<<Disclaimer: Verify this information before applying it to your situation.>>

Here is an interesting, cautionary tale about about medications, especially
if your health plan, like mine, requires generic drugs whenever possible.

For about the last 20 months, I've been taking a drug called nortriptyline
for my perhipheral neuropathy. Although it seems to have helped in some ways,
my symptoms have certainly not improved much for the last couple of months.
After going gluten-free (perhaps "thinking" I was going gluten-free is
better) in January of this year, and after reading all the messages here
about potential gluten in medications, I checked out the ingredients for
nortriptyline by calling the drug company myself and talking to a chemist. I
was assured that it contained no gluten (wheat starch, etc.). The particular
health plan I belonged to at the time had us patients use a mail-in
prescription service, which sent me three months' dosage of the drug at a
time, at practically no cost to me. Unfortunately, I didn't notice that, when
I refilled the prescription last March, the Rx service switched to another
drug company. I found out only yesterday that the nortriptyline from this new
supplier, Creighton, does indeed contain wheat starch! (In the  pharmacist's
reference manual, it is labeled just as "starch.")

I found this out when the pharmacist from my new health plan, Kaiser
Permanente, called Creighton after I came in for a prescription refill last
Friday and gave them detail about needing a gluten-free and lactose-free
drug. (I pressed the pharmacist despite the fact that my physician showed no
interest whatsoever about the possible link between gluten intolerance and
neuropathy.) The Kaiser pharmacists in turn pressed Creighton (whom they
normally use for nortriptypline), who responded that their version of the
drug contains wheat starch. I'm impressed by the willingness of Kaiser to go
this extra step, and I'm also sure that Kaiser's size gives them considerable
clout with drug companies. Kaiser will now get their nortriptyline for me
from Creighton's parent company, Sandoz, which makes the same drug (under the
brand name Pamelor) but uses corn starch instead of wheat starch. (It's no
small irony that a company such as Creighton would include wheat starch in a
drug that can be used to treat perhipheral neuropathy, which in turn can be
caused by wheat intolerance!  As my son would say, "DUH!" It may also help
explain why I've not made much progress on the peripheral neuropathy lately.)

I guess this is just another lesson in what I'm hearing all the time around
here:  vigilance! vigilance! vigilance!