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Ingredients of Medications

Let's Take a Look at the Problem
If you are like most patients, you've gotten complimentary drugs from your doctor before that don't contain ingredient lists. Or, you have purchased medications and vitamins without understanding what certain ingredients are--or haven't even been able to find an ingredient list to begin with.
Well, here's the bad news. Even prescription medications intended to relieve people of their allergic symptoms often contain common allergens! Here are a few of the food products frequently found in allergy medications: corn, fruits (various), gelatin, milk, potato, unspecified flavoring, unspecified starch (grain) . . . and that's just the beginning.
Sadly and surprisingly, even your druggist, doctor and allergist may not know that food ingredients are present in medications. For example, when I went to pick up a prescription, the woman fulfilling it told me that a generic version of a certain painkiller would only have pain-medication in it (of course, it didn't). I knew she was wrong--but she didn't believe me when I tried to explain that medications are not "just" drugs. When I told another druggist asking what my allergies were that I had food allergies, he gave me a dirty look and said, "not that kind," as if they were totally immaterial.
People with serious food allergies can react to minute amounts of their allergens, and even the small amount present in medications can have an effect. According to Johns Hopkins, for example, it takes only 1/1,000th of a peanut to trigger a reaction in some individuals.
I first learned this through personal experience many years ago. Over the Christmas holiday of 1997 I was prescribed Claritin and Flonase. I had had them before and had a reaction, but I figured it was only some sort of mild drug reaction and that I would get better over time (though I have never reacted to drugs themselves before). The second time I was on these drugs things went much worse. On Christmas Eve I was seriously stricken with chills, diarrhea, shakes, temperature drop to 96.0, and vomiting -- and my parents wanted to rush me to the emergency room.
I investigated on the Internet and learned that Claritin contains lactose, which is milk-derived, and I am severely allergic to milk. On a RAST food allergy test, my milk allergy was so significantly high that it would not even register on the number chart. Our family doctor had never mentioned that food products were present, and the free samples came without package inserts (or lists of ingredients). I became so ill as a result of this lack of available information that--believe it or not--I missed half a semester of school. That is why I feel it is so important to share this information with others.

Investigating and Discovering the Ingredients

There are various ways to learn about the ingredients of your medications if you are unable to find them prominently displayed on your prescription. (Which is, sadly, sometimes bound to be the case!)
* I have found that with brand-name prescription drugs, often just typing in the drug name with a .com in the form of "[drug name here].com" in my web browser points me straight to the drug's website. I then have to do a lot of browsing within that page for the ingredient listing, sometimes listed under "package insert" or "chemical make-up."
* Internet search. Donnie uses search engine Google.com to find ingredients. "I put in the name of the drug...This usually gives me several pages to pick from. I often find the information right away." FAST member Anna Marie uses e-mail. "When I couldn't find out if my allergens were in a medicine I sent an e-mail after checking the company's website. I didn't want to open the package to check the insert, because then I couldn't get my money back." Donnie has also tried e-mail, but says that companies are not always good at answering.
* Package inserts. A lot of people throw away these long lists of side-effects and chemical make-ups without realizing the very information they need to know is also hidden within all the technical information. Check this package insert for the term "inactive ingredients." This is generally listed below "active ingredients," which is often by the chemical structure (drawing).
* Your physician. Doctors can pre-check ingredients using a desk reference (book) or Internet resource. However, there is a huge drawback to asking your doctor to check. I had a doctor do this for me during a visit to the ER for a severe ear infection. She worked very hard to find a suitable antibiotic, but when I went to pick up the prescription the pharmacist switched it on me. Pharmacists often switch prescriptions, giving patients generic versions of the medication, or a similar medication from a different company. While the active ingredient is the same, the inactive ingredients in generic/similar versions of medications are usually different. They may do this as a favor to save you money, because your insurance requires it, or because they don't have that specific brand in stock. However, it is not a favor when you have food allergies. Anna Marie says, "Since everything is computerized now, maybe you could mention to your pharmacist to note in your file not to substitute presciptions with generic brands. In Canada the doctor can mark that on the prescription, but it usually gets ignored."

Nothing Looked Bad...Am I Cleared to Take the Medication?

While reading the list of inactive ingredients you may have noticed some non-recognizable ingredients within that listing. Things such as caramel, flavors and starch may also possibly be your allergens, but they aren't specified clearly enough for the average consumer! If you noticed these or similar terms listed you may wish to contact the company further to find out what exactly they are. Please work with your doctor to find a suitable medication quickly, especially in the case of an infection or other serious matter.

The Problem with Health Food Supplements

Many health food supplements contain lists of what they do not contain rather than what they do contain. There are two problems with buying this sort of supplement.
* Products can (packaged prior to 2007; although it's possible this is still in practice or that old supplements still exist on shelves, since they have a long shelf-life) be called "non-dairy" even if they contain dairy derivatives--the very parts of milk that people with milk allergies are allergic to. Oddly, prior to 2007, something that said it was non-dairy generally meant it was free of lactose, and intended for people with lactose intolerance, not a dairy allergy! Similarly, these supplements cannot be trusted to be 100% free of what they claim they are, since products may be cross-contaminated, or the labeler may not have known that xanthan gum, for example, can contain corn. As a rule, I never trust labels of this sort.
* All of your allergens may not be listed. Say a medication claims to be free of your allergens milk and peanuts. That's great, but hey -- it might contain your worst allergen (let's say it's wheat). This type of labeling is confusing and not very helpful.

The Problem with Vitamins

It is worth mentioning vitamin supplements as well. These are different from health supplements in that these are accepted by mainstream medical doctors and sometimes "prescribed" (even though they're generally over-the-counter).
FAST member Kenny Silverman wants to send along "a warning about vitamins: Most if not all vitamins are derived from food, or contain a food product!"
Unfortunately, because we have food allergies we cannot trust that we are getting all we need through the food we eat. Doctors who are "in the know" will want to run various tests to check for vitamins and minerals and keep an eye on this situation, and may end up recommending supplements. How do you find supplements without food?
There's no easy answer. And yet, at the same time, ignoring this problem can result in serious issues, like bone loss and neurological damage.
If you have been frustrated by the lack of an easy answer, here are forms added to FAST (6/09) to encourage manufacturers to work more diligently at finding non-food ingredients and binders for vitamin supplements. In the meantime, speak to your doctor about how to tackle this problem.

Form for adults with allergies
Form for parents of children with allergies

And Yet . . .

Never remove a prescription medication from your diet without first consulting your physician. The results of stopping a prescription without first inquiring with your doctor can be catastrophic! It's also important to speak to your doctor about what types of supplements you should take. As people with food allergies, we are especially prone to missing certain ingredients in our diet. At the age of 30, for example, I was diagnosed with osteopenia. I attribute this to my dairy allergy and not having milk for so many years. Having allergies is not an excuse to refuse all drugs and supplements. Rather, it is a problem that drug companies and doctors need to address so that we can all take the drugs we need.

Please note that nearly every OTC vitamin, pill, and prescription medication will have INACTIVE ingredients in it! These inactive ingredients are derived from foods. Please inform your doctor(s) so that they can help you in your quest to avoid your allergens. If you have any questions, consult your doctor.

Article courtesy of FAST (http://www.angelfire.com/mi/FAST). This article is adapted from Food Allergy Survivors Together Handbook, registered copyright 2002. Because this is a registered copyrighted work, if you want a hard copy of this article, please support the book and purchase a copy from your local bookstore. Thanks! Find out more here.