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I was going to respond just directly to Amy about her Prilosec
question, but I've been meaning to write this to the general list
anyway.  I had an experience which is a bit involved and might be
worthwhile to share with the entire list.  I am hopeful that others
can provide further insight into this matter.  It would seem to me
that it could be (maddeningly) pertinent to perhaps most of the
prescription drugs that any of us take.

I also was recently (about 3 months ago) seeking answers about
Prilosec, as well as the generic form of Prilosec that my
prescription company was insisting that I get, AND about the newer
over-the-counter version of Prilosec.

THE GENERIC VERSION OF PRILOSEC:  When I asked about the gluten-free
status of the generic, I was told by the prescription co. that they
could give me the phone number of the manufacturer to clarify the
situation, but could not guarantee that the next time I order the
generic version that it would come from the same source, or that the
ingredients would be the same, even if from the same source.  I would
need to call the generic provider each time I ordered the drug.  None
of this surprised me, made me nervous, so I proceeded to inquire
about the non-generic form of Prilosec.

THE NON-GENERIC (BRAND-NAME) VERSION OF PRILOSEC:

Again, my prescription co. could not give me the information I wanted
about gluten, saying that the lists of ingredients that are provided
to them by the major drug manufacturers are generally not complete.
Per my pharmacy, the manufacturers are not required to disclose all
ingredients in their general drug literature, and often they do not
disclose them.

My prescription co. gave me their number, so I called Astra Zeneca --
the company that makes Prilosec.  Their answers made me very
uncomfortable.  I later confirmed their answers with my prescription
provider (Merck-Medco Pharmacy), and they said these answers apply,
in fact, across the board to nearly all drugs, including the drugs
that they (Merck) manufacture.  Truthfully, it's making me crazy, and
I wish I had some way to confirm this information.

What Astra Zeneca customer service told me was this:  WHEN any of
their drugs are made up for the FIRST time, they ask for verification
from the sources of other ingredients as to being free of gluten or
not.  However, they told me that AFTER that start-up point (that is,
at any point of the drug's life, until it is otherwise discontinued
or reformulated), they do not continue to verify whether or not the
ingredients provided to them by third parties are changed in any way.
They also do REQUIRE that these 3rd party providers alert them to
changes in the formulations of the ingredients they provide.  They
could tell me that the ingredients of said Prilosec did not contain
any gluten when the drug was first formulated, but they could provide
me with no guarantees that any of the ingredients, since that time,
had not changed to contain gluten.  (I confirmed with a real world
example: which was a capsule that was originally formulated to be GF,
and could later be changed to include wheat starch without any
disclosure to the drug company by the capsule provider -- the answer
was YES that could happen.)  I honestly could hardly believe my ears.
But I called back to Merck-Medco pharmacy, and they confirmed every
thing I related to them about my discussion with Astra Zeneca.  The
customer rep there told me that was true for almost all prescription
drugs, except for a very few that are specifically formulated to be
labeled as "gluten-free," and then there is continual monitoring of
ingredients.  I asked what drugs these might be, but the rep couldn't
name any.

THE OVER-THE-COUNTER VERSION/PRILOSEC OTC:

However, I got far more satisfying answers from Procter & Gamble, of
all things.  P&G oversees the marketing and labelling of Prilosec
OTC, although the drug is provided to them by Astra Zeneca.  However,
the rep at P&G told me that they (P&G) are bound by very strict
labeling laws and they must show gluten ingredients on the label if
any are present.  Somehow, this simply gave me a much greater degree
of comfort.

THE POSTSCRIPT:

I chose to use the Prilosec OTC.  They work just as well (for me,
anyway) as the prescription version ever worked -- and I have some
pretty significant problems with GERD.  It's hard to know, but I
actually think they work slightly better for me -- though that just
doesn't make any logical sense to me.  I have had no gluten reaction
that I can discern, and I take one pill daily.  The Prilosec OTC is
just slightly more $ than the co-pay amount from my prescription co.
for the generic version ... and is ONE-THIRD the $ of the brand name,
even if I buy it on my insurance plan.

But this post really isn't just about Prilosec.  It is about these
issues that were laid out for me by Astra Zeneca and Merck-Medco ...
that is the broader issue that the major drug companies seem to have
a general policy of not monitoring ingredients in their prescription
drugs, and also not requiring notification of changes in those
ingredients from 3rd party providers.  There is also the issue that
the list of ingredients made available to the general public and to
pharmacies are NOT always complete, and may not list sources of
gluten.

I sure hope there are some medical types reading this note who can
better clarify this situation.  I did ask to speak to a customer
service supervisor, at one point during my discussions with
Merck-Medco -- but have no idea how to get connected with a
professional who would really know if I am receiving accurate answers
to these queries.

Thankfully, I take precious few prescription drugs -- but it sure as
heck makes me nervous as a consumer for any I might have to take in
future.  If I get any more knowledgeable responses to this post, I
will summarize back to the list.  (And, believe me, I hope I get
some!)

* Visit the Celiac Web Page at www.enabling.org/ia/celiac/index.html *