Gluten Allergy and Medication

If you have a gluten allergy, you need to check what’s in your medication.

In one way, this is no different from checking the ingredients in food, except that we often forget that not-food items such as medications may also contain gluten.

But are drug companies really using gluten in medications?

As awareness grows of gluten allergies, gluten intolerance and celiac disease, you would think that pharmaceutical companies would be careful about what they use to bulk out their pills.

Given the small amount of filler in a pill, and the high markup, using cheap ingredients like wheat in medications does not make sense.

Most of the time, if not always, medications do not have gluten, wheat, or wheat starch added to the pills.

Having said that, you should always check if you have celiac disease or a gluten allergy.

What you might find, when you call the pharmaceutical company, is that they tell you that there is gluten in your medication.  They may say this about medications you have been taking of some time, previously deemed gluten-free.

According to glutenfreedrugs.com, the reason medications may be considered gluten-contaminated is because they use sugar alcohol as an excipient.

What is an Excipient?

Excipients are non-active ingredients in a medication.

The active ingredients, the ones you are actually paying for and which have some (hopefully desirable) effect on your body, such as (hopefully) curing your disease.

Other ingredients are often required to bulk up the volume of the pill, help with packaging in some other way (for example coatings) or help with processing the material during manufacture.

For example, if the active ingredient is a small amount of powder, it may be mixed with a binder, such as a starch, to bulk it up and hold it together.

If you’ve been on a gluten-free diet for a while, the word “starch” should immediately raise a red flag in your mind, along with the question “what kind of starch?”

Corn starch is the most commonly used starch in pill-making, so if you have a gluten allergy, this usually is not a problem.  If you have a corn allergy on the other hand, it’s not so great.

What is Sugar Alcohol

Sugar alcohol will it get you drunk.  It is not ethanol, its not the type found in beer, wine or spirits.

Sugar alcohol is technical term for certain types of hydrogenated carbohydrate.  Commonly used sugar alcohols used in medications include xylitol, sorbitol and maltitol.

Although usually derived from corn, these ingredients may be manufactured from wheat, which of course contains gluten.

So should you be concerned that there may be a small amount of gluten in your pills because they use sugar alcohols as excipients, which may be made from wheat?

Theoretically, they are highly refined and there is no trace of gluten in these products.

In practice, the Gluten Intolerance Group of North America considers sorbitol  and maltitol (mannitol )to be safe, although they say nothing about xylitol.

Is My Medication Gluten-Free or Not?

Unless wheat starch, wheat or gluten have been directly added to the medication (or oat, barley or rye products), most people would consider medications to be gluten-free.  As discussed above, direct use of such ingredients is rare, although you could have a problem if you have a corn allergy.

It is hard to make definitive statements in this area, so let me put it this way.

I’m not worried.  I’m very particular about avoiding even small amounts of gluten.  Based on my research, I would not worry about gluten in medications with sugar alcohols added, despite my gluten allergy.

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