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Lactose in Medications

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Bad news for some women out there. G. D. Searle recently added lactose to its Demulen birth control pills (or at least to the seven placebo pills that are taken one week out of the month). This appears to mean that every single birth control pill (BCP) on the market today contains lactose.

Lactose is the inactive ingredient of choice for most of the world’s pharmaceutical firms. Sprayed, lactose dries to a hard, impervious, slippery surface that helps a pill go down. In powder form, lactose is slightly-sweet, nonreactive, and anticaking, the perfect filler to bulk out the tiny bit of actual medicine that a pill contains. I’ve found over 300 prescription medications that contain lactose, and the number of over-the-counter (OTC) pills with lactose is uncountable.

The good news is that the actual amount of lactose in any given pill is minuscule. An eight-ounce glass of milk contains as much lactose as 1000 ordinary pills. The vast majority of people who are lactose intolerant need never give the matter a second thought.

There are documented cases of people who do prove to be susceptible even to these tiny amounts, however. Seniors, especially, and those others who may be taking dozens of pills a day, may be most at risk. (It is not clear whether the pure medicinal-grade lactose used in pills will trigger dairy allergy reactions, but those with truly sensitive allergies should never take the chance.)

When you buy OTC products, get used to reading the list of inactive ingredients that should be on the back of every box. This information is not currently required by law, but most large manufacturers comply with a voluntary agreement to include these ingredients.

Prescription products are both easier and harder. You don’t get to see these lists even when you bring home the little bottle of pills, but your doctor has reference books that list the inactive ingredients in every variety of every pill, and pharmacists have the ingredients in front of them. Fortunately, every category of medication has at least one brand that is completely lactose-free. (Even the actual Demulen BCPs are free of lactose.) Work with your doctors to find an effective pill. Additional discomfort when you are already sick is the last thing you need.

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