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The pills your doctor prescribes for your health conditions contain a pharmaceutical drug with some therapeutic effect on the body, as well as a mixture of inactive compounds added to boost the medicine's effectiveness or simply to make the pill more palatable. Inactive ingredients are generally considered harmless. But many pills contain chemicals that can cause allergic reactions or digestive problems in some patients, according to an analysis of the chemical ingredient lists for thousands of pills.
Inactive ingredients are components of a drug product that do not increase or affect the therapeutic action of the active ingredient, which is usually the active drug. Inactive ingredients are added during the manufacturing process of pharmaceutical products such as tablets, capsules, suppositories, and injections. Inactive ingredients may also be referred to as inert ingredients or excipients, and generally have no pharmacological effect. Examples of inactive ingredients include binding materials (which may be excipients), dyes, preservatives, and flavoring agents. Agents that combine with active ingredients to facilitate drug transport in the body are also considered inactive.
However, not all inactive ingredients are always inactive. Alcohol is one example of an ingredient that may be active or inactive based on the specific formulation of the medication.
Researchers searched a database that contained about 42,000 recipes for oral medications marketed in the United States. Of those, 92.8 percent contained at least one of 38 inactive ingredients that..., the researchers report online March 13 in Science Translational Medicine (1). And 55 percent of pills contained at least one of a class of sugars called FODMAPs, which can cause digestive problems in people with irritable bowel syndrome.
According to experts, once an inactive ingredient passes toxicity screening, it is normally considered safe. But these tests are conducted on animals and then on limited number of people. When these medicines are out in the market and when more people take the medicines that contain these chemicals, we start to realize and uncover some of the potential side effects for a minority of patients that weren’t revealed during the approval process because of low sample sizes.
When the doctors prescribe these medicines, even they might not be well aware of the inactive ingredients. There may be dozens of pills on the market that contain the same active ingredient, each with its own cocktail of inactive add-ons. Pharmaceutical companies rarely disclose how much of each chemical is contained in their pills. The healthcare provider doesn’t really know which formulation the patient is going to receive, because that’s generally governed by the pharmacy, i.e., drug companies. Even if they tell the doctors about it, or a warning label is put on the pills, the doctors who are prescribing these medicines might not know that the patient is allergic to these compounds. Neither the doctor nor the pharmacist may know if a patient is liable to suffer side effects from inactive ingredients in their medicines. So every thing is actually been done "in the darkness", if not deliberate!
So, What can you do to avoid these complications? The patient himself or herself has to tell the doctor about his conditions like irritable bowel syndrome, peanut oil allergy, lactose intolerance, gluten intolerance etc. in order to avoid these unwanted reactions to inactive compounds in their medicines. But does the patient actually know what he is allergic to in the first place? Most of the patients don't know about their own hidden conditions! It is better to find out, especially if you are feeling very sick if you take the medicines prescribed to you.
So even if manufacturers did disclose all the levels of inactive ingredients in their products, it’s not entirely clear how many patients would experience negative side effects. Nobody exactly knows how much is sufficient to elicit an intolerance or an allergy from certain compounds.
If healthcare providers had better access to all the information of what goes into different pills, doctors could better judge the patients’ risks of potential side effects, according to the researchers who conducted this study. Doctors who assess a patient’s tolerance for inactive ingredients as a routine part of the prescription process, rather than focusing solely on active ingredients, could offer a more personalized treatment approach with fewer potential complications. Understanding your patient better, and matching each person to the optimal set of drug formulations that are going to help him or her is likely to benefit the patient, say the scientists.
If a patient has a known allergic reaction to an inactive ingredient, they should check for the ingredient in new prescription or over-the-counter medications or check with their pharmacist. Examples of inactive ingredients that are have been reported to cause reactions in some patients include: sulfites, benzoates, aspartame, saccharin, oleic acid, benzyl alcohol, lactose, soya lecithin, propylene glycol, and sorbitan trioleate. Patients who have allergic or adverse reactions to certain inactive ingredients may be able to use products that are color- or preservative-free.
Meanwhile, scientists are still working on this problem and are trying to figure out what can actually be done to avoid these complications.
(D. Reker et al. “Inactive” ingredients in oral medications. Science Translational Medicine. Published online March 13, 2019. doi: 10.1126/scitranslmed.aau6753. )
If you want more information on this please read these papers too ...
A. Cunningham. Hundreds of dietary supplements are tainted with potentially harmfu.... Science News. Vol. 194, November 10, 2018.
B. Mole. Biology may provide just the right chemistry for new drugs. Science News Online. July 20, 2015.
Here is the list of some of the inactive ingrediants added to medicines. Check whether if you are allergic to any of these ...
acaciaacesulfameacesulfame potassiumacetic acidacetoneacetyltributyl citratealcoholalginic acidalpha-tocopherolaluminum chloridealuminum chlorohydrex propylene glycolaluminum hydroxidealuminum lake dyesaluminum oxidealuminum silicatealuminum stearatealuminum sulfateamide resinaminobenzoate sodiumammoniaammonio methacrylate copolymerammonio methacrylate copolymer type Aammonio methacrylate copolymer type Bammonio methacrylate copolymersammonium chlorideammonium hydroxideammonium laureth-5 sulfateammonium phosphate dibasicartificial flavorartificial grape flavorartificial mint flavorascorbic acidascorbyl palmitateaspartameaspartame powder
bananabarium sulfatebenzalkonium chloridebenzoic acidbenzyl alcoholbetadexblack currantblack currant flavorblack inkblack pigmentblackberryblue dyebutyl alcoholbutylated hydroxyanisolebutylated hydroxytoluenebutylparaben
calciumcalcium carbonatecalcium phosphatecalcium phosphate dibasic anhydrouscalcium phosphate dihydrate dibasiccalcium silicatecalcium stearatecalcium sulfatecalcium sulfate anhydrouscalcium sulfate dihydratecandelilla waxcandelilla wax powdercarbomercarbomer 934carbomer 934pcarbomer homopolymer type Acarbomer homopolymer type Bcarbomer homopolymer type Ccarboxymethylcellulosecarboxymethylcellulose calciumcarboxymethylcellulose sodiumcarminecarnauba waxcarrageenancastor oilcastor waxcellacefatecellulosecellulose acetatecellulose compoundscellulose powderedcellulosic polymerscetostearyl alcoholcetyl alcoholcetylpyridinium chloridecherrycitric acidcitric acid anhydrouscitric acid monohydratecochinealcoconut oilcolophonycolorantscoloring agentcompressible sucrosecompressible sugarconfectioners sugarcopovidonecorncorn oilcorn starchcorn syrupcorn syrup solidscorn-derived proteinscottonseed oilcranberrycroscarmellose sodiumcroscarmellose sodium type Acrospovidonecysteine hydrochloride
D&C Blue No. 1D&C Green No. 5D&C Red No. 21D&C Red No. 22D&C Red No. 27D&C Red No. 27 Aluminum LakeD&C Red No. 27 LakeD&C Red No. 28D&C Red No. 28 Aluminum LakeD&C Red No. 30D&C Red No. 30 Aluminum LakeD&C Red No. 33D&C Red No. 40D&C Red No. 6D&C Red No. 6 LakeD&C Red No. 7D&C Red No. 7 Calcium LakeD&C Yellow No. 10D&C Yellow No. 10 Aluminium LakeD&C Yellow No. 10 LakeD&C Yellow No. 5D&C Yellow No. 6dehydrated alcoholdextratesdextrosedextrose monohydratedibasic calcium phosphatedibutyl phthalatedibutyl sebacatedicalcium phosphatediethyl phthalatedihydroxyaluminum sodium carbonatedimethiconedimethylaminoethyl methacrylate - butyl methacrylate - methyl metha...dimethylpolysiloxanedocusate sodiumdyes
edetate calcium disodiumedetate disodiumedible black inkegg lecithinerythrosineerythrosine sodiumethanolamineethyl acrylate - methyl methacrylate copolymerethyl alcoholethyl butyrateethyl isovalerateethylcelluloseethylcellulose (10 mPa.s)ethylcellulose (100 mPa.s)ethylcellulose (20 mPa.s)ethylcellulose (7 mPa.s)ethylcellulosesethylene glycol monoethyl etherethylvanillineudragit
FD&C Blue No. 1FD&C Blue No. 1 Aluminium LakeFD&C Blue No. 1 LakeFD&C Blue No. 2FD&C Blue No. 2 Aluminium LakeFD&C Blue No. 2 LakeFD&C Green No. 3FD&C Green No. 3 Aluminum LakeFD&C Red No. 3FD&C Red No. 4FD&C Red No. 40FD&C Red No. 40 Aluminium LakeFD&C Red No. 40 LakeFD&C Yellow No. 10FD&C Yellow No. 10 Aluminum LakeFD&C Yellow No. 10 LakeFD&C Yellow No. 5FD&C Yellow No. 5 Aluminum LakeFD&C Yellow No. 5 LakeFD&C Yellow No. 6FD&C Yellow No. 6 Aluminum LakeFD&C Yellow No. 6 Lakeferric oxideferric oxide blackferric oxide brownferric oxide orangeferric oxide redferric oxide yellowferric oxidesferrosoferric oxideferrous fumarateferrous oxideflavorflavorsfragrancesfumaric acid
gelatinglucosamineglucosamine hydrochlorideglutamic acid hydrochlorideglyceringlycerolglycerol monooleateglycerol monostearateglyceryl behenateglyceryl distearateglyceryl monooleateglyceryl monostearateglyceryl triacetateglycineglycolateglycyrrhizin ammoniatedguar gum
hard gelatin capsulehard paraffinhydrochloric acidhydrocloric acidhydrogen peroxidehydrogenated castor oilhydrogenated cottonseed oilhydrogenated soy oilhydrogenated soybean oilhydrogenated vegetable oilhydroxyethyl cellulosehydroxypropyl cellulosehydroxypropyl methylcellulosehydroxypropyl methylcellulose phthalatehypromellosehypromellose 2208hypromellose 2208 (100 mPa.s)hypromellose 2208 (100000 mPa.s)hypromellose 2208 (15000 mPa.s)hypromellose 2208 (3 mPa.s)hypromellose 2208 (4000 mPa.s)hypromellose 2910hypromellose 2910 (15 mPa.s)hypromellose 2910 (15000 mPa.s)hypromellose 2910 (3 mPa.s)hypromellose 2910 (5 mPa.s)hypromellose 2910 (50 mPa.s)hypromellose 2910 (6 mPa.s)hypromellose 2910 3cphypromellose 2910 50cphypromellose 2910 5cphypromellose 2910 6cphypromellose 3cphypromellose 5cphypromellose 6cphypromellose phthalatehypromelloses
magnesiummagnesium aluminum silicatemagnesium carbonatemagnesium hydroxidemagnesium oxidemagnesium oxide heavymagnesium silicatemagnesium stearatemagnesium trisilicatemaleic acidmalic acidmaltodextrinmannitolmedium-chain triglyceridesmegluminementholmethacrylic acidmethacrylic acid - ethyl acrylate copolymer (1:1) type amethacrylic acid - methyl methacrylate copolymer (1:1)methacrylic acid - methyl methacrylate copolymer (1:2)methacrylic acid copolymermethacrylic acid copolymer type Bmethanolmethyl alcoholmethyl cinnamatemethyl methacrylatemethylcellulosemethylcellulose (100 mPa.s)methylcellulose (15 mPa.s)methylcellulose (400 mPa.s)methylene chloridemethylparabenmethylparaben sodiummicrocrystalline cellulosemicrocrystalline waxmineral oilmintmint cream flavormint mentholmodified corn starchmonosodium citrate
palm kernel oilparaffinpartially hydrogenated soybean and palm oilspeanut oilpeppermintpeppermint flavorpeppermint oilpharmaceutical glazephenylalaninephosphoric acidpiperazinepolacrilin potassiumpolacrilin sodiumpoloxamerpoloxamer 188poloxamer 407polyacrylate dispersion 30%polycarbophilpolydextrosepolyethylene glycolpolyethylene glycol 1450polyethylene glycol 300polyethylene glycol 3000polyethylene glycol 3350polyethylene glycol 400polyethylene glycol 4000polyethylene glycol 600polyethylene glycol 6000polyethylene glycol 800polyethylene glycol 8000polygalacturonic acidpolyplasdone xlpolysorbatepolysorbate 20polysorbate 80polyvinyl acetatepolyvinyl alcoholpolyvinylpyrrolidonepotassiumpotassium bicarbonatepotassium bitartratepotassium carbonatepotassium carbonate anhydrouspotassium chloridepotassium gluconatepotassium hydroxidepotassium sorbatepotato starchpovidonepovidone k12povidone k25povidone k29/32povidone k30povidone k90precipitated calcium carbonatepregelatinized corn starchpregelatinized starchpropyl gallatepropylene glycolpropylene glycol alginatepropylparabenpropylparaben sodium
saccharinsaccharin sodiumsd-45 alcoholsda-3a alcoholsesame oilshellacsilicified microcrystalline cellulosesilicon dioxidesilicon dioxide colloidalsiliconesimethiconesimethicone emulsionsodiumsodium alginatesodium ascorbatesodium benzoatesodium bicarbonatesodium carbonatesodium carbonate monohydratesodium caseinatesodium chloridesodium citratesodium citrate dihydratesodium glycolatesodium hydroxidesodium laureth sulfatesodium lauryl sulfatesodium lauryl sulphatesodium metabisulfitesodium monolauratesodium phosphatesodium phosphate dibasicsodium propionatesodium starch glycolatesodium starch glycolate type A potatosodium stearatesodium stearyl fumaratesodium thioglycolatesodium tripolyphosphatesorbic acidsorbitansorbitan monolauratesorbitan monooleatesorbitolsorbitol specialsoya lecithinsoybean oilspearmintstarchstearic acidstearyl alcoholstrawberrystrawberry guarana flavorstrong ammonia solutionsuccinic acidsucralosesucrosesucrose stearatesugar 6x powdersugar spheressunflower oilsynthetic ferric oxidesynthetic ferric oxide blacksynthetic ferric oxide redsynthetic ferric oxide yellowsynthetic ferric oxides
tapioca starchtartaric acidtartrazinetaurineTIMERx-Ntitanium dioxidetitanium oxidetragacanthtriacetintribehenintricalcium phosphatetriethyl citratetrimyristintrisodium citrate anhydroustrisodium citrate dihydratetromethaminetropical blend flavor
List source: drugs.com