Saturday, September 09, 2006

The Trouble with Tylenol

Not long ago I had a headache. It wasn’t a bad headache, but I had to be somewhere and it occurred to me that Tylenol would be really nice.

This doesn’t seem like big news. I can see you frowning at the blog now. “So take some Tylenol and get on with it already.”

I urge you to take out a bottle of Tylenol, or Motrin, or Excedrin. Now, look at the ingredients. Acetaminophen and Ibuprofen are fine. Now, look closer. You’re looking for the list of “Inactive Ingredients”. This may not be on the bottle at all, you might need to find the insert or the original box. Inactive ingredients are the bits and pieces that turn powdered drugs into pills (or syrup) so that you can take an accurately measured amount.

In the ingredient list, depending on what pain killing product you like to keep on hand, you should see starch, citric acid, maltodextrin, polyethylene glycol, sorbitol, mannitol or microcrystalline cellulose. You may also see the more obvious “corn starch” or “high fructose corn syrup”. Any of these ingredients mean a corn allergy sufferer must first make some phone calls before taking the medicine.

I have recently contacted the makers of the main drug companies and a number of smaller companies whose products I found on the shelves of local drug stores. I was told over and over (and over) that the product was not safe for someone with a corn allergy, and that I should contact my dr.

I contacted my doctor.

Her nurse suggested I go to the drug store and buy some Tylenol.

I went to the local pharmacist. Her eyes grew wide as I presented her with my list of potential corn derivatives and she helped me search through the shelves. We discovered that Advil infant drops were probably corn free. I would have to take multiple bottles to make up an adult dose (Which is not reccomended by the manufacturer, by the way.). She suggested I get a prescription written and find a compounding pharmacy.

I called my doctor again. This time I was told to try reading labels.

I called a few companies again. This time I asked if they carried ANY products that would work for pain and be safe for a corn allergic individual. After a long pause I was told that I would need to find a special pharmacist who could formulate my own pain killer using pure acetaminophen (or ibuprofen). Corn is cheap. Its not on the top 8, or even the top 10. Its used widely in all drugs.

So I called my dr again. I started from the beginning and included the fact that I not only have to cook all my food from scratch, but apparently need to make my own pain killers from scratch too. (I think I may have cried a bit. My head was throbbing. Pounding it against the wall wasn't helping any.)

This time the receptionist said someone would call me back. Which they did, several hours later. They told me that Tylenol was not a prescription drug. So I explained the whole story to them.

Finally, the doctor agreed to write a prescription.

So began my search for a pharmacist who was able to compound medicine and understood the scope of a corn allergy. Compounding is a dying art.

I started with my insurance company. They gave me the name of a pharmacy in another state and said they would not cover it mail order. When I pointed out the difficulty with procuring a plane ticket just to pick up an OTC pain killer, they came up with the name of a pharmacy that was a bit closer. Just a 3 or 4 hour drive. Not a big deal, but since I live sandwiched between two major metropolitan areas less than an hour away, I was hoping to find something a bit closer. I called my local pharmacist again.

She had found a compounding pharmacist. My exaltation was short lived, however, when the com[ounding pharmacist explained to me that people with corn allergies just don’t understand that corn starch isn’t really corn. (Its just made from corn) He agreed to compound Tylenol using microcrystalline cellulose. Which I looked up, since its on the corn allergy list. Originally, microcrystalline cellulose was derived from tree bark, however now it is commonly derived from any fibrous plant click here and scroll to #22. He refused to verify the source, since by doing the compounding he would be doing me a huge favor anyways. After all, I’m the one refusing to use corn starch just because it makes me sick.

So I kept looking. I found another pharmacist who was certified to compound. But he really wasn’t interested in compounding an otc strenght pain killer. It wasn’t worth his time or effort. Its available mass produced over the counter under many name brands and generic formulations.

He tried to help me find a suitable OTC medication. They all contained corn. He suggested that inactive ingredients weren’t really active and therefore wouldn’t cause a reaction. I think I started to cry again. He took pity on me and agreed to order the materials and compound some acetaminophen.

Finally, about a month after my headache that I would have liked to have taken something for…I had a small bottle of OTC strength acetaminophen (compounded the old fashioned way) in my hand.

Next time I get a headache, it will be worth its weight in gold.

16 comments:

Von said...

I had similar problems getting mine. I am lucky that my general doctor believes me. I made a special appointment to see him to get him to write the script, so that I could look into his eyes and make certain he understood me.

We also have a great chain of compounding pharmacies here in Austin, called People's Pharmacy. They use what they call "Veggie caps" which I made them call and verify its source (pine trees). And they don't use any fillers, just pure medication.

Hearing stories about hardships in finding these resources from other people across the USA, has made me never to want to move.

ALi said...
This comment has been removed by the author.
ALi said...

Were you able to get insurance to cover the whole cost of the prescription? How expensive was it to have a pharmacy make the meds for you? I just found out the hard way that I can no longer have Advil/Ibuprofen.

Administrator said...

Insurance companies don't always cover compounded medications. Some do, and they usually only cover it at the highest copay option on your plan.

sagely said...

Glad to have found you. I am allergic to corn and am finding it frustrating coming up with a consistent list of processed foods and pastes that don't contain maize. The economic crisis has encouraged food producers to use thickeners rather than reducing the liquids in their products. Products I used to trust have become unreliable.
Here in Australia Herron is the only brand of paracetamol that is maize free.

Glen said...

I have used BC Headache Powder and Goody's Headache Powder for years. Although tough to find on shelves, even in the South, they can be ordered online, as can Stanback Headache Powder. None contain fillers.
I use Zomeg for my migraines, in the form that is a nasal spray, not the injection. Corn products trigger my migraines (with auras).

shaunamom said...

I've pretty much given up on processed medication entirely. Sort of like giving up on processed food, LOL. But I did find a solution for pain and a few other common ailments.

I went on a plant walk with a local botanist, and it turns out he was an herbalist as well, with two books on herbal remedies and exactly how to prepare them, dosages, and so on. Many of the remedies used alcohol, but many don't need it, or a potato based alcohol could be substituted with the correct % calculations made.

I have never been all that comfortable with modern herbalists - many seemed a bit too woo-woo for me - but I was getting pretty desperate, you know? So I've now tried two remedies, one for pain relief and one for a cough, made from plants that grow in my yard.

Both of them have worked very well, so I'm hopeful about some of the others, although I haven't explored them much yet.

If you are ever interested, the gentleman's name is Charles Kane. I believe his books can be bought online at various places, or found at libraries.

CeliacChick said...

I used to be able to take vitamins...no problem. I'm a walking corn detector...I get a rash on my face from trace amounts...and the past few years they must have started using corn (my guess cobs) for the microcrystaline cellulose...because my vitamins started giving me a rash and I traced it to this ingredient. Whaa! I can't even take vitamins anymore. There are just two I can find that are for Vit C that is not corn derived. So, don't believe the producers that say it isn't corn...they don't know. My skin will tell you that it is corn!!!

Anonymous said...

I just ordered Kirkman Labs Unflavored Calcium powder with VitaminD. They have verified that none of the (few)ingredients are derived from corn.
-elisssabeth

Anonymous said...

I contacted Aleve, and they responded back that Aleve and Aleve-D are corn free. I haven't had any problems with either of these products. If you contact Aleve directly, they'll mail you some great coupons. Good luck!

Grace said...

I have found more over the counter options in Canada for pain relievers and cough syrup. There is an anti-inflammatory gel called Voltaren Gel that is prescription in the USA but is over the counter in Canada and can be used for joint pain or localized muscle pain.

Luna said...

So I thought you had my answer, but alas, no. :) My son is having a TERRIBLE reaction to his latest medication, and it's compounded with microcrystalline cellulose, but the pharmacy confirmed that it theirs is not corn-based (they have a kid with an anaphylactic corn allergy - omg - and they use their MC in his meds). She's going to find out what it is derived from, and let me know.

By the way, Falls Pharmacy in Snoqualmie, Washington will do mail order compounding. Your doctor just needs to fax them a prescription, and they will fill it and mail it, and not charge you extra for the hassle. They are FABULOUS. (And I promise I am not affiliated. :))

Von said...

Luna - Just because someone with anaphyaxis can eat it doesn't mean it's corn-free enough for you. In my experience with corn allergies, those with deadly reactions are often the less sensitive to the allergen, meaning they can do trace amounts without huge problems, especially with corn allergies.

Microcystaline cellulose is quite often corny. I'd ask them to use a different filler. If you have a safe starch, ask them to use that instead.

Von said...

Luna - Just because someone with anaphyaxis can eat it doesn't mean it's corn-free enough for you. In my experience with corn allergies, those with deadly reactions are often the less sensitive to the allergen, meaning they can do trace amounts without huge problems, especially with corn allergies.

Microcystaline cellulose is quite often corny. I'd ask them to use a different filler. If you have a safe starch, ask them to use that instead.

Von said...

Luna - Just because someone with anaphyaxis can eat it doesn't mean it's corn-free enough for you. In my experience with corn allergies, those with deadly reactions are often the less sensitive to the allergen, meaning they can do trace amounts without huge problems, especially with corn allergies.

Microcystaline cellulose is quite often corny. I'd ask them to use a different filler. If you have a safe starch, ask them to use that instead.

jrhodo said...

Has anyone tried White Willow Bark? I get it at my health food store. It is what asprin was originally made from and it works!