How to identify gluten-free drugs

Celiac disease is a serious genetic illness. It is an autoimmune disease triggered when a patient consumes gluten, a protein found in wheat, barley, and rye. When a person with celiac disease consumes a product containing gluten, it causes damage to the small intestine, leading to poor absorption of nutrients from food and intense pain.

Because of these problems, people with celiac disease have to be very careful about the things they eat and drink (and sometimes even put on their body). The FDA regulates gluten-free claims on food labels and requires manufacturers to call out allergen ingredients on packaged foods. But there is no similar law or regulation that requires drug manufacturers to label gluten-containing versus gluten-free drugs. 

For this reason, it can be difficult for people with celiac disease to know whether or not a medicine is safe for them to take. We checked in with some experts to find out how you can tell if there is gluten in medications.

Is my medication gluten-free?

The good news is: Most medications do not contain gluten.

“It has been demonstrated that the chances of a medication containing an amount of gluten that would be considered harmful or would cause a reaction in a highly sensitive patient is extremely unlikely,” says Dr. Steve Plogsted, Pharm.D., a clinical pharmacist who maintains the website GlutenFreeDrugs.com.

In fact, the FDA reports that the vast majority of drugs contain no gluten or not enough gluten to be harmful to patients with celiac disease.

But even though gluten in medications is not a common problem, it can be a serious one. That is why it is important to check each medication carefully to see if it includes any gluten-containing ingredients. 

Here are a few guidelines for determining if you have gluten-free drugs:

1. What does the medication look like?

According to Dr. Plogsted, if your medication is a clear liquid, it is probably safe. “All translucent liquids are free of starches,” he says. If your medication is a pill, capsule, or non-translucent liquid, there’s still a good chance that it is gluten-free, but you’ll have to do a little more digging.

2. Read the ingredients label.

Remember, many medications contain the same active ingredients. But if they are made by different manufacturers, they might contain different inactive ingredients. That’s where you might find gluten. Certain starches, such as corn, do not contain gluten. But a wheat starch on the label means that the medication is not safe for people with celiac disease.

Sometimes, your pharmacy may give you your prescription drugs in a vial with no documents from the manufacturer. If this happens, ask your pharmacist to give you the package insert. Alternatively, you can search for the drug name at DailyMed, a service of the National Institutes of Health (NIH) that maintains a searchable database of package inserts. The materials on the website can be a little jargon-y, so you might want to skip to the section of the package insert titled “Description.” This is where you’ll find the list of inactive ingredients. 

Here is a list of gluten-containing ingredients to look for, according to Beyond Celiac:

• Wheat
• Modified starch (if source is not specified)
• Pregelatinized starch (if source is not specified)
• Pregelatinized modified starch (if source is not specified)
• Dextrates (if source is not specified)
• Dextrin (if source is not specified; the source is usually corn or potato, which is acceptable)
• Dextrimaltose (when barley malt is used)
• Caramel coloring (when barley malt is used)

3. Check online resources.

There are also a few online resources that can help you research a medication’s gluten content. “The [sites] won’t tell you if the product contains gluten, but it will tell you the specific starch source if it is not marked in the package insert or other reference,” says Dr. Plogsted.

Check out:

• Pillbox (National Institutes of Health)
• DailyMed (National Library of Medicine)

4. Contact the manufacturer.

If you don’t find help online and the ingredients list of your medication doesn’t name any of the above ingredients, the medication is almost certainly safe. But Dr. Plogsted tells us that since drug labeling isn’t regulated in the same way as food labeling is, you might have to contact the manufacturer to be absolutely sure it doesn’t contain gluten. You can find the drug manufacturer’s name and contact information on the label or package insert.

People with celiac disease have to be very careful about the products they consume, including medications. We hope these tips help you to determine whether or not the medications you take contain gluten. Still confused? You can always ask your pharmacists for help identifying gluten-free drugs. If they don’t know the answer, they should be able to point you to a good resource.