Medication and Supplement Use in Celiac Disease

Ashley N. Johnson, PharmD, BCPS; Angela N. Skaff, BS, PharmD Candidate; Lauren Senesac, PharmD Candidate


US Pharmacist. 2014;39(12):44-48. 

In This Article

Abstract and Introduction


Celiac disease is a chronic condition involving an abnormal immune response to the ingestion of gluten-containing foods and products that commonly results in digestive symptoms, although other organ systems may be involved. The current mainstay of therapy is the avoidance of gluten-containing foods, beverages, and other products. However, if not equipped with the knowledge that medications, OTC products, supplements, and vitamins may contain gluten, patients with celiac disease may experience ongoing symptoms from continued ingestion of these products. Therefore, pharmacists play an essential role in educating patients and evaluating their medication use to ensure the optimal management of celiac disease.


Celiac disease (CD) is a chronic autoimmune disorder that is characterized by a multisystem immune-mediated inflammatory response to the ingestion of gluten in genetically predisposed individuals.[1] Inflammation in the gastrointestinal (GI) tract results in the malabsorption of nutrients, triggering a cascade of clinical symptoms in individuals who are either unaware of the condition or noncompliant with the completely gluten-free diet (GFD) required in the case of known CD.[2] Recent studies have shown that drug absorption may be impaired in CD patients who require oral medications for comorbid conditions.[3] This suggests that it is imperative for the pharmacist to not only identify patients with known or suspected CD and closely monitor the efficacy and safety of any orally administered medications, but also be aware of gluten-containing excipients in medications to ensure that CD patients avoid their use.