Allergy Awareness: Are There Food Allergens in Medicine?

May 12-18 is Food Allergy Awareness Week. This important event gives us the perfect opportunity to talk about a matter of extreme importance: food allergens in medications and how pharmacies can help sensitive patients avoid them.

Food allergies are no joke. Depending on the severity of the allergy and the patient, they can cause everything from itchy eyes to anaphylactic shock.

That’s why it’s so important that pharmacies play an active role in helping patients with allergies avoid triggers – even within prescribed and over-the-counter (OTC) medications.

First, we’ll explain the basics of food allergies, including what causes them and why most medications contain food-based fillers. Then, we’ll share how pharmacists and pharmacy technicians work together to keep you healthy, well, and safe.

Here’s to your health!

What is a Food Allergy?

A food allergy is an immunological reaction to the presence of a certain food-based item or product (for example, nuts or strawberries). Although researchers aren’t yet sure why it happens, the human body sometimes confuses food molecules as some kind of pathogenic threat.

The immune system acknowledges the threat by generating disease-fighting antibodies that trigger a massive release of histamine.

Histamine is a self-protective chemical that widens blood vessels to improve blood flow. It also encourages smooth muscle groups to contract.

Together, both of these reactions make up the basis for inflammation – swelling, redness, and increased circulation.

While few people enjoy experiencing inflammation after an injury, it is an important part of overall wellness. Improving circulation and blood flow makes it easier for the body’s natural immune system to fight off threats and/or heal damaged tissue.

In allergy patients, the immune system is hypersensitized and overactive.

It responds to food items as if they were threats, launching an all-out assault in an effort to purge them from the body.

The symptoms associated cause the allergic reaction.

Are Food Allergies Dangerous?

Allergies occur on a spectrum, so every patient’s reaction is unique. Some patients experience only minimal itching, while others struggle with itchy welts (called hives) for days after eating trigger foods.

In rare cases, allergies can be so severe that they cause anaphylactic shock. In anaphylaxis, even the normal histamine release spirals out of control; the body releases a waterfall of chemicals only seconds after ingesting a specific food. These chemicals cause:

• Breathing difficulties
• Extreme swelling
• Dizziness
• Sometimes, even complete respiratory failure or death

Around 50 million Americans suffer from allergies each year. Some of these people are born with a specific allergy, and experience reactions from day one. Others suddenly develop allergies later in life.

Scientists aren’t yet sure exactly why some people seem to be more likely to develop allergies than others. However, general consensus among the medical community favors the influence of genetics and environmental factors.

Are There Food Allergens In Medication?

We mentioned earlier that most medications contain food-based additives that preserve, stabilize, or bind drug ingredients together. They may also help to flavor certain formulations to make them easier to take.

According to Medical News Today, 93 percent of all medications on the commercial market contain at least one type of food-based additive.

A significant portion are, in fact, sourced from foods, while others are sourced from certain chemicals. Even synthetic chemical additives may be sourced from base food allergens!

For example:

• Wheat and corn starch: These are frequently in caplets, tablets, and capsules. Both give the tablet bulk and help drug ingredients retain their shape over time.
• Sucrose: (A type of sugar) is added to most oral liquid medications (such as children’s antibiotics). It reduces the bitterness associated with many drugs.
• Egg protein: Also called ovalbumin, may be found in the MMR, Rabies, and Influenza IIV It serves as a stabilizer and preservative.
• Gelatin: Is present in nearly all capsules. It may also be in suppositories, oral films, chewing gum, oral gels, and some vaccines. Generally, it serves as a filler, a binding agent, or a stabilizer.
• Peanut oil: Is a common ingredient in valproic acid and progesterone. It is also sometimes in topical creams and ointments. In both cases, it serves as a filler and/or alters the consistency of the product, boosting absorption.

There are thousands of different food-based additives used in pharmacology, including colorants, flavorings, bulk-forming fillers, and more.

Each serves a slightly different purpose, but all are included because they offer something beneficial to the manufacturer or patient using the drug.

Should Allergy Patients Avoid All Medications?

Not necessarily. In fact, very few patients react to food-based additives even if they have a specific allergy to an ingredient within the formula; the amount of additive included is usually very small.

Still, particularly sensitive patients may react to even the slightest presence of food allergens. Furthermore, the risk for a reaction to worsen suddenly does exist.

It pays to be cautious and avoid medicines containing triggers when you can.

Often, avoiding food allergens in medications is easy; substitutions are available.

Changing the medication or opting for a special custom formula can help you gain all of the benefits of using medicine without putting yourself at risk.

How Your Pharmacist Can Help

Your pharmacist is your first line of defense between you and any potential allergy triggers within medications.

If you become aware that you have a food-based allergy, or if you experience an allergic reaction after ingesting certain foods, tell your pharmacy so they can record the information on your patient profile.

Your local pharmacy can help you manage food allergies and avoid food allergens in medications in a variety of ways.

Pharmacists can:

• Provide on-the-spot advice: for avoiding food-based allergies you may encounter at work, at home, or out in the world. This includes identifying surprising sources of allergens you might not be aware of.
• Educate you on how to respond: if you believe you are experiencing an allergic reaction, including when to take over-the-counter medicine and when to see a physician.
• Teach you how to use allergy medications: in a medical emergency, including over-the-counter allergy drugs and Epipens for anaphylaxis.
• Record your food-based allergies: on your patient profile to ensure that any new prescription interactions don’t put you at risk.
• Review your medications: to ensure you aren’t inadvertently taking a medication containing food allergens.
• Help you find substitutions: when you are prescribed a drug that contains food allergens. Alternatives are almost always available.
• Compound medications from scratch: using only ingredients known to be safe for you to take (only available at compounding pharmacies). This is an excellent option for patients with multiple food allergies.

Conclusion

If you struggle with food allergies, don’t be afraid to reach out to your pharmacist when you need help.

Whether it’s compounding a medication to avoid side effects from an allergy reaction or just having someone to listen when you’re struggling with symptoms, your pharmacist is a valuable part of your care team.