Category: Medications

Treating Allergic Reactions: Corn-free Benadryl

The go-to drug for treating a severe allergic reaction is diphenhydramine, the active ingredient in Benadryl.  Unfortunately, there is no corn-free version of this drug available off the shelf. Benadryl dye-free liquigels contain sorbitol from corn. Benadryl children’s liquid formula contains glycerin and sucrose from corn. Many generic store-brand versions of Benadryl, such as Wal-dryl, contain corn starch.  All of these are derivatives that would send me to the hospital, especially if I were already reacting when I took them.

The only way to get truly corn-free Benadryl at this time is to get it made specially for you by a compounding pharmacy. This isn’t a post on how to do that, but there is a very nice blog post on getting medications compounded on the News For Corn Avoiders blog. Here are my additional notes on compounding medications and here is some advice on finding a compounding pharmacy.

Another possibility, though it requires a prescription, would be to get a prescription for an injectable version of Benadryl, and then drink it.This is an off-label usage but I am told it works just fine and will be relatively corn free. (It is in water though so if you react to some waters it may not be 100% safe for you.) Always check ingredients. There are probably several versions of the injectable Benadryl and all of them may not be corn free.

When I got my first Benadryl prescription compounded, I spent 30 minutes on the phone with the pharmacist deciding on ingredients used in my prescription. The pharmacist assured me that the microcrystalline cellulose they used for a filler in capsules was corn free. It was not. I got $50 worth of pills I reacted to worse than the corny off the shelf meds, and they wouldn’t take them back or give me my money back. I had very very recently gotten much more sensitive to corn products at that time, and was reacting constantly so feeling very sick and muddled while trying to hold down a full time job, and just did not have the mental energy to get it done right. I just gave up on getting medications compounded.

But I had to have something for reactions. Fortunately, I was still able to take one version of over the counter Benadryl and have it do more good than harm. While I am not *the most* sensitive corn allergic person in the world, I am pretty sensitive, and my reactions are pretty dramatic. However there are some derivatives I react to less than others.

This stuff has *lots* of corn ingredients, but for me the derivatives are ones that don’t cause huge reactions:

Alka-Seltzer Plus Allergy. Active ingredient: diphenhydramine hcl 25mg. Inactive ingredients:  croscarmellose sodium, D&C red #27 aluminum lake, dibasic calcium phosphate dihydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polyvinyl alcohol, talc, titanium dioxide.

I also found this”sleep aid” which is actually benadryl- the inactive ingredient, diphenhydramine, and the dosage, 25mg, is the same ingredient and dosage as benadryl.

Walgreens Sleep II Nightime Sleep Aid. Active ingredient: diphenhydramine hcl 25mg. Inactive Ingredients: Croscarmellose Sodium, Dicalcium Phosphate, FD&C Blue #1 Aluminum Lake, Magnesium Stearate, Microcrystalline Cellulose, Silicon Dioxide, Stearic Acid


Both of these products still have  a number of ingredients that could be (and often are) from corn. I’ve bolded them. They are definitely *not* corn free. It is the same drug as Benadryl, just a different brand. When I was VERY desperate, I was able to take them for reactions and they helped more than they harmed. I would definitely feel some reaction right when I took them, but once they kicked in the antihistamine effect would overtake the reaction. 

Getting compounded Benadryl made a world of difference though- it works faster and leaves me feeling much less hung over. A good portion of the effectiveness of the drug was previously being spent on counteracting the corn in the pills themselves.

But if you are ever in a very bad spot, you may find that there are some versions of the drug off the shelf that you can tolerate enough to help you out when you are reacting severely.

Note that which version will work best for you will depend heavily on what derivatives bug you. The liquigels contain sorbitol, so are a bad choice for me as sorbitol in toothpaste sent me to the ER once. Granted the quantity in the liquigels is probably small but I just skipped it because of the toothpaste reaction. Others may do better with that tiny amount of sorbitol versus the inactive ingredients in the product pictured above. Please choose carefully, use good sense, and consult your physician.

For those that are allergic to benadryl (this does happen), another option is hydroxyzine hcl (atarax) or hydroxyzine pamoate (vistaril). Atarax is more commonly prescribed for allergies, Vistaril is more commonly prescriped for anxiety. Both forms help both allergy and anxiety. They also are comparably as strong of antihistamines as benadryl. They do tend to sedate more then benadryl, but not everyone experiences this.  Hydroxyzine is prescription only. You would need to either get it compounded or identify a brand and manufacturer that does not contain corn, or does not contain *much* corn. You can use these instructions for finding the inactive ingredients of medications to try to identify something that might be safe.

Corn Free Antibiotics

There is no such thing as a 100% corn free antibiotic. BUT, if you have an infection and need a safe-ish antibiotic right now, here are some possible options:

Rocephin (Ceftriaxone) Injection

Many corn allergic folks have had success with a rocephin injection. I have never personally done this, but here is the package insert. It looks like it can be prepared in water or in ethanol. Ethanol is corn alcohol, so request that the solution be in water, and double-check the package insert in the office to be sure that the inactive ingredients look safe. (Cross reference with the corn allergens list.)

Additionally the rocephin injection is often combined with a numbing agent, lidocaine, which can be skipped. Preservative free lidocaine (Xylocaine is one brand) can be corn free but you will need to check package inserts, not all clinics have the corn free version in stock.

There may also be other injections that could be safe. Check using these resources: how to find inactive ingredients of medications.

Update 2015: I personally have gotten this injection… There are a few different brands but basically I got a Ceftriaxone injection that was a powder with only the active ingredient. My doc mixed it only with distilled water. It hurt a LOT. I am a grown up with a fairly high pain tolerance, and I was crying a little.  I did have a mild/moderate reaction from it that passed within 3 hours, and I believe it was a corn reaction from the growth medium, but I don’t really know. I recommend pre-treating with any safe antihistamines you have before getting the injection.

Zithromax Brand

The Zithromax brand, 600 & 250mg,  are very corn lite.  Not corn free, but I’d take them in a pinch. The generics all seem to have corn starch, so brand name only.

Cephalexin

There are many corn-lite formulations of cephalexin.

Here’s a list of all the formulations of cephalexin and their inactive ingredients. Depending on sensitivity, you may be able to get away with taking one that just has as few ingredients as possible and no corn starch.

If you need pills and can’t tolerate potentially corny derivatives, you will need to have your antibiotics compounded. Here’s some good advice on how to do that. 

Note that much like probiotics, antibiotics are not 100% corn free just due to what they are. They are a product of microbes and are almost always grown on a medium containing corn sugar.

So with that in mind, I would avoid antibiotics as much as possible, opting for natural remedies as much as you possibly can. But sometimes you have no other choice, and when that’s the case, be aware that even if you get the “cleanest” antibiotic you can get your hands on, you will still be getting some corn, and prepare yourself accordingly.

Finding Inactive Ingredients of Medications

There are a few different ways to find inactive ingredients of a medication. My absolute favorite by far only works for pills, but I always check it first. It’s a brand new search engine from the NIH called Pillbox. In fact, it’s so new it’s still in beta stages.

This search engine is intended for identifying “mystery” pills, but I’ve been using it to get a quick list of every manufacturer of a particular drug and the inactive ingredients.

Here’s a brief tour:

pillbox_0

Go to http://pillbox.nlm.nih.gov/ and click on Advanced Search (picture on the right).

pillbox_1

In “Drug Name,” enter the name of the drug you’re looking for. In this case, I’ve entered cephalexin, the generic name of Keflex. This will give me both the brand-name drug and all generic variants.  Click Search.

cephalexin_2The search results will give you a listing of all known manufacturers and dosages of the drug, with the inactive ingredients listed right on the page. You can click hide/show next to “Inactive Ingredients” to see the full listing.

If I can’t find what I’m looking for on this search engine, or need more details, my next go-to search engine is NIH’s DailyMed database, which is an archive of package inserts for all kinds of medication and medical supplies.

For each med listed on DailyMed, there should be an “ingredients and appearance” section on the bottom.

dailymed1

The inactive ingredients should be listed in this section.

dailymed2