Prescription Medication Insecurity

[Guest hungryman]

Whenever I start a new medication, I try to check it out to make sure it is gluten free. To date I have been gluten free, but recently ran into a difficulty.

When checking out a new set of medications, I found one to which the manufacturer, Glaxo Smith Kline, said they are not sure if it is gluten free.

It is called Combivir and is a combination of two drugs that can be obtained seperately. I know the individual drugs are gluten free.

I have taken Combivir, and I don't think I have had problems from it. But I can't be sure because the drugs can cause problems similar to being glutened.

So, should I switch to the individual drugs or stick with the combination pill?

[psawyer]

In my experience, it is quite rare for gluten to be intentionally included in a pharmaceutical product.

Most manufacturers purchase raw ingredients, such as corn starch, from outside suppliers, and do not test them for possible cross contamination. So if you ask, they are unable to guarantee (be sure) that it is gluten-free. Unless they test everything they buy from someone else (and even what the make themselves) they cannot be "sure" that it is gluten-free.

These statements are couched the way they are to protect the company from liability issues if at some point there is cross contamination present. If a pharmaceutical manufacturer says they don't have any known gluten ingredients, then that is sufficient for me.

I would use the product.

[mysisis]

I was able to obtain information last month from the research department of an insurance company. curiously, when they were my insurance company they had no knowledge about gluten in medication, but as soon as i switched companies, they were quite helpful and provided me with this information. It says:

"The FDA does not require any mention of gluten in drug labels. Most of the gluten in drugs comes from inactive ingredients obtained from whole grains, grain flour or starch grain. Inactive ingredients such as starches that are derived from corn or potato sources should be acceptable(unless there is a contamination with gluten); unspecified or "pregelatinized" starch , dusting powder or flour may be derived from wheat. The source of an inactive ingredient can be changed without changing the label.

Sweeteners used in pharmaceutical products may also be sources of gluten. Uncontaminated sucrose, honey, detrose, fructose and corn syrup solids should not be problematic."

It goes on that : fillers "should be acceptable if not contaminated with gluten."

Then it gets to the meat and potoes of the matter:

"what manufacturers know: some pharmaceutical companies that responded to a survey reported that they believed their products were gluten free but could not guarantee it, in part because the supliers of the raw materials could not guarantee that their materials were gluten free. OBTAINING gluten-free drugs- information about the gluten content of phamacuetical products can be found on websites such as www.glutenfreedrugs.com. However, it may also be advisable to ask the manufacturer whether a specific product is or continues to be gluten free. In making these inquiries, providing the drug's lot number is generally helpful. If all else fails, a compounding pharmacy may be able to provide gluten-free products." Then, their "CONLUSION-Gluten in drugs as well as in food & cosmetics can be a problem for patients with celiac disease. Drug labels may not be helpful because the source of inactive ingredients can be changed without ghanging the label. Even some manufacturers may not know whether their products are gluten-free."

OK- so that is what the insurance provider has!!! Very illuminating! I recall there was an article in the last month or 2 on one of the celiac sites about just this thing. It was about the "excipients" in medicines and had info to print out for your pharmacists; you may be able to find it in a search. I've been wrestling with getting the new insurance company to give me name brands, because the generics keep changing their excipients, and the pharmacy has to go with whichever generic company they are commanded to go with, which makes me a neverending guinnea-pig. There is a list of the name brands that are gluten free, but the generics are forever ghanging their recipes. Besides the perfumes or possible cross cotamination possibilities, here are the ingredients that COULD be possible problem causers. DEXTRIN (can be from rice or tapioca or WHEAT-and they don't have to say -or may not even know), MALTODEXTRIN (obtained from corn, potato or rice, or WHEAT and again they may not know and the label won't differentiate), PREGELATINIZED starch(from corn, potato, tapioca, or WHEAT, same story), SODIUM STARCH GLYCOLATE & SODIUM SALT OF CARBOXYMETHYL (usually from potato, corn or rice but can be from WHEAT, and again same thing.) Now, If the drugs you are taking are specifically on the "glutenfree list", then they are fine, and if they do not have these ingredients then the only risk should be any crazy cross contamination. BUT, depending on your sensitivity level, these ingedients are the potential problem causers. What my Dr. has done to try to get the co-operation of the insurance company, is to list these items as medical allergies. It's a long shot, but they do not seem to be getting the concept that they are poisoning me. Some months more than others. The problem you MAY be having is when 2 drugs are combined, sometimes they use a binding agent, and depending on what that binding agent is, it could be problematic for you. I hope that some of this help you. Sorry it's so doggone long though.

[slmprofesseur]

I asked the Kroger pharmacist about some Gluten-free vitamins for my ds. He laughed, yes laughed and shrugged saying there was another lady wanting to know if her prescription medication was Gluten-free. I don't like to go there when he is working to say the least@!!!!

[mysisis]

The kroger affiliate here did the same thing to me. The CVS pharmacist said, "oh, I know ALL abaout Gluten! But it is no t in ANY medications !!!! " Then I went to ocso/albertsons (who I really do not like); they have 2 pharmacists. They rotate weeks. There's a guy on even number weeks who is a... hmm, let's say he knows everything about something but I haven't figured out what that might be. I have circle his work days on my calendar and will not call or go in if he is working. Then there is the other guy. He is BRILLIANT. He is one of those genius type guys that you just know excelled at physics and chemistry, and probably sits at home reading periodic charts for entertainment.He was completely open to the information. He had heard of celiacs but wasn't too familiar with it. When I would find PERTINANT information that applied to him as a pharmacist, I would print it out and take it to him. He has gone out of his way to follow along. Yes, I have guided him I ask him for the package insert for EVERY medication, and together we go through the ingredients to see if any of the items are on the list of possible problem-causers. He has gotten to where he will have already checked the list by the time I go to pick up my meds. If there is a possible problem, h e will try to find a brand or manufacturer who doesn't use the same recipe.

Together we are trying to work the glitches out of the medication drama. The cannot give a diabetic meds with sugar, they shouldn't be able to give wheat to people with wheat allergies.

I'm glad I shopped around for a pharmacist rather than a pharmacy. I don't like the pharmacy, but this Pharmacist is worth his weight in gold!!!