As if following the gluten-free diet isn’t tough enough when we feel good, but having to make sure that medication is also gluten-free can be a challenge. Over-the-counter meds don’t seem to be as much of a problem in my experience. Some OTC companies even label their medication “gluten-free” on the bottle. I find the most trouble with prescription medication.
There is a website is maintained by Steve Plogsted, a pharmacist at Nationwide Children’s Hospital here in Columbus, Ohio, that lists hundreds of gluten-free drugs. I have used this resource a countless number of times to check medications that have been prescribed for myself or Jon. There is a new update on the top of the page that I feel that it is important to pass on:
Some drug companies have been telling people that some of the drugs that they manufacture contain gluten. When I investigated their claims it appears that the reason they are blatantly claiming that their drugs are contaminated is because they have used a sugar alcohol as an excipient.
Sugar alcohols are not truly sugars or alcohols rather they are carbohydrates that provide a source of calories. The sugar alcohols are naturally found in a number of fruits and vegetables and may be extracted from many sources including any starch, including wheat. During the manufacturing process they are completely refined leaving behind no gluten proteins similar to making table sugar. The mostly widely used sugar alcohols used in prescription drug manufacturing are mannitol and xylitol. Both of the products are used either as sweeteners in liquid drug products or as bulking agents in the solid dosage forms.
The sugar alcohols are used in many diabetic products as well as in many health foods such as nutrition bars. Any person who consumes one of the sugar alcohols in significant quantities can experience gastrointestinal disturbances and diarrhea which may mimic symptoms celiac patients may suffer after being exposed to gluten.
National celiac organizations such as the Gluten Intolerance Group of North America. consider mannitol to be safe for use in celiac patients. Additionally, if you go to the Celiac.Com website dated 11/29/07 you will find a list of items safe for the celiac patient to consume. On that list you will also find both mannitol and xylitol as well as the following sugar alcohols sorbitol, malitol, lactilol and isomalt.
What does this means for the celiac patient? If you happen to contact a drug company for information and you are told that a drug contains gluten you really need to push them to tell you which excipient in that drug product is considered the source of the gluten contamination. If it turns out to be one sugar alcohols you may wish to re-evaluate their response. While it is always up to the celiac patient to determine whether a product is safe for them, the prevailing literature continues to suggest that these sugar alcohols are safe for use.
I am glad that I read this, and now feel better armed with information and more confidence should I encounter a medication that contains gluten according to the drug company. Another thing to remember is to ask your pharmacist the same questions if they are the ones to call the drug company, as I know mine has done this for me in the past.
***Last month I wrote an article about the NFCA conducting a study on gluten in medication. The study is only open for another week, so make sure to weigh in.