“Inactive” ingredients may not be, study finds – relevant for allergies?

Most pills and capsules, whether over-the-counter or prescription, include components other than the actual drug. These compounds, known as “inactive ingredients,” help to stabilize the drug or aid in its absorption, and they can make up more than half of a pill’s mass.

While these components are usually considered benign, a new study from MIT and Brigham and Women’s Hospital has found that nearly all pills and capsules contain some ingredients that can cause allergic reactions or irritations in certain patients. In most cases, doctors have no idea which of these ingredients will be included in the pills they prescribe to their patients, because there are so many different formulations available for any given medication.
“For most patients, it doesn’t matter if there’s a little bit of lactose, a little bit of fructose, or some starch in there. However, there is a subpopulation of patients, currently of unknown size, that will be extremely sensitive to those and develop symptoms triggered by the inactive ingredients,” says Daniel Reker, a Swiss National Science Foundation postdoc at MIT’s Koch Institute for Integrative Cancer Research and one of the lead authors of the study.
The researchers hope that their study, published in the March 13 edition of Science Translational Medicine, will raise awareness of this issue among patients and health care providers and help to stimulate reforms that could protect patients from drugs that they don’t tolerate well.

“Right now there is an imbalance in the amount of information and understanding out there with respect to the inactive components of medication,” says Giovanni Traverso, an assistant professor in MIT’s Department of Mechanical Engineering, a gastroenterologist at Brigham and Women’s Hospital, and the senior author of the study.
Steven Blum, a clinical fellow at Dana-Farber Cancer Institute, is also a lead author of the paper. Other authors include Christoph Steiger, an MIT postdoc; and Kevin Anger, Jamie Sommer, and John Fanikos of the Investigational Drug Services at Brigham and Women’s Hospital.

Unknown effects
Traverso began looking into this issue about five years ago following an experience involving a patient he was helping to look after. The patient, who had celiac disease, reacted poorly to omeprazole, a common acid suppressant used to treat stomach ulcers. Read the full MIT article