Inactive ingredients in medications more 'active' than previously thought, study finds

15 March, 2019, 22:12 | Author: Sherman Richardson
  • Credit Christine Daniloff MIT

A new study reveals that a majority of the frequently prescribed medication in the United States contain at least one inactive ingredient that could cause an allergic or gastrointestinal reaction in sensitive patients.

Analysts found 38 inactive ingredients that can cause allergic reactions after they've been ingested. But they can also spell trouble for patients who are allergic to those ingredients. "However, there is a subpopulation of patients, now of unknown size, that will be extremely sensitive to those and develop symptoms triggered by the inactive ingredients", says Daniel Reker, a Swiss National Science Foundation postdoc at MIT's Koch Institute for Integrative Cancer Research and one of the lead authors of the study. Moreover, almost 93 percent of the drugs the researchers studied had at least one of these ingredients.

"I don't want to malign inactive ingredients in any way", study co-author Giovanni Traverso, MD, a gastroenterologist at Brigham and Women's Hospital, told NPR.

The specific formulation of omeprazole the patient had obtained contained ingredients derived from wheat products (potentially containing gluten). This information was only available from the manufacturer at the time. A week after obtaining the medication the patient had reported feeling sick from taking the medication. These "inactive" ingredients serve a objective to; for instance, they can help with the digestion and absorption of the main active ingredient.

He hopes his team's work will inspire efforts to create more detailed databases and labelling, as well as to pressure pharmaceutical companies to develop more alternative formulations of their drugs.

Traverso says these inactive ingredients are essential to stabilize medications and sometimes to help the body absorb the active ingredients.

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Penicillin, though an active ingredient, is a prime example of overreaction. These ingredients may not have an effect on some patients, but could result in a reaction in others, such as people with a sensitivity to the compound, allergies to the ingredients, and similar situations.

Still, not all experts are convinced that inactive ingredients are particularly problematic. However, the researchers believe these milder reactions may affect many more patients.

While most of the worrisome ingredients are in small amounts in most medications, the researchers pointed out that 39 percent of seniors take at least five prescription medicines daily, so even the tiniest amount can add up. They found that active ingredients make up, on average, just over a quarter (29 percent) of the weight of an oral pill; the remaining 71 percent of the weight comes from inactive ingredients.

An overwhelming majority of the oral medications tested, approximately 92.8 percent, contain at least one of these inactive ingredients.

- About 45 per cent of the analysed medications contained lactose.

When medications contain peanut oil, manufacturers print warnings on the labels, but for most other allergens or irritants, no warnings are given, and it is not easy to find out if a compound such as lactose or gluten is in the medicine, the researchers say. And, says a new study, many doctors don't even know what those ingredients are. "Education, increased awareness, and legislation are all important". These "inactive" substances, like lactose or gluten, can also be the source of allergies and intolerances. An allergist can test people to see if they're actually allergic to this useful and affordable antibiotic.

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