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

			  Newsletter Roundup
			  ------------------
		Compiled by Janet Armil and Jim Lyles

This section contains excerpts from newsletters produced by other
celiac groups.


...........................................................
:                                                         :
:        Excerpts from _Gluten-Free News_ (Oregon)        :
:        -----------------------------------------        :
: Fall 2000     Portland/Vancouver Affiliate of GIG of NA :
:                                      9525 SW 12th Drive :
:                                     Portland, OR  97219 :
:.........................................................:

Are Meds Gluten-Free?, by Margaret Fowler, Rph, MS
---------------------

In keeping with a gluten free (GF) diet we want to be sure the
medications we take are also GF.  At the GIG Annual Meeting in May
2000 the speakers presented several principles that can help us.

-- The first principle is:  the item (in this case, the medication
   that might contain gluten) must come in contact with the small
   intestine.  Robert Shneidman, MD, reviewed this concept in his
   presentation.  So dosage forms that are swallowed or inhaled need
   to be checked out.

-- The second principle is:  gluten cannot be absorbed through the
   skin.  Cynthia Kupper, RD verified this fact with several
   dermatologists at a recent meeting in Washington, DC, so lotions,
   topical creams, and topical ointments should be safe.  It is
   important to wash your hands carefully after using such items, to
   avoid accidental ingestion of the item.

-- The third principle is:  distilled products such as alcohol (and
   vinegar) are GF since the gliadin amino acids are not
   "volatile"--they will not vaporize during the distillation process
   and thus will not pass over into the liquid that condenses at the
   end of the distillation device.  Don Kasarda, PhD, a grain
   scientist, made that point in his presentation.  So [distilled]
   alcohol that may be in a liquid medication is GF.

This leaves the oral dosage forms such as capsules, tablets, syrups,
oral suspensions, and inhaler medications as possible sources of
gluten.  For prescription medications the pharmacist needs to know if
the brand name product or a generic product was dispensed.  The label
on the prescription vial should have the abbreviated name of the
generic manufacturer or the brand name of the medication.

Once the exact product is known the next step is to find out if
someone else has researched the GF status.  I have found that the book
by Stokes Pharmacy, Celiac Sprue, A Guide Through the Medicine
Cabinet, is an excellent reference.  It lists both prescription and
non-prescription medications, indicating whether or not gluten is
present.  It also indicates for some products whether or not lactose
is present.  (Lactose intolerance is a problem some celiacs have.)  A
new version of the book is due out in the fall of 2000 and may be a
subscription service of some sort, according to Ellen Magaziner,
PharmD candidate, another of the speakers at the conference.  Stokes
Pharmacy carefully interviews the various manufacturers to determine
the GF status of each product listed.  [Celiac Sprue, A Guide Through
the Medicine Cabinet, can be purchased for $22.20 from Stokes Pharmacy
by calling 800-754-5222 or visiting their web site at
http://www.stokesrx.com/<4>]

If your prescription medication is not in the Stokes book, then
reviewing the ingredient list from the package insert or in a book
like the Physicians Desk Reference is the next step.  The ingredients
that are most likely to be sources of gluten are "starch", "sodium
starch glycolate", and "pregelatinized starch" (although the last two
items have a very low protein content and thus more likely to be
gluten free).  From my investigations into this issue the last few
years I have found that corn and potato are the more common sources
for these three ingredients.  Cellulose and related substances are
from wood products so I do not suspect them as a source of gluten.  I
am continuing to research other ingredients that may be sources of
gluten.  If any suspect ingredients are listed, then we need to call
the manufacturer to determine the biological source of the item.  Most
manufacturers have toll-free phone numbers.

What can we do if the medication DOES contain gluten?  Finding an
alternative medication (either brand name or a generic product from a
particular manufacturer) that is known to be GF is one option.  The
prescriber needs to write on the prescription "No Substitution" or
Dispense As Written" as well as the brand name or generic name and its
manufacturer to be sure that a different manufacturer's product is not
dispensed.  Another option is to use the "patch" form, if one is
available.  A third option is to have the medication formulated for
you as a gluten-free capsule, patch, or lozenge by a pharmacy equipped
and skilled in making dosage forms "from scratch".  These are now
called "compounding pharmacies".  [Stokes Pharmacy is a compounding
pharmacy.--ed.]  Medication formulations can change every once in a
while.  Periodically check your medications to see if they are still
GF.

                            -=-=-   -=-=-

Going to Disneyland?  Contact Customer Services, Food Preparation at
714-781-4650, or Chef Chris Justesen at 714-781-3569 for assistance
with gluten-free meals while in the park.