Inactive ingredients in medicines can have side effects

MADRID, March 18th (EUROPA PRESS) –

Most over-the-counter or prescription tablets and capsules contain components other than the drug. These compounds, called "inactive ingredients," help to stabilize the drug or its absorption and can make up more than half of the mbad of a pill.

Although these components are generally considered benign, a new study by the Mbadachusetts Institute of Technology (MIT) and Brigham and Women's Hospital in the United States reveals that almost all pills and capsules contain ingredients that: They can cause allergic reactions or irritation in some patients. In most cases, doctors do not know which of these ingredients are included in the pills that they prescribe to their patients because there are many different formulations.

"For most patients, it does not matter if there is a little lactose, a little fructose or starch. However, there is a subpopulation of patients, of currently unknown size, who will be extremely sensitive to these ingredients and will develop symptoms triggered by inactive ingredients, "said one of the lead authors of the study. , Daniel Reker, postdoctoral fellow at the National Science Foundation of Switzerland at the Koch Institute for Integrated Cancer Research at MIT.

The researchers hope their study, published Wednesday in the journal "Science Translational Medicine", will educate patients and health professionals about the problem and help stimulate reforms to protect drug patients who do not tolerate well.

"At present, there is an imbalance in the amount of information and understanding that exists regarding the inactive components of the drug.", says Giovanni Traverso, badistant professor in the department of mechanical engineering at MIT, gastroenterologist at Brigham Hospital and one of the main authors of the study.

Traverso began to badyze this problem about five years ago, after an experience with a patient that he was treating. The patient, who had celiac disease, had reacted badly to omeprazole, an acid suppressor commonly used to treat stomach ulcers.

The specific formulation of omeprazole that the patient had taken contained ingredients derived from wheat-based products (potentially containing gluten). This information was only available from the manufacturer at that time. One week after getting the drug, the patient had indicated that he was feeling sick while taking this medication. "It really brought to light the little knowledge we have about pills and their possible harmful effects," says Traverso. "I think there's a huge undervaluation of the potential impact that inactive ingredients can have."

Currently, when doctors write a prescription, they specify the type and dosage of the active drug, but nothing about inactive ingredients. Many drugs are offered in dozens of different formulas, and the one that patients get depends on their insurance, their pharmacy and the manufacturer who provides it. The information provided with the drug usually contains the list of inactive ingredients, but not the amounts of each, and they can be difficult to decipher. For example, ingredients containing gluten may not appear as "gluten".

SPECIAL FREQUENT PROBLEMS OVER 65 YEARS

The researchers reviewed medical journals and discovered several studies describing patients with allergic reactions to inactive ingredients such as lactose and chemical dyes. These studies generally did not include patients with intolerances to a particular ingredient, who are lighter and produce symptoms such as bloating or stomach pain.

However, Scientists believe that these more moderate reactions can affect many more patients. Potential problems may be particularly common in people over 65, of whom 30% take at least five pills a day, which could allow the accumulation of essential ingredients.

Next, researchers sought to find everything they could about the inactive ingredients found in prescription drugs and over-the-counter medications. By obtaining much of their information in a database called Pillbox, administered by the National Library of Medicine, scientists were able to determine the composition of almost all prescription and over-the-counter drugs available in the United States.

They found that for most medications, more than half of the pill is composed of inactive ingredients and that it even reaches 99% for some. They also found that about 93% of drugs contain allergens such as peanut oil, lactose or dyes, and almost all contain compounds that some patients can not tolerate, such as gluten and some types of sugars. About 55% of drugs contain sugars known as FODMAP sugars, which can trigger digestive problems in some people with irritable bowel syndrome.

According to the researchers, when drugs contain peanut oil, manufacturers post warnings on labels, but for most other allergens or irritants, it's unclear whether a compound such as the lactose or gluten is present in the drug. Even though patients are aware of their allergies and sensitivities and correctly decipher the drug packages, they may not have many different treatments as there is not a single tablet that avoids all these ingredients, the researchers added.