Reactions to food substances in medicines
Medicinal products contain not only active drugs but also other ingredients included for a variety of purposes. These other ingredients are known as 'excipients' and they are often referred to as 'inactive' ingredients which has mislead some people into thinking that they are totally safe. These other ingredients are only safe if you do not have an allergy or intolerance to them.
The cases below highlight the importance of checking all the ingredients in any medication that you take – never ever assume that it is okay without reading the detailed ingredients list.
Pinney et al looked at the type of excipients present in allopathic drugs that were derived from food allergens in the various pharmaceutical formulations of the 50 highest-selling drugs in French pharmacies in 2002. An excipient deriving from an allergen with obligatory labelling in food was present in 58.6% of the studied pharmaceutical formulations. [5]
Dueñas-Laita et al report on the cases of two women(58 and 81 years of age) who experienced anaphylactic reactions after taking a generic omeprazole capsule Both women had previously taken nongeneric omeprazole and had not had a reaction. The generic drug that each of the women took contained soybean oil as an excipient. Testing revealed that both women had reacted to the soybean oil. [2]
Atopic dermatitis in one person was made worse as a result of hazelnut essence being present in hydroxyzine syrup. [6]
Vaccines often contain preservatives, excipients, and manufacturing residuals in addition to pathogen-specific immunogens. Offit and Jew reviewed some of these substances and confirmed that both gelatin and egg proteins are contained in vaccines in quantities sufficient to induce rare instances of severe, immediate-type hypersensitivity reactions. [4]
Vaginal suppositories that contain lysozyme and other contaminating egg white proteins can either elicit allergic reactions in patients with a preexisting egg white allergy or induce sensitization to lysozyme and other egg white components. Reactions have included urticaria and anaphylaxis. [7]
Abidec drops prescribed to a newborn baby were found to contain arachis (peanut) oil.[1]
Sulphites are widely used as preservative and antioxidant additives in the food and pharmaceutical industries. Sulphites can be found in creams, pills and tablets and in sensitive individuals can lead to symptoms ranging from dermatitis, urticaria, flushing, hypotension, abdominal pain and diarrhoea to life-threatening anaphylactic and asthmatic reactions. [8]
Greenhawt et al presented the case of a woman with documented carmine hypersensitivity, who experienced anaphylaxis ninety minutes after taking a generic azithromycin. Their investigations showed that this was an allergy to the carmine dye in the tablet's coating rather than to the antibiotic. [3]
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You can find out more about food allergy and food intolerance in Change Your Diet and Change Your Life.
REFERENCES
(1) Dixon V, Habeeb S, Lakshman R. Did you know this medicine has peanut butter in it, doctor? Arch Dis Child. 2007 Jul;92(7):654.
(2) Dueñas-Laita A, Pineda F, Armentia A. Hypersensitivity to generic drugs with soybean oil. N Engl J Med. 2009 Sep 24;361(13):1317-8.
(3) Greenhawt M, McMorris M, Baldwin J. Carmine hypersensitivity masquerading as azithromycin hypersensitivity. Allergy Asthma Proc. 2009 Jan-Feb;30(1):95-101.
(4) Offit PA, Jew RK. Addressing parents' concerns: do vaccines contain harmful preservatives, adjuvants, additives, or residuals? Pediatrics. 2003 Dec;112(6 Pt 1):1394-7.
(5) Piney D, Commun N, Kanny G. Food allergens submitted to compulsory food labelling in the 50 highest-selling drugs in France. Eur Ann Allergy Clin Immunol. 2005 Oct;37(8):309-13.
(6) Peroni DG, Dall'Agnola A, Piacentini GL, Boner AL. Worsening of atopic dermatitis by hazelnut essence contained in hydroxyzine syrup. Acta Paediatr. 2007 Nov;96(11):1710.
(7) Pichler WJ, Campi P. Allergy to lysozyme/egg white-containing vaginal suppositories. Ann Allergy. 1992 Dec;69(6):521-5.
(8) Vally H, Misso NL, Madan V.
Clinical effects of sulphite additives.
Clin Exp Allergy. 2009 Nov;39(11):1643-51.