Gluten in the Pharmacy
Can your pharmacist tell you whether there's gluten in your prescriptions?
Comments (6)Posted by Erica Dermer
Have you ever actually gone into the pharmacy and said, “Hey pharmacist, does this medication have gluten in it?” and received a verified 100% safe answer in return? If you’re like me, you are more likely to get a blank stare, or maybe something like, “Well, I don’t think so, but I can’t be sure.”
If you have a good pharmacy staffed by good pharmacists, they’ll probably have to spend 20 minutes and look over the product insert and call the manufacturer—but even then, sometimes the answers are a bit muddled.
For any gluten-free detectives out there (and usually most with celiac are), an unclear answer can lead to anxiety and frustration. Most people with celiac tend to panic when they see the word “food starch” or “starch” in an item because it could potentially be wheat starch.
Now, in food, if an item has modified food starch, it would contain wheat only if it states it on the mandatory FALCPA warning signs on the product. Most of the time, the starch will come from corn in the U.S. The same goes for medications; starch will likely come from corn, potato, or tapioca—although sometimes the starch is wheat-based starch. You’re likely to see the words like “starch (corn),” “coatings and ink,” “pregelatized starch,” or a cellulose phrase like “methylcellulose.”
Don’t worry, you’re not alone in this frustrating game of “what starch is in my medication.” This is where Michael Weber comes in, and the recent Wall Street Journal piece that has been passed around online about filing a lawsuit again the FDA. The Wall Street Journal blog states, “After taking a generic drug seven years ago and developing side effects consistent with ingesting gluten, Weber petitioned the FDA to either eliminate wheat gluten in medicines or require new labeling on drugs containing the protein. The agency response has been slow. In 2011, the FDA sought public comments about the issue, but otherwise has not taken action. So Weber has now filed a lawsuit to demand the FDA do something.”
Like many of us have experienced, the pharmacy Weber went to was not able to determine whether the drug was gluten-free. It’s not easy to simply call one number, one person, and determine whether a drug is safe for us. Weber is fighting for all of us to get better labeling on medications—and I for one, am very thankful for that.
But How Likely Is It That My Medication Contains Wheat?
While attending a Celiac Disease Foundation webinar (1) about gluten in drugs, they posted a slide about resources. I was so excited to find another website—Pillbox—on top of what I was already using to double-check my medication. Between these two sites, I can easily check my medications and was assured that I was safe to take everything prescribed to me.
According to the webinar, a search from the Pillbox website from the National Institute of Health showed more than 8,500 records of medication containing starch, but only 11 of those records found had wheat. And according to a labeling search of more than 4,000 package inserts in 2008, only three contained wheat starch. Those percentages made me a little more at ease and a little less likely to have a panic attack in the CVS pharmacy when the white lab coat behind the counter can’t find the proper information for me. But that in no way means we should rest on our laurels and just take whatever prescription is handed to us.
What I Can Do To Keep Gluten Out Of My Medicine Cabinet
According to the webinar, when calling the manufacturer of the drug (whose contact information usually is located in the product information pamphlet inside the medication), ask these specific questions:
1) Does the medication contain gluten?
2) Does the medication contain any starch?
3) Is there any special coating?
If you can’t get a straight answer to those queries from the manufacturer, check with the pharmacist and have them read through the package insert to catch any red flags. You can always ask them to call the manufacturer directly for a second opinion. If all else fails, or if you want to triple-check, visit the online aggregate websites to confirm whether your medication is gluten free.
Needless to say, I’ll be watching the developments with the FDA case and hoping that eventually medication will be as easily labeled as packaged foods is today.
(1) You can get more information from the Gluten in Medications webinar from Celiac Disease Foundation with Janelle Smith RD and special guest Steve Plogsted PharmD, BCNSP, and CNSC by clicking here.
Erica Dermer is managing editor of Gluten Free & More and digital content director at GlutenFreeAndMore.com. She's also author of Celiac and the Beast: A Love Story Between a Gluten-Free Girl, Her Genes, and a Broken Digestive Tract and founder of SheKnows.com.