Pharmaceutical Drugs Containing Gluten: Concerns for Celiac Disease Patients

Problematic Ingredients in Medications

Starch is gluten-free if from corn or potato starch, but not gluten-free if from wheat, according to gastroenterology guidelines 1
Dextrimaltose is not safe as it is made from wheat, posing risks to patients with celiac disease 1
The safety of drugs with wheat starch is questionable, and patients with celiac disease should be cautious 2
Malt and malt syrup's gluten content must be determined by knowing their source, to ensure safe use in medications 1
Dextrin, dextrates, and cyclodextrins are processed by enzymatic action of barley malt or corn flour, and their gluten content should be verified 1
Maltodextrin's gluten content must be determined by knowing its source, to ensure safe use in medications 2
Sodium starch glycolate is generally not gluten-free, and should be used with caution in patients with celiac disease 1
Caramel color is derived from barley and used in production of other ingredients, posing a risk to patients with celiac disease 2
Alcohol's gluten content must be determined by knowing its source, to ensure safe use in medications 1

Sodium starch glycolate in Sevelamer is generally not gluten-free, according to gastroenterology guidelines 1
Pregelatinized starch in Prednisone is gluten-free only if made from corn, rice, tapioca, or potato, and its source should be verified 1
Sodium starch glycolate in Prednisone is generally not gluten-free, and should be used with caution in patients with celiac disease 2

Problems with medications are generally caused by the source of inactive ingredients, and are of concern in oral medications, according to gastroenterology guidelines 1
The responsibility for safety of medications and supplements starts with the ordering physician, who should verify the gluten content of prescribed medications 2

Adding a statement such as "As ordered if gluten-free or provide a gluten-free equivalent" to prescriptions can help ensure medication safety, by obligating the pharmacist to verify medication safety 1
Avoiding generic substitutions, whose sources could change frequently, can help minimize the risk of gluten exposure in patients with celiac disease 2
Being aware that FDA regulations for ingredients differ between medications and foods can help prescribers make informed decisions about medication safety 1

Patients with celiac disease should consult with pharmacists about the gluten content of prescribed medications, to ensure safe use and minimize the risk of gluten exposure 1, 2

Patients with celiac disease should inform all healthcare providers about their diagnosis to ensure safe medication management, as maintaining a strict gluten-free diet is essential for preventing complications such as lymphoma and adverse health outcomes 3