Medicines are not a significant source of gluten

A growing number of patients are asking about gluten in meds.

Most meds don’t contain gluten from wheat, barley, or rye.

If they do, it’s likely no more than 0.5 mg/dose…less than a serving of gluten-free food.

But labels rarely say if meds are gluten-free…and there aren’t any “gluten-free manufacturers.”

Reassure patients that meds aren’t a significant source of gluten.

Any small amount of gluten in meds isn’t likely to cause GI symptoms (bloating, gas, etc) in gluten-sensitive patients.

And even some patients with celiac disease…who must restrict dietary gluten to minimize GI symptoms, intestinal damage, and malabsorption…may tolerate up to 50 mg/day of gluten.

Use these rules of thumb when gluten in meds is a concern…such as patients who still have symptoms despite adhering to dietary restrictions.

Review the med’s inactive ingredients on the package label or in the product monograph.

But don’t search for the word “gluten.”

Instead, check for starches or starch derivatives…pregelatinized starch, sodium starch glycolate, dextrin, or dextrate.

The product may contain gluten if the source of these starches is wheat…or isn’t stated. Meds don’t have starches from barley or rye.

The more common starches from corn, potato, rice, or tapioca…such as “sodium starch glycolate type A potato”…are okay.

If needed, contact the manufacturer to ask for the starch’s source.

But don’t be surprised if you’re told a product can’t be guaranteed gluten-free…even if the starch isn’t derived from wheat…for legal reasons or possible cross contamination.

Don’t worry about non-oral meds…only ingested gluten is a concern.