People who don't to eat animal products, may be in for shock when they reach for the medicine cabinet.
Most people are unaware, that many common medicines contain animal protein derivatives in the form of gelatin, which is derived from animal skin, sinews or bones.
Other drugs contain traces of egg which is used to produce many vaccines and other drugs.
A recent survey published in the Postgraduate Medical Journal showed that about 25% of patients are prescribed drugs that contain gelatin when the patients are totally unaware that gelatin is present and which is contrary to their beliefs.
Even the doctors may not be aware of these issues when prescribing drugs.This article discusses these issues.
Doctors usually only look at the ‘active’ component of a drug formulation and ignore the other components of the medicine which make up most of the volume of the tablet or capsule or liquid drugs.
These accompaniments to the active ingredients are known, as 'excipients'. For example many drugs used to treat urinary tract infections contain gelatin which may conflict with the food restrictions of the patients such as vegans who aim to avoid eating any meat products whatsoever.
Others don't eat animal products for religious reasons. Some may choose to make an exception for drugs, but they should be made aware of what's in the drugs so that they can make informed choices.
A recent study, based on questionnaires of 500 patients,undertaken in 2010, was designed to determine how many patients who avoided eating animal products, had been prescribed gelatin-containing oral medicines without their knowledge. The gelatin may have compromised their religious beliefs or dietary practices. The study found that:
Clearly there is a need for an urgent revision of the advice to patients provided by healthcare professionals, including doctors about excipients. Vegetable-based alternatives for gelatin containing products should be offered. The issue also applies for non-prescription drugs sold over the counter. Most capsules use gelatin for the outer skin. There is clearly a need for better labelling on drug packaging to help reduce the risks that a patient's diet beliefs or preferences is not inadvertently compromised when prescribing oral medication. Doctors should be advised to ask their patients about their dietetic preferences before prescribing drugs or recommending over the counter treatments.
While its true that many countries throughout the world require full information of all ingredients on the leaflet that accompanies the drugs, most people don't read the information. This is designed to help concerned patients to check if a product ingredients of concern, but this is too late. People are advised to get advice from their pharmacist or even contact the manufacturer of the product.
Many vegetarians will be shocked and distressed to learn about the almost universal use of animal ingredients in medicines. Many of these ingredients in tablets, capsules and liquid forms of medicines are non-active components help binds or package the drugs or thicken liquids. Gelatin is very commonly used, especially in generic medicines - mass-produced versions of a drug that are promoted as cheaper alternatives once the initial patent for the drug has expired.
There is a clear message to doctors as well. They need to be aware that far more than the active drug is being dispensed. A whole group of various other agents accompany the active ingredients in the drugs prescribed. The researchers proposed that drugs should be sold with an "ingredients" list published on the outside of the package, similar to those used for found packaging. The symbols promoted by the Vegetarian Society in the UK could also be adopted for medicines.
The researchers also stated that there are lots of vegetarian alternatives to gelatin available and should be adopted by the manufacturers of the products.
Liz O'Neill, spokesman for The Vegetarian Society in Britain, said that it frequently received calls from patients concerned about animal products in their medication. She said that current labelling made it hard for them to make an informed choice.
'Some vegetarians will be shocked to learn about the widespread use of animal ingredients in medicines. 'This is a complex area with no overnight solutions, but the Vegetarian Society believes that everyone has a right to know what they are consuming.'