One active substance is usually responsible for the operation of a medicine, but in a tablet or capsule there is not only the medicine. It also contains many excipients. Some of them are not indifferent to he alth, sometimes they can even be harmful.

A tabletcontaining 200 mg of ibuprofen weighs 600 mg. This means that the active ingredient makes up only 30 percent of the weight of the tablet. The rest areexcipientsthat have no pharmacological effect. Their only task is to shape the medicine into a form that allows it to be taken. Some of them also give the tablets the right color, and the syrups - the flavor. They are all listed on the back of the medicine pack and in the package leaflet. We rarely think about them, because also few people are aware of their existence. Meanwhile, there are situations when their presence may affect the safety of using the drug containing them. It turns out that some substances referred to as auxiliary substances may have an effect on the he alth or life of people who take them.

Orange Yellow

Sunset Yellow is a synthetic azo dye marked with the symbol E110. It can be found in syrups, suspensions, granules, jellies, but also in food jellies and lollipops. It became famous after the advertisement of a syrup for children, the manufacturer of which suggested the harmful effects of orange yellow, which is in the competitor's preparation. Indeed - in people allergic to salicylates, E110 can cause an allergic reaction. It also stimulates the secretion of histamine, which may worsen asthma symptoms. Interestingly, combining E110 with sodium benzoate (a commonly used preservative and flavor enhancer) can cause hyperactivity. Despite the information about the carcinogenicity of yellows, according to the IARC (International Agency for Research on Cancer), this relationship has not been confirmed, because no such studies have been conducted on humans.

  • Important for the patient: due to its harmfulness, E110 was banned, among others in Norway, Finland, the USA and Great Britain. May cause hives, hay fever, rash, angioedema and anaphylactic shock, vasculitis, purpura. Sometimes it causes food intolerance manifested by abdominal pain, vomiting, indigestion or reluctance to eat.

Aspartame

Aspartame isalso known as a sugar substitute. Often referred to as the E951 symbol. It is chemically composed of phenylalanine and aspartic acid. In the human body, it is broken down into two natural amino acids. It poses a serious threat to people with phenylketonuria. These people do not metabolize phenylalanine. Aspartame is most often used as a sugar substitute for diabetics and as a sweetener in various preparations and "sugar free" medicines. It is sweeter than sucrose and at the same time has no calories. There used to be a lot of talk about its carcinogenic potential. Currently, over 100 organizations dealing with food safety, incl. EFSA, UK Food Standards Agency, He alth Canada, considers aspartame safe. There is also insufficient scientific evidence to favor cancer.

  • Important for the patient: In December 2013, EFSA published a study showing that aspartame in daily doses up to 40 mg / kg body weight is completely harmless.

Lactose

Lactose is often hidden in drugs and foodstuffs under the names: Lactosum, Saccharum Lactis, milk sugar. It belongs to the most commonly used fillers for capsules and tablets. The main contraindication to its use is lactose intolerance - recently more and more popular. The most common symptoms of lactose intolerance are gas, watery diarrhea, abdominal pain, nausea, and painful colic. They appear 30 minutes to 2 hours after consuming the product with this substance. Lactose digestion disorders are the most common digestive tract dysfunctions, in the Polish population it is estimated that the percentage of people with lactose intolerance is 20-30 percent. Medicines containing this substance should not be administered to people who are lactose intolerant and allergic to cow proteins.

  • Important for the patient: people with such problems should pay attention to the presence of lactose in contraceptive pills, preparations regulating stomach acidity or preventing flatulence. Patients who do not tolerate even small amounts of milk sugar should especially avoid homeopathic tablets because they usually contain a large amount of it.

Starch

Starch is a bulking agent, a component of tablet coatings. Its presence can be very dangerous for people with celiac disease. It is important how much gluten is in the starch added to the medicine. If above 0.3 percent, it should not be used in celiac disease. Even 50 mg of gluten a day can lead to the disappearance of intestinal villi in a short time. Some patients with cutaneous celiac disease, Duhring's disease, experience itching and burning, even after contact with the skin.gluten with the skin. People suffering from this ailment should therefore remember to pay special attention to the starch content of the medications used. Often, even trace amounts of gluten in it can result in a serious exacerbation of the disease.

  • Important for the patient: the list of gluten-free drugs safe for patients with celiac disease and all people on a gluten-free diet was prepared by prof. Kamil Hozyasz from the Institute of Mother and Child in Warsaw, more info: www.forum.celiakia.pl.

Thiomersal

It is an organic mercury compound in ethylated form. Due to its preservative properties, it is added to some medications (e.g. ointments, eye drops, vaccines) and cosmetics. Accumulation of ethylene mercury in the body of pregnant women (e.g. as a result of long-term use of drugs with thiomersal) may cause neurological disorders of the fetus. However, it has not been confirmed that this may happen as a result of preventive vaccinations. Studies conducted by the European Agency for the Evaluation of Medicinal Products (EMEA) in infants in the first 6 months of life who were given thimerosal-containing vaccines showed that ethylmercury is cleared from their bodies within 4-9 days after administration, so there is no accumulation and does not affect the child's development.

  • Important for the patient: drugs or cosmetics preserved with mercury ethylene in the case of adults do not pose any risk. The exception is long-term use by pregnant women as it is harmful to their babies.
You must do it

Read the leaflets!

The presence of specific excipients in drugs should be especially attended to by people suffering from metabolic diseases: diabetes, phenylketonuria, celiac disease, etc. In their case, these neutral compounds will have an effect, the effects of which may endanger he alth and even life. Therefore, be sure to read the leaflets, labels and packaging of medicines. The information they contain is sometimes of key importance. And in case of any doubts, e.g. when taking other medications, it is worth asking the pharmacist for clarification.

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