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Q: My grandson is allergic to soy. How can I find out if soy or other inactive ingredients are in a medication before he takes them?
A: All inactive ingredients in drugs are approved by the U.S. Food and Drug Administration (FDA). They're almost always considered "GRAS," or "generally recognized as safe." While most people may not care to know what inactive ingredients, or excipients, are in their medications, people with certain health conditions, ingesting specific binders and fillers that are present in some drugs can be problematic. For example, people with celiac disease need to avoid gluten, those with food allergies may need to avoid soy or dairy, people with diabetes may look to avoid sugar, while those with an alcohol abuse problem should avoid alcohol. And all of these substances are used as inactive ingredients in some medications.
Guidelines for the labeling of inactive ingredients from the U.S. Pharmacopeia (USP), which sets standards for medicine that are enforceable by the FDA, require manufacturers to disclose every single ingredient in all medications. So it's possible to learn whether something you need to avoid is lurking in your drugs.
"Every drug manufacturer is obliged to list every excipient, every little part including coloring and flavors for each drug," says Andrzej Wilk, PhD, senior scientific liaison to USP's Nomenclature, Safety and Labeling Expert Committee. "This can be found on the package of a prescription drug or in the drug's package insert. For over-the-counter drugs, inactive ingredients have to be on the outside of the box."
Often, consumers are given prescription medication in a pharmacy vial with no accompanying documents from the manufacturer. If this happens, ask your pharmacist for the package insert. Or, type in the drug name at DailyMed; which has a searchable database of package inserts. Though be aware, these materials are written for healthcare professionals, not consumers. You can usually skip to the section of the package insert titled "Description" to find the list of inactive ingredients.
Occasionally, the generic version of a drug contains slightly different inactive ingredients than the brand-name version. If you switch from brand-name to generic and need to avoid a particular ingredient, read the generic label or ask your pharmacist, to be safe.
Lists of inactive ingredients in medications aren't likely to be as convenient to obtain or reader-friendly as ingredient information on food products, for example, which often bold potential allergens. So it may take patience and a keen eye to determine whether a drug contains the substance you're trying to avoid.
Here are some examples:
Substance: Look for the ingredient(s)
Dairy products: lactose
Gluten: wheat starch
Soy: soybean oil, (in supplements, look for soy protein or soy lecithin)
Sugar: dextrose, glucose, sucrose, fructose