Gluten in a Variety of Medications

Steve Plogsted, a pharmacist at Nationwide Children’s Hospital in Columbus, Ohio, is an expert on gluten in medications. His website, glutenfreedrugs.com, is widely recognized as the most reliable source of information on gluten-free prescription and over-the-counter drugs. Have a question about gluten and medications? Send it to [email protected].

 

 

I heard that there is a new dissolvable Advil tablet, which sounds like a good idea, but I understand that it contains gluten. Can you help me with some information?

The product is called Advil Film Coated. Available in tablet or caplet form, it rapidly dissolves in the mouth, which enhances absorption. The company has stated that the outer coating is painted with a wheat-based chemical. I contacted it to ask which one of the product’s listed ingredients is the source of the wheat and learned that it is mannitol. One of a group of ingredients known as polyols or sugar alcohols, these products go through extensive processing. Therefore, no gluten particles remain, and the product is safe. As an additional note of interest, I was told that there is no known gluten in the Advil Liqui-Gels. Until just recently, Advil’s website stated that the product did contain gluten, so I’m happy that it has improved the statement’s accuracy.

I am a physician and would like to administer peppermint oil capsules to a patient who has functional abdominal pain. Is the product IBGard gluten free?

I looked over IBGard’s ingredients, none of which contain gluten. Also, the manufacturer states on its website that the product is free of both wheat and gluten.

I recently was prescribed clarithromycin and told that it contains no gluten. However, after taking the medication, I experienced significant intestinal problems similar to the symptoms I experience when I accidentally ingest gluten. Can you explain this?

Clarithromycin is classified as a macrolide antibiotic. Macrolide molecules stimulate motilin receptors in the intestine. Motilin is a substance involved in stimulating intestinal motility, which helps move food and other materials through the bowel. Your symptoms, therefore, are due to the drug itself and not the result of gluten exposure. Other drugs in this class include erythromycin and azithromycin, both of which are used to treat people with motility disorders.

My doctor prescribed a generic version of Augmentin, and within 24 hours of taking it, I became crampy and experienced diarrhea and other celiac-like symptoms. I was told that the brand I took contained no gluten, but I still experienced intestinal problems. Why?

One of the ingredients in Augmentin, clavulanate, increases intestinal motility and is actually used by some gastroenterologists specifically to treat certain intestinal motility disorders. Other names of this ingredient include clavulanic acid and clavulanate potassium.

Can you tell me which inhalers are gluten free? My son uses two different ones, and the brand changes frequently when I fill his prescription.

The good news is that all prescription inhalers are gluten free. The same applies to all prescription eye and ear drops as well as all topical and injectable products.

My doctor prescribed doxycycline for my son’s acne. He has celiac. Are there are any brands that I should avoid due to gluten contamination?

The only brand that you should avoid is Doryx capsules, which contain wheat starch. The Doryx tablet is OK to use because it contains cornstarch.

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