Food Allergies and Medications: Can Food Products in Medications Cause Reactions?
These days, allergies to various food products are becoming more and more of a problem for both adults and children. Estimated 8 and 5 percent of children and adults respectively are allergic to at least one food. While the only way to prevent food allergies is to avoid the triggers, it may be quite challenging to avoid them completely. Often, an allergic reaction is triggered by accidental exposure to the allergen, hidden in various products or restaurant dishes.
According to statistics, most people with food allergies are sensitive to the following eight foods: peanut, tree nut, fish, shellfish, milk, egg, soy, and wheat. There is a legislation in the United States that requires these foods to be stated on the label whenever they are contained in a product. This helps many people allergic to ant of them to avoid products with hidden allergens.
However, there is another potential risk, such as drugs containing certain food proteins, potentially causing allergy symptoms. Pharmaceutical excipients are inactive ingredients of a medication that are included in the manufacturing process. Combined with active ingredients, excipients help to facilitate transportation, protect stability and effectiveness of the medication, and eventually make it taste or look better. Normally, excipients don’t produce any pharmacological effect, but sometimes, these inactive ingredients are not completely inactive. Certain types of pharmaceutical excipients, for example, food proteins, may trigger a reaction in people with allergies. Therefore, medications potentially containing an allergenic food protein are often contraindicated in people with food allergies.
The most common food allergens associated with pharmaceutical products include: egg, fish, gelatin, milk, peanut, pine nut, sesame seed, shellfish, and soy.
An ingredient such as egg lecithin is often contained in medications. Although allergies to egg lecithin are quite rare, this excipient contains some amounts of egg protein that may potentially cause a reaction.
Egg and soy lecithin are often used in intravenous lipid emulsions. Both ingredients are potentially allergenic, but compared to egg, reactions to soy lecithin are more common. For instance, an anesthetic Propofol, that is used during surgeries, contains both soy and egg protein. Propofol is a somewhat common cause of allergic reactions; however, people with an egg allergy rarely develop symptoms after receiving this medication.
If you have had a reaction to Propofol, you may want to perform a skin test to determine your allergen.
Soy is a common ingredient of many medicines, but most of them are safe for people a soy allergy. Thus, certain types of inhalers, especially those that are used for treating COPD (e.g. Combivent and Atrovent), contain soy lecithin. Although there have been several cases when people developed problems with breathing after using these inhalers, they were never proven to be actually allergic to soy, and neither was soy lecithin proven to cause the reaction.
In addition, intravenous lipid emulsions found in total parenteral nutrition contain soy oil, which increases the risk of an allergic reaction. Total parenteral nutrition (TPN) is the feeding of a critically ill patient intravenously, replacing the normal process of eating and digesting. In fact, TPN may sometimes lead to allergy-like symptoms, but there is no proof that they are caused by soy allergy.
Another intravenous medication called amphotericin B contains soy phosphatidylcholine. This medication is commonly used in the treatment of severe fungal infections, and soy phosphatidylcholine is the fatty component that allows it to enter and eliminate the fungus. While amphotericin B has also been shown to cause allergic reactions, these reactions weren’t linked to soy allergy.
Some forms of insulin contain an ingredient protamine that is found in salmon testes. It is also often used to reverse the anticoagulant effects caused by heparin. Some people taking protamine have reported developing allergic symptoms, but generally, people allergic to fish are not likely to react to this ingredient. Protamine is safe for most people with a fish allergy.
Fish oil is often recommended for prophylactics of heart disease, as it contains high levels of omega-3 fatty acids. Fish oil used for medicinal use is refined, which means it doesn’t contain fish protein. Therefore, people with fish allergy can safely take fish oil.
A number of people with shellfish allergy have reported allergic reactions after receiving glucosamine, which is found in the shells of shellfish. However, according to various research studies, glucosamine is safe for people allergic to shellfish.
A substance called iodine is found in shellfish and intravenous dye (IV dye), but it does not cause a reaction in people with an allergy to shellfish or IV dye.
Gelatin that is an ingredient of many medications contains animal proteins and may sometimes trigger reactions in people with allergy. This ingredient is extracted from the connective tissue of cows and pigs. Allergic reactions to gelatin are more likely with injected medication and vaccines, rather than pills and capsules. People with gelatin allergy also can develop a reaction to suppositories or erythropoietin infusions containing gelatin.
Gelatin is also contained in gelfoam sponges that medical workers use to stop bleeding during surgery. Sometime, these sponges may cause reactions in those with gelatin allergy.
Besides, people allergic to gelatin can also react to intravenous fluids containing gelatin, but these medications are not used in the US.
Various medications contain small amounts of milk protein. However, allergic reactions to these medications are very rare, and they are normally safe for people with milk allergy. For instance, these medications include as casein-based probiotics, as well as asthma inhalers (Flovent Diskus, Advair Diskus, Pulmicort Flexhaler and Asmanes), and methylprednisolone (corticosteroid) injections containing lactose.
There are other pharmaceutical products containing lactose and lactose-related molecules, but they rarely contain milk protein. They might trigger an allergic reaction in people allergic to milk, but this happens rarely.
Such medications as dimercaprol, progesterone and valproic contain peanut oil. However, this peanut oil doesn’t contain peanut protein, since it’s refined, which means it shouldn’t cause reaction in those with peanut allergy.
Some people are allergic to pine nuts, which are produced by pine trees. A pine tree is also a source of rosin, or a colophony. This substance is often used as a tooth varnish. However, people with an allergy to pine nuts usually don’t react to rosin. Yet, colophony may sometimes trigger contact dermatitis, but it’s linked to a pine nut allergy.
Sesame oil used in pharmaceutical products (e.g. progesterone) doesn’t contain sesame protein. Therefore, most people with sesame allergy can safely receive medications containing this ingredient.