Medicinal drugs are composed of two parts: active and inactive ingredients.
Active ingredients provide the therapeutic effects of a drug (Registrar Corp). For example, the active ingredient in Advil Tablets is ibuprofen. Ibuprofen creates the pain relief and fever-reducing effects of the drug.
Inactive ingredients foster drug absorption, improve stability/taste, make the drug more appealing, or hinder tampering. Oral medicines contain an average of 8.8 inactive ingredients, though the number of inactive ingredients ranges from zero to 35! (Harvard Health, 2019) Gelbe Liste, a German database of almost two thousand medications, reported an average of 71% ± 26% inactive ingredients in each tablet formulation (Reker, et al. 2019). In short, inactive ingredients generally compose at least three-fourths of a pill.
Inactive ingredients are not entirely benign.
Reports of adverse reactions from inactive ingredients continue to mount (Reker, et al. 2019). The formulation of new inactive ingredients requires comprehensive toxicology profiling. As a result, most medicines use the same inactive ingredients (Elder, et al. 2016). FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) commonly cause adverse reactions, and 55% of all medications contain at least one of these potential irritants (Harvard Health 2019).
A common FODMAP in medications is lactose. Though 75% of the world's population is lactose intolerant, lactose is in 45% of all oral medications (Harvard Health 2019). All available formulations of rosuvastatin, a common medication for lowering cholesterol (WebMD), include lactose as an inactive ingredient, leaving no options for patients that are searching for an animal-free option. Even more concerning, the mass content of medications is not always reported by manufacturers, making it difficult for consumers to avoid certain ingredients, including known allergens (Reker, et al. 2019).
How do we make a difference?
What is the solution to this widespread problem?
1. Increase research into the effects of different inactive ingredients
2. Produce more alternative formulations that avoid certain inactive ingredients
3. Increase awareness of animal-derived ingredients in medications and supplements
Multiple manufacturers will commonly produce formulations of the same medication. In some cases, "more than 23 alternative combinations of inactive ingredients have been commercialized to deliver the same [active ingredients]" (Reker, et al. 2019).
The VeganMed team believes that labeling on medications should be complete and clear, to include designating ingredients that were derived from animals. We hope that through our educational efforts, outreach to manufacturers, and animal-free certification, we can make steps towards our vision of a world where medications and supplements are completely free from animal-derived ingredients.
Disclaimer: The product and/or medical information provided on VeganMed is of a general nature and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or product.
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Thank you for your awareness and concern for animal-derived ingredients!
If you have any further questions about ingredients in your medicines and supplements, feel free to reach out to the VeganMed team!
References
Steinberg, Marshall, et al. “From Inactive Ingredients to Pharmaceutical Excipients.” Pharmaceutical Technology, July 2001, pp. 62–64., https://pdfs.semanticscholar.org/b4ff/6e1ca5d5ab3154d02cc9eb1843a35cdf6aa4.pdf.
Berlin, Jr, et al. “‘Inactive’ Ingredients in Pharmaceutical Products: Update (Subject Review).” Pediatrics, vol. 99, no. 2, 1 Feb. 1997, pp. 268–278.
Elder, David P., et al. “Pharmaceutical Excipients — Quality, Regulatory and Biopharmaceutical Considerations.” European Journal of Pharmaceutical Sciences, vol. 87, 25 May 2016, pp. 88–99.
Harvard Health Publishing. “The Risk of Inactive Ingredients in Everyday Drugs.” Harvard Health, July 2019, www.health.harvard.edu/staying-healthy/the-risk-of-inactive-ingredients-in-everyday-drugs.
Registrar Corp. “U.S. FDA Drug Definitions.” Registrar Corp, www.registrarcorp.com/definitions/.
Reker, Daniel, et al. “‘Inactive’ Ingredients in Oral Medications.” Science Translational Medicine, vol. 11, no. 483, 13 Mar. 2019.
WebMD. “Rosuvastatin Oral : Uses, Side Effects, Interactions, Pictures, Warnings & Dosing.” WebMD, www.webmd.com/drugs/2/drug-76701/rosuvastatin-oral/details.
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