Gluten in Pharmaceutical Products



Am J Health Syst Pharm. 2001;58(5) 

In This Article


Celiac disease, also known as sprue, is a gluten-sensitive enteropathy elicited by an autoimmune response to the ingestion of wheat, rye, and barley [1] and possibly oats.[2] The treatment is lifelong total abstinence from gluten,[1] the alcohol-soluble peptides responsible for triggering the hypersensitivity. Gluten in all forms and amounts must be excluded from food,[1] drugs,[1,3] and nutritional products [3] ingested by people with celiac disease.

Celiac disease is more common than most health care providers realize. In several European countries, the prevalence is approximately 1 in 300. [4,5,6,7] Preliminary studies in the United States indicate a similar prevalence.[7] Classic symptoms include diarrhea, abdominal distention, weight loss, and asthenia; nongastrointestinal symptoms also often occur.[6,8] Consequences of untreated celiac disease can include malnutrition, osteoporosis, [9,10] malignancy,[4,5,11,12] anemia, and infertility.[4,5] Total permanent exclusion of gluten allows rejuvenation of the small bowel and resolution of symptoms, and complications are prevented or curtailed.[4,5,9,10,11,12,13]

Optimal care of the celiac disease patient requires that the pharmacist and other members of the health care team have accurate information about the gluten content of pharmaceutical and nutritional products. The objective of this study was to identify pharmaceutical companies with an established policy of producing only gluten-free products and to identify specific gluten-free and gluten- containing products produced by companies without such a policy.


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