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Allergens in Medication

What You Need to Know

By

Updated June 19, 2008

Medicine

Your pharmacist can be your ally in helping avoid allergic reactions from medications.

Photo © Huseyin Bakir, stock.xchng

The idea that something you could take to improve your health could make you sick is ironic (and not even in that Alanis Morissette way). But if you have food allergies, it's a real possibility. Fillers, binders, and other ingredients in medications are common hidden allergens. They can be difficult to avoid, too, just because of some of the oddities in how medications are labeled and the circumstances in which you may be given medicine. Read on to learn some of the ways you can keep yourself safe when dealing with medications.

Be Aware of Differences Between Medicine Labels and Food Labels

When buying over-the-counter medicines, you should know that FDA regulations for labeling food and medicine are not quite the same. For example, "starch" on a food label means cornstarch. On a medicine label, it could mean potato, corn, tapioca, or wheat starch. Similarly, maltodextrin must not be made from wheat in American-made foods unless specifically indicated; this is not the case for medications. The bottom line: Don't buy a medication over the counter unless you're absolutely sure all the ingredients are safe for your diet.

Prescription Problems

You'll need to enlist your pharmacist's help to determine whether a medication you've been prescribed is safe as-is. This may entail phoning the manufacturer to confirm ambiguous ingredients in the packaging the original medication was shipped in. It's also a good reason to keep all your prescriptions at the same pharmacy if at all possible; once you've found a pharmacist you trust to do this sort of legwork, it pays to maintain that relationship.

Be especially aware of excipient ingredients: bindings, coatings, or other inactive ingredients where allergens are especially likely to lurk. This list of excipients explains the sources of many common ingredients you're likely to find in your prescriptions. Corn and wheat are the two common allergens you'll find in a variety of excipients. But dairy, potatoes, coconut, and gelatin are also not uncommon. Arachis oil, a peanut derivative, is also sometimes used in creams or other topical medications.

What happens when a medicine you've been prescribed includes an allergen in the standard preparation? In this case, you'll have two options: Either your doctor may be able to prescribe you a similar medication (or a different formulation of the same medication, like a syrup or inhaled version) that's safe for you, or you may need to have your medicine compounded at a compounding pharmacy. The latter will be much more expensive. But if you can prove medical need -- which your allergist can document -- insurance should cover the additional expense. (Unfortunately, it may require a lot of paperwork and time to sort out.) About.com Celiac Disease guide Nancy Lapid also recommends you ask your doctor for first and second choice medications whenever possible at the time you get your prescription -- good advice for anyone with a common food allergy or sensitivity.

At the Hospital: Precautions You Can Take

One situation where you may encounter special difficulties is during a hospitalization, especially an unexpected one. Wearing medical alert jewelry that indicates your food allergies is one step that can help, but protecting yourself during a hospital visit shouldn't end there. Appointing a local friend or family member to act as a liaison between you and hospital staff can make a difference, especially if your condition is severe or if you may not be in a position to ask questions about medications due to drowsiness, severe pain, or other medical issues. They should ask about any medicines you're given and make sure they've been vetted for your food allergies.

In addition to excipient ingredients in pills, be especially aware of -- and ask your liaison to be on the lookout for -- IV solutions if you have a corn allergy. Corn-based dextrose is a common ingredient in many IV saline solutions, which are likely to be among the first therapies you'll receive during any hospital visit. Plain saline solution should be a safe alternative.

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