Hidden compounds in many medications can trigger allergies

TOUGH PILL TO SWALLOW The inactive ingredients in many pills and capsules may trigger allergic reactions or intolerances in some patients.

For some patients, the so-called inactive ingredients in pills may be more active than previously thought.

Every pill contains a pharmaceutical drug with some therapeutic effect on the body, as well as a mixture of inactive compounds added to boost the medication’s effectiveness or simply to make the pill more palatable. Inactive ingredients are generally considered harmless. But many pills contain chemicals that can cause allergic reactions or digestive problems in some patients, according to an analysis of the chemical ingredient lists for thousands of pills.

Researchers searched a database that contained about 42,000 recipes for oral medications marketed in the United States. Of those, 92.8 percent contained at least one of 38 inactive ingredients that have triggered allergic reactions in patients, the researchers report online March 13 in Science Translational Medicine. And 55 percent of pills contained at least one of a class of sugars called FODMAPs, which can cause digestive problems in people with irritable bowel syndrome.

Science News spoke with study coauthor Giovanni Traverso, a gastroenterologist and biomedical engineer at Brigham and Women’s Hospital in Boston and MIT, about what we do and don’t know about the risks posed by oft-overlooked inactive ingredients. His comments are edited for clarity and brevity.

Why are potential allergens and irritants so common in pills?

Once an inactive ingredient passes toxicity screening conducted by the U.S. Food and Drug Administration, it’s considered safe for the general population in approved levels. But as more people take medications that contain these chemicals, “we start to appreciate and uncover some of the potential side effects” for a minority of patients that weren’t revealed during the…

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