Corn and Excipients in Prescription Medication
Food Allergies and Drugs
Most people don't even think about medication when they start out on an allergy journey. After all, food allergies relate to FOOD, right? Not drugs. That stuff you take for a headache? It might be a potential allergen (if you're really health savvy) but not filled with allergens. Think again.
While medication is created to give you a specific dose of a specific drug, or specific mixture of drugs, it needs a little help getting those substances into a format that will appeal to the patient. The help comes in the form of 'excipients' which help to bind the whole pill together, or make the final product easier to measure out, or fill a whole small capsule. They might also improve the taste or aesthetic appeal of a medication. And some medication is even colored and stamped with it's initial. This helps the pill to be easily identifiable, both in case of a mix up in medicating and in case of an accidental ingestion. If the original container isn't easily available, the unique shape and color might help emergency personnel quickly identify what pills some toddler thought were candy and treat them appropriately.
The trouble comes when you are allergic to a substance used as an excipient. Unfortunately, although doctors and pharmacists are well aware of medication allergies and food allergies, they don't think about the food grade products that go into the manufacture of prescription medication any more than the rest of us do. Most people with food allergies do not react to the substances used as excipients in medication. But some do.
One of the most difficult of these are people with a corn allergy or intolerance.
What's a Corn Allergy?
A corn allergy or intolerance is an unpleasant reaction to any corn derivative. Most aren't fatal, but some can be. Symptoms range from mild stomach ache or hives to full blown anaphylactic shock. Many individuals note swelling, dizziness, fuzzy thinking, and GI problems when they have a corn related reaction.
There are a myriad of different corn derivatives used in processed, and not so processed, foods. It's hard enough for an individual with a corn allergy to get dinner, they also need to thoroughly investigate any medication that might cross their lips.
Common Medication Additives Potentially Derived From Corn
Find a Safe Medication
When investigating food, one starts with an ingredient list. After all, most foods contain a list of ingredients. But medications are different. Medications contain both a list of active and inactive ingredients. They are also highly protected formulations, manufacturers want to keep their proprietary information secret from their competitors.
Over the counter drugs generally have a list of active ingredients somewhere near the top of the box. These are the ingredients that are going to improve your symptoms. Things like Ibuprofen or acetaminophen go here. If you read past the list of contraindications and how to use the product you will eventually find a list of "inactive ingredients". This is the list that is useful for individuals with a corn allergy or intolerance.
Corn allergic individuals (or their caretakers) will need to read each and every ingredient. They may also need to call the manufacturer. Most over the counter medications display customer service information on the outer package, although the customer service reps may not necessarily be able to answer questions about corn derivatives right away. They will be able to get back to you within 48 hours or so with an answer.
Prescription drugs are much more difficult. When a doctor hands you a prescription, they don't dictate anything other than the active ingredient they are prescribing. Few doctors think about the potential excipients and how they may impact the consumer with allergies. After receiving a prescription for a new medication, corn allergic individuals need to then go to their pharmacist and ask for a list of inactive ingredients. This is not always available, but sometimes it is.
If it is available, look for corn derived ingredients. If there aren't any, you just need to ask the pharmacist if it's possible to verify if the medication itself is corn derived. If there are corn derived ingredients, you will need to ask if there is a different manufacturer. Some pharmacies are quickly able to access a variety of formulations of a single drug. Others aren't. If your pharmacy isn't willing to work with you, go elsewhere. Your health is worth it.
If your pharmacist is unable to find a safe formulation of the drug that's been prescribed for you, you have a couple of options. Your first option is to ask your doctor if there is another suitable medication. Ideally, your doctor can give you a list of suitable medications for your specific condition, and your pharmacist can help you choose the one that is free of corn derivatives, then contact your doctor to have a prescription faxed in. Sometimes, a doctor prefers that their patients do the leg work and be the go-between. Occasionally, a doctor will be willing to contact the pharmacist directly and sort the problem out immediately.
The second option would be to bring a prescription to a compounding pharmacy. A compounding pharmacy is one that contracts for pure ingredients and can put those ingredients into a non-allergenic shell for the consumer. As you might imagine, this service costs a little bit more than prepackaged medications. But, if you have a unique allergy and require a medication that is unavailable in any other formulation, the compounding pharmacy is worth every penny.
Compounding for Kids with Corn Allergy
While it may be easier to get kids to swallow liquid medication, many parents find it's more practical to have children's medicine packed into capsules and then sprinkled into a spoonful of applesauce or melted chocolate as needed. Once medicine is mixed into the liquid form, it loses it's efficacy quickly. Capsules or powder have a much longer shelf life than liquid. Of course, it's important to make sure that all of the prescribed medication is properly ingested, so if you choose to empty a packet into a food or drink, make sure that all of the food gets consumed. Limiting the item mixed to about a spoonful is helpful because it's relatively easy to get down a whole spoonful, as opposed to a whole cupful.
How to Get Compounded Medication
If you are lucky enough to have a compounding pharmacist available, make sure that they are aware of what a corn allergy is. Give them your list of potential corn derivatives. Talk to them. Make sure that you are already comfortable with their level of understanding when it comes to your allergy. The last thing anyone needs when they're sick is to argue with the people who are supposed to help!
When you ask your doctor for a compounded prescription, they will need to write the name of the medication, and request that it be 'with no corn derivatives'. Your personal compounding pharmacist can help with the wording that they are most comfortable accepting. Every time you visit a doctor, bring your compounding pharmacy phone number and their fax number for easy coordination.
A compounding pharmacy may also be necessary if you need an over the counter medication, like an antihistamine or a painkiller (analgesiac). Unfortunately, even though people who aren't allergic to corn are able to walk into any neighborhood pharmacy and pick up all the over the counter drugs they want without a prescription, if your needs aren't met by preformulated brand name options then you will need to ask your doctor to write a prescription. The compounding pharmacy isn't even allowed to mix up acetaminophen into pine-bark capsules without a prescription signed by a medical professional.
When you work with a compounding pharmacy, you may need to choose some suitable excipients. A few common options are tapioca starch or lactose. You will also need to verify the ingredients of the capsule that the final product will be tucked into. Pine bark is one option. Gelatin is another. Verify the source of the gelatin.
When you have a corn allergy, things tend to feel twice as difficult. There are hoops to jump through, and research to do on everything from apples to bath salt. However, it's most important to be prepared for medical issues. When you are sick, you are most vulnerable. You aren't up to advocating for yourself. It's easy to think that this time, it won't be that bad. But when you're sick is also a miserable time to have a reaction. If you have a reaction, you won't know if it's an anticipated side effect to corn derivatives, or if it is a complication to your condition. You'll already be weak, and the double stress is going to make recovery time longer. When you're sick, it's hard to take care of yourself. When you are having a reaction on top of being sick, it may be nearly impossible.
So do your research and find a pharmacist you trust before you get sick. Maybe start out by finding a compounding pharmacy that will help you get some acetaminophen or ibuprofen to have on hand. (This can take between 24 hours and a full week) And keep their contact information with you, in a file that also includes your corn allergy or intolerance information. The more prepared you are, the more smoothly any problems will go.