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.


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 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.

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!

Anonymous said...

You might be able to supply potato starch as a filler. My wife has a corn allergy and she takes vitamins from Pure Encapsulations. Aleve works for her, but no Advil or Tylenol. If you desperately need Tylenol with no corn and don't have time to wait, it is available in most pharmacies if you know where to look. Now the bad news -- it is Tylenol in suppository form. It's not fun, may create a fight if it's for your child, is many times more expensive per dose, and is often available in only childrens' doses (under the name Feverall) so if you're an adult and your pharmacy doesn't carry adult doses, you may have to take a number of them in a row. Not fun, but I guess it depends on how bad the pain is.

Anonymous said...

One additional thing -- we just got Goody's headache powder. Haven't tried it yet, but looks pretty safe. Only other ingredient is potassium lactate I believe, which is suspected sometimes, but I looked up how it is made and can't see where the corn would come from except cross contamination and if you count possible cross contamination, everything has to be on the corny list.

Donna said...

I have to say I have been there with you. I found out I was allergic 11 years ago this September. Do not believe what these drs. and companies tell you about inactive ingredients. I have researched and researched and there is nothing that you can take for pain that isn't compounded because they all have corn derivitiaves. I talked with one compounding pharmacy and they do have to have a prescription to compound the med but he also told me if I would bring in potato starch with the prescription he had no problem about doing it. The medical field is so ignorant about this rampant allergy problem and we who have it have to learn to compensate on our own. I am now writing a book about my experiences with this corn allergy and how I have adapted. I hope that it will help others. There is hope of which I am living proof. Hang in there.

Marie said...

On MAN. I have recently found out I have numerous food allergies -- Corn, Soy, Gluten, White Potatoes, Sunflower, Corn, ... are on the list. I have been actively researching and eliminating problem foods from my diet. I am feeling better and all my hives are gone. This morning, when I took my morning thyroid pill, levothyroxine, my chest started tightening yet again. This time I realized I needed to check the ingredients--Corn Starch. From there I pulled all my vitamins and ibuprofen out of the cupboard and started checking. Yep, you guys are right. To my dismay Ibuprofen, which I take every day for pain and inflammation has corn. Some of my vitamins contain corn, soy, and sunflower.

I was majorly distressed. I am thankful I landed on this site. You have done a lot of the leg work for me.

I keep reminding myself, there are worse things than food allergies.


Nimdoh said...

After having proplems finding medications free from corn/maize, microcrystalline cellulose etc.and researching pretty much every brand and ingredients list on the UK market i have found that SOME effervescent (water-soluble) versions sometimes don't have corn/maize, but instead have artificial sweetners like saccharin sodium, aspartame or sucralose which gives me insane stomach cramps. The best bet to look for is if they do the medicine yr after in capsule form. Sometimes they to have maize/corn though so you need to check the "other ingredients", and it'll have a bunch of unnecessary colourings in it but you can't really get away from that if you use any pharmaceuticals.
It's what works best/with the least reaction for me.

Catherine Hobbs said...

It seriously blows my mind that people who work in the medical industry can say this stuff with a straight face for other allergies when they wouldn't dream of saying the same for peanut allergy. "Oh, hey, peanut oil is listed as an INACTIVE ingredient, so you therefore have nothing to worry about," said no one ever. But any other allergy, it's all in your head.

Belinda Kurtz said...

Artificial sweeteners have corn in them also. :(

Celia Smith said...

Yes, I use it without problems. However, right now I need a pain reliever that is not a blood thinner, white willow bark is a blood thinner like aspirin. This blog is very helpful, thank you.

Judy Batt said...

I am having the same problem with gluten corn medications. They just look at the word INACTIVE and assume thats it....people WONT react to it. An allergy is an allergy to ANY amount WHY dont they wake up. I have just had a compound chemist (AUSTRALIA ) make up a script because I started reacting to corn and became very sick, excruciating body pain couldnt sit on my tailbone couldnt sleep due to chronic restless legs and irritable body and mind like you wouldn't believe. He now suspects microcrystalline cellulose as the culprit and is now working on a second compound formulation WITHOUT CORN,MICROCRYSTALLINE CELLULOSE AND GLUTEN. I dread going through any more of that horrific pain. I have been battling these symptoms for THREE YEARS......UNBELIEVABLE how we all suffer with corn allergy and it's NOT EVEN LISTED AS AN ALLERGY.

Judy Batt said...

Artificial sweeteners and even Paracetamol have corn in. Most older folk in Australia take PANADOL OSTEO, (Paracetamol), for pain, three times a day. If you are corn intollerant don't take it, it will only exacerbate your pain as I found out. Most UPDATE.... Pharmaceuticals contain corn. Its a never ending battle with Foods, Pharmacueticals and even topical products for those of us corn intollerant. I was diagnosed with corn allergy 29 years ago and advised by Specialist to take antihistimine (YES, it contains corn, they ALL DO not that I knew that until now) and eat what I liked. This worked for 17 yrs for me until 4 operations in the last 3 yrs, huge dosages of corn containing (microcrystalline cellulose included), pain medications, 5 corn containing, (plus microcrystalline cellulose) regular scripts and food additives. This overdose stopped the antihistimine taking effect and corn allergy surfaced with a vengeance. The past three years I have had gradually worsening stomach problems and am now Gluten, (possibly Coeliac, now waiting for confirmation) yes microcrystalline cellulose free. I do hope this helps and warns others. My heart goes out to ALL.

Erin Cox said...

This is an old post but Adams Pharmacy in Montgomery, AL does all the compounding for my sons corn free. They are thorough and kind and ship your Rx too. Call the Copperfield location.

Unknown said...

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