[Note: My pharmacist authorized me to summarize our
discussion on behalf of corn-allergic patients without revealing his identity
or name of the pharmacy.]
May 29, 2020, Discussion with My
Pharmacist Re: Corn-Derived Excipients in Drugs:
As
posted in corn allergy support group:
“I had a very
enlightening discussion with my pharmacist this morning. He was very gracious
to spare a few minutes of his time with me.
I first asked
him if pharmacists have a drug reference book which lists the "source of
inactive ingredients in drugs." After he looked puzzled by my question, I
brought up the difficulty of corn-allergic patients to source safe drugs, since
the majority of drugs contain corn-derived ingredients as fillers.
I then asked
him if a patient is registered in their database as having an allergy to corn,
would their database flag drugs containing corn-derived ingredients; thereby
contraindicated for corn-allergic patients? He stated that they would have to
make that determination through research.
With the utmost
respect, I asked him if he knows the difference between dextrose and glucose.
After thinking about it for a moment, he stated that these are forms of sugar.
I agreed with him, but stated that there is a critical difference between
glucose (blood sugar) and dextrose (corn sugar derived from cornstarch per the
Code of Federal Regulation 21CFR184.1857), which is why IV fluids containing
dextrose are contraindicated for administration to corn-allergic patients on
the package insert. I also explained that I am aware that glucose and dextrose
are "biochemically identical" per published literature; however,
glucose (blood sugar) cannot provoke an allergic reaction; whereas, dextrose (corn
sugar) can prove fatal to corn-allergic patients. He confirmed that he was not
aware of this difference.
IMPORTANT UPDATE: Apparently, glucose (blood sugar) is NOT biochemically identical to dextrose (corn sugar). I recently discovered that the molecular formula for dextrose (corn sugar) is C6H14O7.
https://pubchem.ncbi.nlm.nih.gov/compound/66370
https://pubchem.ncbi.nlm.nih.gov/compound/66370
I then asked
him if he knows what ascorbic acid is, to which he replied "It’s vitamin
C." I agreed; however, I pointed out that ascorbic acid is synthetic
vitamin C which is usually derived from corn, and could provoke an allergic
reaction to anyone with an allergy to corn.
After he
revealed that he wasn’t aware of the source of magnesium stearate in response
to my question, I then asked him if pharmacists are educated about the source
of inactive ingredients in drugs in their colleges of pharmacy. He confirmed
that they are not educated about the source of inactive ingredients in college,
and thanked me for educating him about corn in drugs.
You may also
want to respectfully question your own pharmacists. This is the type of
documentation required to add to our FDA citizen's petition requesting that
corn be declared an official allergen subject to FDA labeling requirements,
since we can’t rely on pharmacists to
protect us.”
Testimonies
from corn allergy group members reprinted with permission:
[Note that a
common complaint by our corn allergy group members is the fact that their physicians
are aware of their allergy to corn, but still prescribe drugs containing
ingredients derived from corn; and now it has been revealed that pharmacists
are not educated about the dangers of NMIs (non-medicinal ingredients) in
drugs. Since the majority of drugs
contain corn-derived excipients, many of our members are required to have their
medications compounded to exclude corn-derived ingredients. For
these reasons, it is critical that corn allergen warnings be immediately
mandated on all drug and biologic products for the safety of corn-allergic
patients.]
"I’m a
pharmacist who works in community practice. Earned my doctorate in 2007. We
don’t learn hardly anything about the sources of inactive ingredients in
school. I would never have known that so many meds have corn and corn
derivatives in them unless my son had been diagnosed with FPIES in 2015. I
would venture to say only a handful of other pharmacists nationwide are aware
of this particular issue." - Pharmacist
"I
basically had to get my entire list of no-nos to my pharmacist so that he could
look them up individually as the need arises. He was entirely unaware and even
had a difficult time getting answers from the manufacturers about where their
ingredients were derived from whenever the source was not stated." - D.D.
" I have
had a 20 year relationship with my compounding pharmacists and I have had to
educate them over the years. They haven't any idea which inactive ingredients
are corn derived, so whenever they look up drugs in their pharmaceutical book,
or check packaging for me, I get them to read out the ingredients and I tell
them which inactive ingredients are likely derived from corn. It is a shame
they are not taught the sources of inactive ingredients. My pharmacist also
told me that inactive ingredients are purchased in huge vats for pharmaceutical
companies, usually from China, and even they don't know the origins of the
inactive ingredients they buy." - S.P.
“The day that I
offered the list of newly diagnosed food allergies to my daughters pharmacist,
he essentially told me he didn’t need a list of food allergies because he
couldn’t cross check them anyway. I then verified this with a few of the
pharmacists and pharmacy techs that I work with and they verified for me that
this is true. My daughter is required by her health insurance plan to get
medications either from this pharmacy or their mail order pharmacy which would
mean I would not even have a person to discuss this with. We now keep her at
the bare minimum of medications for this reason.” – B.M.
My
personal testimony related to compounded doxycycline:
Due to my
life-threatening 7-week allergic reactions to most antibiotics (QT interval
prolongation, and an 8-week acute reaction to the blue dye in doxycycline for
which I was prescribed an Epi-Pen®), I was required to have doxycycline compounded to
exclude all excipients. The compounding pharmacist asked me to provide him with
the documentation for all of my allergens in the event the FDA requires proof
for the need to have this drug compounded.
Even after I presented the pharmacist with my 16-page summary of each of
my allergens with the corresponding derivatives, he asked me if I would like
flavorings or sweeteners added – which I declined; since they are included in
the list of corn-derived ingredients I have to avoid due to my allergy to corn.
It was clear that my compounding pharmacist was not familiar with the dangers
of NMIs (non-medicinal ingredients) in drugs.
Additional Published Corn Allergy
Testimonies:
The Truth About Corn Allergy, MomLifeTV, LLC
Part 2: Corn Allergy-The Real Story, MomLifeTV, LLC
https://www.momlifetv.com/lifestyle/health-fitness-wellness/part-2-corn-allergy-the-real-story/
https://www.momlifetv.com/lifestyle/health-fitness-wellness/part-2-corn-allergy-the-real-story/
Diane H., Corn Allergy Advocate
Corn Allergy Advocacy/Resources
Twitter:
@CornAllergy911
References:
PETITION:
DRUG PRODUCTS W/DEXTROSE MUST BE UNIFORMLY CONTRAINDICATED FOR CORN-ALLERGIC
PATIENTS
DEXTROSE
(CORN SUGAR), CODE OF FEDERAL REGULATION 21CFR184.1857
LACTATED
RINGER’S IN 5% DEXTROSE CONTRAINDICATED FOR CORN-ALLERGIC PATIENTS
Vitamin
K1 Injection Contains Corn-Derived Dextrose [NO CONTRAINDICATION WARNING]
ACD-A
Anticoagulant Citrate Dextrose Solution, Solution A [NO CONTRAINDICATION
WARNING]
My
April 20, 2020, Email to the Children’s Hospital of Philadelphia Re: Corn
Allergies and Vaccines
My
May 11, 2020, Email to the FDA Re: Corn-Derived Excipients in Vaccines
My
March 5, 2020, Email to the FDA Re: Dextrose (Corn Sugar), Code of Federal
Regulation 21CFR184.1857, vs. Glucose (Blood Sugar)
"Probable
anaphylactic reaction to corn-derived dextrose solution."
BCPharmacists,
"Warning: corn-related allergens . . ."
Corn
Allergy: A Potentially Life-Threatening Diagnosis
Corn
Allergy References, Surveys, Studies, Statistics, & Petitions
(Includes my
submission to The Joint Commission, Congress, FDA, & U.S. Dept. of Health
requesting emergency mandate that hospitals stock corn-free foods, liquids,
& drugs.)
Published
Corn Allergy Studies/Statistics (“. . .
Maize major allergen . . .”)
United
States Hospitals/Health Systems Contacted Re: Protocol for Treating
Corn-Allergic Patients
https://cornallergyadvocacyresources.blogspot.com/2017/07/united-states-hospitalshealth-systems.html
Colleges
of Medicine Contacted Re: Protocol for Treating Corn-Allergic Patients
Colleges
of Pharmacy Contacted Re: Protocol for Treating Corn-Allergic Patients
Pharmaceutical
Companies Contacted Re: Protocol for Treating Corn-Allergic Patients
STRICT
AVOIDANCE OF ALLERGENS IS ALWAYS ADVISED
https://cornallergyadvocacyresources.blogspot.com/2020/05/strict-avoidance-of-allergens-is-always.html
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