Gluten Free Medications, What is Really Safe?

It started this past Sunday night, I was so incredibly thirsty that it could only mean one thing - I was coming down with a cold. Sure enough, I woke up Monday morning very congested and with a slight sore throat. Luckily this cold hasn't progressed to be too unbearable, but I would love to be able to smell and taste again real soon. 

I decided to run to the store during my lunch break to find something to alleviate some of my symptoms and grabbed a box of Alka Seltzer Plus, since I've heard it works well. I got back to my computer and decided to look it up online to make sure it was really gluten-free, despite the ingredients not listing anything sketchy. Boy am I glad I did, the company states on its website (mind you nowhere on its packaging):

"We do not add any gluten to our products. However, we cannot guarantee that they are 100% gluten free as this product is produced in a facility that manufactures or packages other items which may contain gluten"

Thankful that I saved myself from a potential glutening on top of already feeling crummy, I decided to find a cold medicine that could actually be trusted. After some research, I found that although a lot of cold medicines might be inherently gluten free, a lot of companies state that the product may have the opportunity to come in contact with gluten, or that there is no actual testing done to verify it is GF. So what can we really trust then?? I came across Vicks Nature Fusion products, which seemed trustworthy based on what I found on the company's website, so I contacted Proctor & Gable just to make sure. This was the response I recieved:

"Thanks for contacting Vicks, Andrea. We've confirmed there is no gluten in the following Vicks products: All NyQuil and DayQuil Nature Fusion products only (liquids and caplets).

NyQuil Alcohol Free liquid, Custom Care liquids, DayQuil Severe Cold & Flu, and NyQuil Severe Cold & Flu have not been tested for the presence of gluten. 

For all other Vicks products: We do not label or claim that other Vicks products are gluten free.  If you are looking for a gluten-free product, please consider the Nature Fusion line of cold products."

I am not endorsing Vicks in any way, nor was I paid or given a product to promote. I just wanted to make sure that you are all aware of the dangers of assuming a medication is safe based solely on the ingredient label. I was happy to hear back from them promptly and that they do have a confirmed GF product.

As I continued my research, I found that gluten is used often in OTC medications as an inactive ingredient. The most common gluten-containing inactive ingredient used is starch which as you may know, can be derived from corn, wheat, potato, or tapioca. Other ingredients where gluten may be hiding is in, but not limited to, wheat, modified starch, pregelatinized starch, dextrates, dextrimaltose, and dextrin.

So how do you know if a drug is GF? By doing your due diligence through research and contacting the company directly. 

The Food Allergen Labeling Consumer Protection Act of 2004, which requires that a food product containing wheat must list the word "wheat" on the label, does not require the same of over-the-counter and prescription medications [21 U.S.C. § 321(qq) (2012)].The Food, Drug and Cosmetic Act does require that OTC medications list the inactive ingredients in the drug on the "Drug Facts" panel on the medication's container [21 C.F.R. §§ 201.66(c)(8) (2012)]. Prescription drugs must include a description of the drug, including the inactive ingredients, in the drug's package insert, which is part of the labeling for prescription drugs. [21 C.F.R. §§ 201.56, 201.57, 201.100 (2012)].

Unfortunately, these acts do not protect Celiacs due to the fact that although the inactive ingredients are listed, they are often hard to read and it is unknown what derivatives (wheat, corn, etc.) are used to create them. There are currently no laws in place to require manufacturers to state whether or not a product contains wheat or gluten. That leaves us, as the consumers, to embark on a intensive search of drug inserts as well as multiple websites to determine if a product is actually safe. Even when you do contact the company, most of the time they will tell you that although the product is inherently gluten-free, it does not test the product for gluten, nor can it certify that the drug has not come into contact with gluten. Additionally, companies change their ingredients often, so even if a product is gluten free right now, it may not be the next time you go to purchase it.

Without any regulations in place, it can be a nightmare for anyone with Celiac Disease or Non-Celiac Gluten-Intolerance to figure out if a medication is actually safe for them. Most of us do have access to a computer to do research and have the ability to contact our pharmacist, but not everyone has that available to them, which is why product labeling is so important.

Below are some other resources to help you stay gluten-free while you try to get healthy. When in doubt though, don't consume the product and/or contact the company to help you make a more informed decision. 

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