The only treatment for Celiac disease is the lifelong gluten-free diet. A gluten-free diet means eliminating all foods, beverages, vitamins, supplements – and medications (prescription and over-the-counter) – that contain wheat, rye or barley.
If you have been diagnosed with Celiac disease or need to follow a gluten-free diet you must be aware of potential sources of gluten. In the area of pharmaceuticals, potential sources of gluten contamination come primarily from the addition of the excipient (filler) ingredients added to the active drug in order to make a particular dosage form.¹
Gluten can be used in many medications as an excipient, so it is important for you to check that each medication you take is gluten-free. If you have Celiac disease and are filling a prescription, ask the pharmacist to verify the ingredients to ensure that it is gluten-free. You can ask their help in reading and understanding the list of ingredients or contact the manufacturer. IF IT IS DISCOVERED THAT YOUR PRESCRIBED MEDICATION CONTAINS GLUTEN, ASK THE PHARMACIST TO CONSULT WITH YOUR PHYSICIAN TO DETERMINE AN APPROPRIATE COMPOUNDED DRUG. If you need a drug made without gluten Apple Valley Pharmacy in Warwick, NY can compound it for you.
It is important for pharmacists and physicians to be aware that medications may not work as expected in people with undiagnosed or newly diagnosed Celiac disease due to problems with malabsorption. IF YOU DO NOT FEEL WELL OR THE MEDICATION DOES NOT SEEM TO BE WORKING, IT IS IMPORTANT TO CHECK WITH YOUR PRESCRIBING PHYSICIAN RIGHT AWAY.
Some Excipients to look for:
- Dextrins – Result from the hydrolysis of starch by heat or hydrochloric acid (from corn). It can also be obtained from wheat, rice or tapioca. Dextrates (when source is not specified)
- Dextri-maltose (when barley malt is used)
- Maltodextrin – A startch hydolysate that is usually obtained from corn but can be extracted from wheat, potato or rice
- Modified Starch (when source is not specified)
- Pregelantinized Starch – a starch that has been chemically or mechanically processed. The starch can come from corn, wheat, potato or tapioca
- Sodium starch glycolate – a starch that is usually obtained from potato but many come from any starch source
Questions to ask:
What are the inactive ingredients or excipients? What is the source of the ingredient or excipient? Answers can be found on the package insert and the key word to look for is starch. If the starch is listed as “cornstarch” or starch (corn) it can be assumed to be gluten-free. However, if starch is listed by itself the only way to confirm the source is to call the manufacturer.
> Generic drugs do not have to contain the same excipients as brand name drugs or another generic equivalent
> Botanical sources of a starch may not be specified and need to be investigated
> There are currently NO requirements for labeling gluten found in prescription drug ingredients
¹ Medications and celiac disease: Tips from a pharmacist. Parrish, C. R. (2007). Practical Gastroenterology
January, 2007, pages 58-64. For a complete copy of the article above go to:
www.glutenfreedrugs.com Maintained by Steven Plogsted, PharmD., pharmacist at Nationwide Children’s Hospital, Columbus, Ohio
Celiac Disease Foundation; Citing Blog Source [http://celiac.org/]