Vegetarians: Are Your Meds Animal-Free?

Vegetarian patients may not know their drugs contain gelatin and other animal products

(RxWiki News) Do your beliefs prevent you from eating animal products like pork? If so, you may want to be sure your medications don't contain similar products that violate your dietary restrictions.

Although the active ingredients are the most important part of what makes a medication effective in treating a condition, drugs are full of other inactive ingredients to help the drug's consistency, preservation, potency, taste and other attributes.

These binders, fillers, disintegrates, lubricants, sweeteners, preservatives, coating agents and other components may include animal products that are not clearly labeled for vegetarians or others who have dietary restrictions on eating animal products.

"If you're vegetarian, talk to your doctor about animal products in your Rx."

In a study led by Bharat Vissamsetti, of the Department of Urological Surgery at Manchester Royal Infirmary in the U.K., researchers interviewed 500 patients in Manchester, England, who were receiving treatment for urinary and urological disorders between January and June 2010. Manchester is a city with significant racial and religious diversity, where one in four residents is non-white.

Vissamsetti's team asked patients about their dietary restrictions, their willingness to take medication that included animal products and their willingness and ability to ask their caregiver or pharmacist what might be in a drug. The patients were also asked whether they refuse to take drugs that they know contain animal product ingredients.

Many major religions include dietary restrictions as part of its orthodoxy, such as the requirements to eat only kosher food in Judaism or eat only halal meat in Islam.

The Jewish, Muslim and Christian religions also contain restrictions on eating pork, which is the most common ingredient used to make the gelatin often used as a binding agent in food, cosmetics, pharmaceuticals and other products.

A total of 283 patients surveyed by Vissamsetti's research team were currently taking medications, and a subset of 75 were taking multiple medications at once.

Of the total, 200 patients said they were not supposed to eat animal products, and 88 percent of these patients (176 total) said they would rather not take drugs that contained any animal products. Only a tenth of this group said they didn't care about whether their prescriptions might not be vegetarian.

Although a little over half of these 176 patients would be willing to take a drug made with animal products if no alternative was available, 43 percent said they would not take the drug if they knew it contained ingredients made from animals.

Even so, among those who did not want to take meds containing animals products, only a fifth of them would have asked their doctor or pharmacist if the drug might contain ingredients that would conflict with their religious beliefs or dietary requirements. In fact, 49 males in this group had been prescribed medicines with gelatin even though it went against their dietary preference.

The authors conclude that this issue presents significant ethical concerns for doctors, nurses, pharmacists and other caregivers who may not know much about the inactive ingredients, called excipients, in a medication or think to ask patients about dietary and/or religious restrictions that might affect the drugs they would be willing to take.

Gelatin content "is almost certainly a much bigger issue for the 860 million non-urological preparations prescribed in the UK each year, whose excipient content is not easily identified," the authors state. The number of medications prescribed in the U.S. each year far exceeds this number prescribed in the U.K.

The authors state that more comprehensive and detailed labeling of ingredients and components should be required for medications and that animal gelatin should be replaced with an a vegetarian alternative in pharmaceutical manufacturing.

They also suggest creating a vegetarian symbols that can be used on food and medication labeling to make it easily and instantly identified as a product that contains no animal products.

"Systems to help patients, doctors and pharmacists identify those oral medications containing animal-based products require evolution," the authors write in their conclusion.

"This would facilitate choice for patients about the oral medication they take, whatever their dietetic beliefs, and would conform to best practice in medical care," they write.

The research appeared online February 27 in the Postgraduate Medical Journal. Information was not provided regarding the study's funding, but the authors state they have no competing interests.