The only treatment for celiac disease is to follow a strict gluten-free diet for life. As gluten can be found in medication, pharmacy care is critical in the treatment of this disorder.
The Food Allergen Labeling Consumer Protection Act of 2004, which requires packaged food labels to identify all ingredients containing wheat and other common allergens, was a major landmark for people with celiac disease and food allergies. Yet no similar requirement exists for medication labels.
The risks of leaving gluten off the label:
- Manufacturers use excipients to bind pills together and help deliver the medication to the patient. There are several types of excipients, and some of them may contain gluten.
- Although few medications actually contain gluten, it is important that the ingredients of each medication are explored to determine the source of excipients – and to verify the particular drug is gluten-free.
- The generic form of a medication may use different excipients than the brand name drug. Even if the brand name is determined to be gluten-free, the gluten-free status of each generic must be verified.
The following inactive ingredients indicate the need for additional investigation to determine the gluten-free status of the drug:
- Modified starch (source not specified)
- Pregelatinized starch (source not specified)
- Pregelatinized modified starch (source not specified)
- Dextrates (source not specified)
- Dextrimaltose (when barley malt is used)
- Caramel coloring (when barley malt is used)
- Dextrin (source not specified, but usually by corn or potato)
Resources for Patients:
- Gluten in Medications Guide: This guide, created and developed in collaboration with American Society of Health-System Pharmacists (ASHP), can help when asking pharmacists about gluten-free prescriptions and other medication needs.
- Gluten-Free Drugs: This list is maintained by Dr. Steven Plogsted and his pharmacy students at Columbus Children’s Hospital, Columbus, OH.
- The Rubins: This website dedicated to senior citizens maintains a directory of drug manufacturers. Website addresses and phone numbers are provided, and may prove useful when one needs to contact a manufacturer to determine if gluten is an ingredient in a medication.