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Hi List,

I think what would be most important for the List as a whole to know is
whether we can trust generic drug manufacturers to not include gluten in
their formulations of drugs that are GF in the brand-name version.  And how
we can find out if they do or don't.  I hope a professional or someone who
has info about manufacturing practices will reply to this.  We all know of
the many of hidden forms in which gluten crops up.  Do the generic
manufacturers know?  Do they care?

I think it's especially important for the List to know because so many HMOs
and PPOs are switching to generic drugs to cut drug costs.  For years I read
that generics are"exactly the same as brand name drugs," so don't waste your
money buying expensive brand name meds.  Then I read in a magazine I trust
(I THINK it was Consumer Reports) that generic formulations of a drug could
differ widely from the brand name version.

My immediate personal reason for asking this general question is that I've
repeatedly tried to uncover the gluten status of Duramed 1mg. Estradiol
tablets.  Their Customer (dis?)Service Rep informed me that "gluten is not
listed as an ingredient;" she DIDN'T say, "it's gluten-free."  I don't
recall seeing gluten listed as an ingredient on patient info inserts, even
those of meds that the Celiac ListServ says contain gluten.

Is "gluten is not listed as an ingredient," an adequate guarantee of a
product's being gluten-free?

I'm certain Estradiol itself is GF.  My previous brand-name estrogen caused
me no problems -- and their Customer Service Rep said it was definitely
gluten-free.  Since my HMO switched to the generic, I've gradually begun to
have symptoms.  At first they were so slight, I didn't believe they were
actually Celiac.  I've been on the new estrogen for about two months and
today realized that I'm having full-blown across-the-board Celiac symptoms.

I usually have full-blown flat-out, run for the john (and try to remember
that your first symptom is loss of depth perception, so that you don't run
head-long into the door jamb again this time!) symptoms.  These new symptoms
came on slowly and very subtly.  Today I finally noticed I've lost my sense
of smell, again (usually one of the last symptoms and I don't always get
it).  So I guess that EITHER being (mostly) GF for 17 months has changed my
symptom onset pattern (a few months back it hadn't), OR there's miniscule
gluten in whatever it is I'm getting, so it took a long while to build up.

There was an earlier post re:red dyes containing gluten.  These pills are
pink, for what it's worth.  I also started taking Ranitidine again when my
Reflux returned.  I thought I'd recovered from Reflux, then I started the
new estrogen pills and a little later the Reflux returned.  Ranitidine is
another generic, made by Par, and it's orange.  It seemed to never give me
Celiac symptoms during the first 17 GF months.  And I think I was able to
contact Par and they said it's definitely GF.  (I'm not certain, though;
memory loss and confusion is another one of my Celiac symptoms.)

I've rewritten this a jillion times.  If it's confusing and disjointed,
please forgive me.  As I said, I'm really having flat-out symptoms.

Whew!

Raynelle/Oregon