Going Gluten-FreeDecember 28, 2011

Is There Gluten in Your Meds?

Do you soothe chapped lips with Carmex? Brighten your smile with Crest Whitestrips? Ease a headache with Motrin IB?*

A few weeks ago, The Journal of the American Pharmaceutical Association posted a study where manufacturers of 41 nonprescription medications, including these three items, were contacted to see whether or not their products contained gluten. Researchers wanted to answer two questions: Is info about gluten content in over-the-counter drugs readily available? And how do gluten-free consumers get their questions answered?

Findings revealed what you may already know. Info about gluten content is available--but you won’t find it on any labels nor is it included in package inserts. You have to call to get it. So researchers did just that. They dialed up the manufacturers. Time spent on the phone ranged from a relatively easy 2 minutes (for Nicorette Gum, which GlaxoSmithKline reported was gluten free) to a lengthy 20 minutes (for McNeil’s Pepcid Complete, also reported to be gluten free).

There was a disturbing note gleaned from this study: Gluten status was listed on 6 company websites but the info on 4 of them differed from the info provided over the telephone by the manufacturer. The take-away lesson is that those with celiac disease should double-check directly with the manufacturer before ingesting any medication.

The Food and Drug Administration (FDA) currently doesn’t require labeling of the gluten content in medications (neither nonprescription or prescription)—but that’s changing soon, hopefully. Here’s the good news: FDA’s Center for Drug Evaluation and Research (CDER) just issued a request for public comments about gluten in prescription and nonprescription drug products. Comments must be submitted by March 20, 2012. For more information, go to http://www.ofr.gov/OFRUpload/OFRData/2011-32551_PI.pdf

Is there gluten in your medicines? To answer this question, we go straight to the expert. We interview pharmacist Steve Plogsted, creator of the popular website glutenfreedrugs.com, in Living Without’s February/March issue for his advice and safety techniques.

How do you determine that your medicines are safe for you?

*According to the study, Carmex Original, Crest Whitestrips and Motrin IB are gluten free. (The manufacturer does not add gluten to Whitestrips but the product has not been tested.) To access the study “Determining the Gluten Content of Nonprescription Drugs,” go to http://www.medscape.com/viewarticle/753350.

Comments (10)

I was diagnosed with celiac in Sept. 2012. My routine blood tests continued to show some mild levels of gluten exposure and I was still not feeling so hot. I went on a serious elimination diet to see if I missed any gluten exposure in my diet. After I stopped taking Kroger brand generic Ibuprofen I felt 90% better after about 4 days. Was it the Ibu itself or was there gluten in the tablets? My next blood test should help solve the mystery. So nice to have my life back and feel so much better!

Posted by: John R. | February 23, 2014 2:48 PM    Report this comment

My family just had the most disturbing phone conservation with Tina, a CVS Customer Service Rep. Phone # 401-765-1500, ext # 7705537. We called to ask whether or not CVS' ibuprofen liquid gels are gluten free. Tina told us that she isn't sure, because CVS is "at the mercy of its manufacturers." But, if we had the bar code off the box we intended to buy, she would use it to determine which of CVS' manufacturers had produced it. And then call this manufacturer to make our inquiry...

When we asked her for a list of the possible manufacturers, she told us that this list is confidential. When we asked her if she planned to ask the manufacturer (once it was determined) whether its product is certified gluten free or just inherently gluten free, she asked us what we meant. After we explained what we meant, she promised to get back to us in a couple of days.

You know what? If CVS is "at the mercy of its manufacturers," no thank you. What is so difficult about putting this information on the label of the box instead of making us go through all of this trouble? I am told it is because prescription and over-the-counter medications do not qualify as "food" under FDA definitions, so drug companies do not have to comply with FALCPA. I don't know about the rest of you, but this makes us feel helpless in my family to protect one another from unsafe products that result in missed days at school or work. Not to mention the pain and suffering.

Posted by: Bunny H | January 5, 2012 12:08 PM    Report this comment

I feel I need to add something to my previous comment. A lot of times pharmacy workers do not have the time to call manufacturers to check the gluten free status on a medication. I work in a pharmacy and believe me, most people have no idea how many things are going on back there. I am also severely gluten intolerant, so I do understand the concern of gluten in medications. My point is, do not expect your pharmacist or technician to drop everything to check these things for you. Giving them a couple of days is more realistic because of the amount of time it would take. If you want or need to know sooner than that, then sometimes you, as the patient, need to call the manufacturer or research it yourself. Again, there is more going on back there than most people realize. Also, on brand versus generic medications. For 95% of Americans, there is no difference between (for example) brand name Norvasc and it's generic equivalent Amlodipine Besylate. For those with celiac disease and gluten intolerance, there may be a difference because of different inactive ingredients. But as a general rule the Pharmacist or technician telling you they're the same are correct. Celiac Disease and Gluten Intolerance are still subjects that most people do not know or learn about until they or someone they know has to deal with it. I just wanted to offer a viewpoint from the other side of the pharmacy counter. Most pharmacy employees really do care about their patients and want to help them out and answer their questions. Please just give us enough time to do so.

Posted by: Kailey C | December 30, 2011 7:32 PM    Report this comment

According to the CPS (Pharmasist and Physician guide for medications) in Canada - Amoxicillin is gluten free. I just checked it in the book when at the pharmacy and saw a picture of the green caps that are 500mg.

It is important to note the side effects of a medication before jumping to the conclusion that it might be causing a gluten type reaction - there are many things along with gluten that can cause gluten type reactions and I personally think medication is to blame way too often.

For Amoxicillin the side effects "include diarrhea, dizziness, heartburn, insomnia, nausea, itching, vomiting, confusion, abdominal pain, easy bruising, bleeding, rash, and allergic reactions. Individuals who are allergic to antibiotics in the class of cephalosporins may also be sensitive to amoxicillin."

In addition, if you are taking more than one medication there can be cross medication side effects. I know Amoxicillin as I am prescribed it when I get ear infections from swimming and it does impact my digestive system also - sort of like if I had put something caustic into my body. MANY antibiotics from the penicillin family do that to people - that is why so many people say they are allergic to penicillin - it is due to the side effects that make them feel really crappy.

Unfortunately, due to my health issues outside of CD, I am on a lot of medications and have been through a lot of medication changes in the last 10 years so I have been following this quite closely. My pharmasist is yet to find a prescribed medication that contains gluten in it. The CPS guide that the pharmacy uses had until this year a section listing all the GF manufacturers in it - it was removed this year as all the manufactures that issue meds in Canada claim their meds are gluten free. Until this year there was a warning about 5 medications that were not gluten free however they have been removed from the market as far as I am told.

I heard Steve Plogsted talk at the Cdn Celiac Association conference 2 years ago and his response about gluten in medication wa very similar to what the pharmacists in Canada say - the excipients these days do not contain gluten.

Net for me - when you experience a side effect call your pharmasist and talk to them about possible side effects. They know you the best as they have a record of all your prescribed medication (well in BC all pharmasists are on the same system and can see all meds prescribed) and can help you work through it. A lot of medications cause celiac like symptoms of diarrhea, consipation, bloating, sore stomachs and abdominal pain. I think it is GREAT that the US Pharmacy industry is looking into this and can hopefully quell this rumour of whether there is gluten or not in medication.

Posted by: Lynda Marie N | December 30, 2011 6:20 PM    Report this comment

LeAnn, I found the problem is bigger than not wanting to tell us. I found that my pharmacist couldn't discover who or where one drug was being produced because it was a generic equivalent. I find it difficult to swallow (pun intended) when a pharmacist or tech tells me "They're the same." but they really aren't. The fillers or inactive elements can be a big issue for us.

I've often wondered if these drug companies sell their "recipe". Then, others companies make substitutions to the"ingredient list" to make it cheaper to mass produce. I do this all the time when I convert a recipe to make it safe for me. Anyone out there have an explanation?

Posted by: Maria S | December 30, 2011 3:41 PM    Report this comment

I'm used to reading labels, and routinely check labels for vitamins etc. What really concerns me is that pharmacists either do not know, cannot know, or do not care to find out whether a drug Rx they fill is GF. I recently asked when picking up a Rx whether it was gluten free and was told they had no way of knowing, but I heard later that the information is available in the doctors desk reference on prescription drugs. But from what I've read and experienced the US medical community lacks the education and/or concern for this increasingly common diet problem.

Posted by: leann g | December 30, 2011 2:23 PM    Report this comment

This is just a royal pain, isn't it? My suggestion, take only Brand name products, not generic or store equivalent because ingredients are easier to trace. In my case, I'm not celiac but wheat intolerant. I was prescribed an brand name antibiotic for an infection but my prescription coverage would only dispense generic equivalents when available. The generic version caused my system to go haywire with itching and digestive upset. This was also the case with a generic equivalent allergy med to be taken at night...I itched every night for a month before I put the whole thing together. Just two weeks ago, I accidentally picked up a store brand vitamin supplement. The packaging was almost identical to a brand that's GF. I itched for two weeks. I have to question everything now. In my experience, the gel caps were part of one situation and fillers in others. My prescription drug file & medical records now reflect my reactions to generic & only Brand name meds can be prescribed. I still have to be vigilant with my doctors & prescription company to make sure my prescriptions are Dispensed As Written (DAW). The big downside, I have to pay the difference between the brand name and generic and sometimes there is a wait until my pharmacy can order the product in for me. Another suggestion with meds, make sure anyone who accompanies you to an ER or out-patient surgery checks with doctors about you meds & acts as your advocate. Good luck!

Posted by: Maria S | December 30, 2011 1:38 PM    Report this comment

I would check on the glutenfreedrugs.com website under alpha listing. It shows the particular manufacturers who are gf, and indeed, not all are.

Posted by: Elgie | December 29, 2011 9:18 PM    Report this comment

Diane,

There are several different manufacturers of Amoxicillin and while the medication (Amoxicillin) may be gluten free, the manufacturers use different inactive ingredients (called fillers) which may contain gluten. To be positive which prescription medications are gluten free or not, you would need to find out what manufacturers your pharmacy stocks and then contact the manufacturer directly. For over the counter medications I like to use an app called scan avert. It costs $1.99 a month to use, but is totally worth it. You just scan the barcode of an item and it tells you whether it is gluten free (it can also help you avoid other foods that might be an issue for you). They are adding more and more food items and otc medications all the time, so it's definitely a good resource. Also talk with your pharmacist. I know that at Walgreens (where I work as a Sr. Pharmacy Tech.) we can print out a list of otc medications that are gluten free. Hope this helps.

Posted by: Kailey C | December 29, 2011 7:56 PM    Report this comment

I checked the gluten-free drug list and saw that Amoxicilin is on the list. Yet, this week I was prescribed Amoxicillin 500 mg Cap mfg:Green,FB:CEL-EOT (not sure what all that means). Anyway, I am taking this prescription for a toothache and the infection that is causing the ache. I started taking it on Wednesday afternoon, and today, I began to experience the digestive reaction I usually experience when I ingest gluten by accident.

Can I get a positive response that this particular medicine is indeed gluten-free??? Would there be a question about the gelcap???

Thanks for any help on this. The prescription says to take the entire 21 capsules, but I'm not up for that.

Posted by: Diane C | December 29, 2011 6:37 PM    Report this comment

New to Living Without's Gluten Free & More?
Register for Free!

Already Registered?
Log In