Saturday, January 9, 2010

Are these medications gluten free?

A recap from Margaret Flower Smith's presentation at the January support group :

1. Visit this website maintained by a pharmacist knowledgeable about Celiac Disease:
Please note you can find this in the side bar under Helpful Links.

2. Examine the list of inactive ingredients. For non-prescriptions items it is on the labeling. For prescription items ask the pharmacist to review the "package insert" with you, or do a Google web search on the brand name product.

You are looking for the following "red flags":
*starch, modified starch
*pregelatinized starch
*sodium starch glycoate

OK items: cellulose and its many variations, povidone, colors, alcohol (medicinal alcohol is GF according to our GIG conferences and experts), dextrins (from corn).

3. If any "red flags" are found you need to contact the manufacturer and inquire about the source of the particular ingredient that causes you concern. Do NOT ask if "gluten" is in the product. Remember that the USA "starch" in medicines can be from corn, wheat, potato or tapioca/cassave. It's best to ask what the botanical origin of the starch used in the filler is.

4. Other sourcesof information about GF status of meds:

PDR (Physician Desk Reference), often in the physician's office or in a public or in a public library, may have the "inactive ingredient" list from the package insert.

Clan Thompson's - see their extensive Celiac site for print and electronic media such as:
Clan Thompson Pocket Guide to Gluten Free Prescription Drugs
Clan Thompson Pocket Guide to OTC Meds

5. General principles about gluten status of meds:
*Gluten must be ingested to cause a reaction. Wash hands after using topical products.
*Topical products are not toxic.
*Medicinal alcohol is GF.
*When in doubt, don't use it.
*Ask the manufacturer
*Identify the ingredients

6. When presenting a new prescription to the pharmacy, ask to speak to the pharmacist to clarify the gluten free status BEFORE it's filled. See the Package Insert for the list of inactive ingredients (see #2). If you cannot determine the source of the offending ingredient, ask the pharmacist to suggest a substitute that IS gluten free. Ask pharmacist to contact the physician to suggest a change.

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