it can be helpful if relevant to others. Thanks again!