Hidden Harm: Compounding Medications for Gluten-Free and Lactose-Free Patients

Hidden Harm: Compounding Medications for Gluten-Free and Lactose-Free Patients

i-pillGastroenterological disorders like celiac disease and lactose intolerance are painful and life-altering; no one likes to adjust their entire lifestyle and the cultural experience of being at the table. As a younger person, I had a fairly easy time eating whatever I liked without any trouble. However, more recently I have been directed to avoid wheat after having an allergy test; this came in the wake of literally years of what felt like completely random attacks of pain related to my consumption of normally innocuous foods.

While I definitely hate dealing with food allergies, I’m not alone. Millions of Americans need to avoid a variety of foods and must treat for related gastroenterological issues. As a result, compounding medications for individuals with gluten-free and lactose-free requirements for celiac disease and lactose intolerance is a hot new area for many compounding pharmacies.

Gluten-Free Compounding for Celiac Disease

About 1 percent of individuals in the U.S. suffers from celiac disease, a digestive and autoimmune disorder. People with celiac disease cannot digest gluten without causing their immune system to attack their small intestine; gluten is a protein found in wheat, barley, rye, some other grains, and in many processed foods. Symptoms vary, but typically include bloating, abdominal pain, chronic diarrhea, or constipation, vomiting, and unusually foul-smelling stool. Celiac disease may be diagnosed with stool samples and blood tests, but may need to be confirmed with endoscopic tests.

There is no cure for celiac disease and there is no medication that can cure it. Sufferers simply must go gluten-free for life; many also need to eliminate most refined sugars and lactose sugar. However, many standard over-the-counter and prescription drugs contain gluten, lactose, and/or sugar. For this reason, compounding pharmacies play an important role in the treatment of celiac disease because when drugs lead to accidental consumption of gluten, even in tiny amounts, it can be a serious issue for celiac sufferers. The creation of customized gluten-free and lactose-free medication is a huge benefit to these patients.

In addition, a number of celiac disease sufferers do not heal and thrive even when they go gluten-free. These people suffer from refractory celiac disease and have suffered permanent damage to their intestines from the disease. They may need to receive parenteral nutrition since their intestines cannot absorb nutrients properly; this is another key area for custom compounding solutions.

Lactose Intolerance

Between 30 million and 50 million Americans are lactose intolerant, meaning they are unable to digest dairy products. This is because their bodies do not produce the enzyme lactase which allows the body to digest lactose, the main sugar found in milk and milk products. African-Americans, American Indians, and Asians are most likely to be lactose-intolerant. Some cases are mild, but lactose intolerance can produce severe symptoms including bloating, cramping, diarrhea, gas, and nausea. Typically the onset of symptoms happens 30 minutes to 120 minutes after consumption of dairy products.

Healthcare providers usually test for lactose intolerance with blood, breath, or stool tests used after consumption of dairy products. However, most patients report knowing about their problem easily; the symptoms are usually apparent. Some sufferers with mild intolerance may be able to consume dairy products if they use over-the-counter pills that contain lactase, or by consuming lactose-free substitutes. However, many sufferers do need to eliminate most dairy or be careful about when and how they consume it.

Compounding medications that are lactose-free is very important for lactose intolerant patients and for many other patients as well. Research shows that the presence of “hidden” lactose in medications can be harmful for not only lactose intolerant patients, but also for celiac sufferers, certain cancer patients, and potentially any gastroenterological patients. This same work indicates that “lactose is present in medications prescribed for the treatment of a wide range of GI disorders,” highlighting the need for compounded lactose-free medication.

The current explosion of attention to gluten-free and lactose-free products underlines the importance of this area of specialty compounding for pharmaceutical professionals. There is a tremendous need and growing demand for custom compounding for celiac disease, lactose intolerance, and related issues that your business can meet with the right tools.

If your pharmacy is in need of compounding ingredients, Pharmaceutica North America would like to be your resource for high-quality compounding products for all of your compounding needs. For more information regarding products available through PNA, please contact our very knowledgeable and friendly team.


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