Ask Corn Allergy Girl: Finding a Compounding Pharmacy

The Question

Hello,

I recently developed an allergy to ALL of my prescription medications. I take several of them and they are medications that I desperately need. Everytime I take them I have itching. I researched all of the ingredients and found that they all contain the same fillers & inactive ingredients. The common ingredient is magnesium stearate, but I’m not sure if it is the specific culprit. There are so many. I am having trouble finding substitutes that do not have all of the same exact fillers or any fillers for that matter! This is so frustrating! I don’t know what to do. Even OTC meds have all the same crap. I have prescriptions that need to be filled right now, but I am afraid to. My pharmacist thinks I’m crazy and we got into an argument over it. I live in a rural area where there aren’t any compounding pharmacies. Do you know of a reputable national compounding pharmacy that uses pure medication without fillers? I am going to an allergist next week. I hope she believes me & is will to try a REPUTABLE compounding pharmacy that uses pure medication without using crushed pills. Please I would appreciate any suggestions.

Thank you!
Sheri

Some Background: There’s Corn In Medications?

If you look at the inactive ingredients of just about any prescription medication, chances are you will find at *least* one item from the corn allergens list, very likely corn starch. What to do then? Sometimes you may be able to find a version of the medication that is either corn free or has little enough corn that you can tolerate it. If not, you may need to have some of your meds custom-made for you with ingredients you tolerate. There are pharmacies called compounding pharmacies that can do this for you.

My Response to the Question

I have been exactly here and it’s scary and frustrating.

First, are you on the Facebook Corn Allergy group and/or the Delphi Avoiding Corn Forums? If not, join one or both of them immediately. You need some support, and there may even be a member of one of those groups who is in your state and already has a pharmacy they are working with.

There are a couple of reputable national compounding pharmacies. College Pharmacy is one. However the “big guys” that can ship to every single state rarely use custom filler, and I find it highly likely that you will need to provide your pharmacy with a custom filler you know you tolerate. If not now, you probably will later. So rather than go for a national compounding pharmacy, it would be better if you can find someone more local to you via the Pharmacy Compounding Accreditation Board.

If I were you, I would use that registry to find someone near you, either in your state or in a neighboring state, and ask them:

1) Do they make their custom prescriptions out of the pure drug, without fillers, and mix in their own fillers on site if fillers are needed? (Some “compounding” pharmacies get the drug already diluted with corny fillers, and this will not work for us.)
2) If fillers are required, are they able to use a filler that YOU provide, if you are unable to tolerate any of the fillers they stock?
3) If you do not tolerate the soap they use to clean the capsule machine (many use Dawn which is corny), would they be able to use a different soap for you?
4) If you do not tolerate the gloves they use to handle the meds, are they able to switch to a different type?

The answers to all of the above should be yes in order for you to do business with a pharmacy. Even when they answer all your questions correctly, be prepared that the first time you fill a script, it may not be successful, so don’t go ordering a 90-day supply to begin with.

Note that I personally do not need to have them use a custom soap on their capsule machines, however my pharmacy is willing to do so if needed and that is comforting to me. At the time of writing I have them use Karlin’s Finest Baking Soda for a filler and Letco brand gelatin capsules. They don’t use custom soap on their capsule machines but they do refrain from stuffing their bottles with cotton and I have asked them to not use packing peanuts when mailing my prescriptions.

Getting Medications Compounded on News for Corn Avoiders

My Additional Notes on Getting Medications Compounded

Corn Free Asthma Treatment

What’s corny about asthma inhalers?

The propellant in modern HFA puffer-style inhalers almost always contains ethanol from corn.

There are several steroid or combination steroid-and-topical-anti inflammatory diskus inhalers that don’t use a propellant at all, but rather contain dry powder that you use the power of your inhaled breath to pull into yoyur lungs. Some preventative diskus inhalers are: Advair Diskus, Asmanex, and Flovent Diskus.

Note that so far all diskus inhalers contain lactose, so the severely dairy allergic are out of luck here.

However steroid inhalers are only useful for preventing an asthma attack.. they won’t treat one that is already happening.

What do I do if I’m already having an attack?

Your best bet would be the Ventolin brand HFA inhaler. It contains contains albuterol sulfate, but the propellant is not corn ethanol, it’s tetrafluoroethane (HFA 134a). The Xopenex HFA inhaler also uses this propellant but contains other exipients such as oleic acid and dehydrated alcohol which is most likely from corn. Ventolin has no other ingredients. I use the Ventolin HFA and sometimes I react to it just a little, so I don’t think it’s entirely corn free, but so far the benefit has outweighed the negative outcomes. Other inhalers including the popular ProAir HFA made my throat close.

Update March 2016: I’ve just discovered that ProAir is now making a non propellant albuterol inhaler that works like the steroid inhalers mentioned above. The only ingredients are the albuterol and lactose: ProAir Respiclick

If you can’t tolerate that, your best option is to get a nebulizer, which is a device that does the propelling for you. Then you just put the powdered drug which can be compounded corn free into the chamber and get the medication delivered. (Some nebulizer powders may be corn free off-the-shelf, check inactive ingredients.) There are pocket nebulizers for carrying with you however they are still somewhat bulky.

Ask Corn Allergy Girl: Water Filtration

The Question

I got a Berkey water filtration system and seem to be having trouble with the water. I saw on a post somewhere – and I thought it might be one of yours – that you should get the ceramic filters, not the black ones. I’m just wondering why. I’ve made two calls to Berkey. Both times they doubted me. The gal I talked to absolutely refused to believe there could be corn in, around, through or in any way associated with the black filter. I don’t even understand what would make the black filters a problem, but not the ceramic. Do you know anything about this?

– Darcy

[I’ve edited the question a bit to withhold some identifying information.]

A Little Background: There’s Corn In Water?

Yes, there is. Here’s the Hidden Corn entry on water. Like many other chemicals the additives and disinfectants in drinking water can be derived from corn (citric acid especially) or can be in a corn-based carrier to help them dissolve. Then, when it comes to water filtration systems, information is often proprietary so we don’t know for sure *what* is corny about it, we only know that the corn allergic react. My best guess is that the activated charcoal in some water filters could be from corn, or could have been “activated” using a corn based acid. Additionally filters that add minerals back in to the water will do so via corn-based carrier chemicals. *And*, I don’t have a reference for this, but there are reports of antimicrobial polymers such as antimicrobial toilet seats causing BIG contact reactions with corn allergics. The housing of the water filter could be made from an antimicrobial polymer, and that polymer would likely be corny.

Now the Answer

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