"Let Food be thy medicine and medicine be thy food."
My heart sank when I read a message from my friend Libby that she had discovered that the drug information insert given to her by CVS pharmacy with her food allergic son’s medication was for the brand name drug and not the generic she was being given. She had made a startling discovery after months and months of anguish and worry for her son’s declining health: the generic version of the drug contained a milk derivative. The brand name did not. She had been giving her son a medication that contained an ingredient directly contraindicated by his allergies. Libby wrote more on her blog, The Allergic Kid.
Think about it this way, if pharmacies are supposed to look at the interplay between one medication you take and another, shouldn’t they also (1) provide accurate ingredient information, (2) consider the act of avoiding an allergen a prescription equal to something actually produced by a company and shipped to the pharmacy, and (3) have to engage in safe practices so that a person obtaining a medication won’t have their pills sorted on the same surface as a medication that would be unsafe for them to ingest?
Like any mama bear would, Libby has sprung into action and I want to help her reach as many people as possible. If her petition to the White House (remember, President Obama is directly impacted by food allergies in his family) gains enough signatures by July 4, 2014, we can get an official response to her request that FALCPA be updated to include direction that prescription drugs, like the food on our store shelves, take food allergies into account. This benefits the food allergy community, the celiac community, and the public at large that is owed transparency.
Will you join me in signing this petition? Thank you!
Update: I am pasting this wonderful comment here so it isn’t missed. Reader Tiffany writes:
I am a registered pharmacist. Actually I have a Doctorate of Pharmacy–PharmD. I am also the sister of a person within milk protein allergies and the mother of a son with severe food allergies–egg, soy, peanuts, and various tree nuts.
Pharmacists, in general, get no formal training when it comes to food allergies. I must train the technicians at each pharmacy to ask for food allergies in addition to medication allergies. A lot of food allergies can be placed into the pharmacy’s database. However I cannot guarantee that the inactive ingredients are tagged and appropriately flagged—that’s a whole other discussion LOL . Brand and generic medications do not, by law, have to contain the same inactive ingredients. Generic medications are only required by the FDA to show that they compare to the active chemical in terms of efficacy/safety.
I will say that there are numerous medications that contain potential food allergens such as soy, fish, milk, and wheat gluten. For example: Gel caps –soy oil, over the counter vitamins–especially children’s–soy, spectracef (antibiotic) contains milk protein, Androgel–soy, certain vaccines such as flu, MMR–egg, certain diabetes medication–fish/shellfish. I could go on…
Combivent just re formulated this year and no longer contains soy/peanut allergens–hurray!
My top three suggestions would be :
1. Please tell the pharmacist–and stress the importance and severity of the allergy. Make sure that the food allergy is placed into the profile either in the allergy section OR via a patient note. Heck, why not both! As I stated above, pharmacists are somewhat like the general population in terms of food allergy knowledge and most do not even realize that this could be as big an issue as it is. A pharmacist will/should know the difference between lactose intolerance and milk protein allergy. So by discussing the issues–the pharmacist should “get it.” But if the pharmacist/pharmacy staff was never informed then they can’t intervene.
By the way, the doctors are just as clueless. Should you make the doctor aware of food allergies? Yes. Does the doctor weigh this info when prescribing? Probably not.
In my opinion, standard allergy questioning for medical purposes should contain food allergy questions as well.
2. Ask for the package insert (PI) for the NDC THAT YOU ARE RECEIVING. The actual medication that is in your bottle. The NDC is the number that signifies the specific manufacturer, drug, and bottle size from which your prescription was filled. The inactive ingredients are listed there usually. Each bottle comes with a PI–some may have fallen off during shipping. Every pharmacist will know what an NDC is.
As a matter of fact, in most retail settings the pharmacist can order a specific NDC–one that does not contain a specific FA–provided that the product exists and is available. Be patient–it is going to take more than 15 min to track all this information down. It’s worth the wait.
3. Call the manufacturer if unsure. The pharmacist has access to and can provide you with the phone number for the manufacturer of the medication you are receiving.
I have discussed these issues on small scale and I totally agree that medical staff including doctors and pharmacists need better FA knowledge and training as it related to medications and treatment.
Sorry I wrote a book but I hope that will help answer some questions about FA and the pharmacy (FA and the pharmacy that sounds like a good title for a blog—hmmmm LOL)
I think she should certainly start that blog! Thank you Tiffany for sharing your expertise!
The petition didn’t gain enough signatures (when I checked last before it went offline I believe it was at about 200) but that doesn’t mean the issue should go quietly into the night. In other news, Tiffany did get her blog started!