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Celiac.com 05/13/2015 - In addition to being a common ingredient in many commercial food products, gluten is also used in numerous medications, supplements, and vitamins, often as an inert ingredient known as an excipient. Because chronic gluten-related inflammation and damage impairs absorption of nutrients, and likely causes malabsorption of oral medications, it is extremely important for people with celiac disease to review the nutrition labels of all foods and beverages, as well as the package inserts (PI) for information about gluten content. Most oral medications depend on absorption through the small intestine via passive diffusion. GI-tract damage may shift this diffusion process into systemic circulation, which can result in increased or decreased absorption, depending on the drug molecules. Since drug molecules have varying and unique chemical properties, it is hard to determine the exact means of drug absorption in celiac patients, and also hard to determine the impact of celiac disease on drug absorption. Based on their molecular properties, researchers suspect the absorption of a number of drugs is impaired by gluten sensitivity. These drugs include: acetaminophen, aspirin, indomethacin, levothyroxine, prednisolone, propranolol, and certain antibiotics. For these reasons, it is important for doctors to monitor serum drug levels for medications with narrow therapeutic indexes in people with celiac disease. If you have celiac disease, please let your doctor know before you take these drugs. Source: US Pharmacist. 2014;39(12):44-48.