Pharmaceutical excipients in patients with intolerances and allergies: an updated review

Abstract

Introduction: An increasing number of people suffer from some kind of food allergy or intolerance, with an estimated 1-10% of the population suffering from one of these pathologies. Many of these compounds are found in the excipients of medicines, so it is important to know how many can be tolerated by patients.

Methods: A systemic review was performed using the keywords “excipients”, “intolerances”, “allergies” and “adverse reactions”. Articles that did not include quantitative values of excipients, duplicates and those that did not provide information on maximum tolerable amounts of excipients were discarded. Studies published in the last 20 years that provided information on the most relevant and documented intolerances and allergies in the bibliography were included.

Results: It was observed that, in patients with wheat, lactose, soybean oil and peanut oil allergy, the use of these excipients is contraindicated. In other diseases such as phenylketonuria, it is recommended to reduce phenylalanine intake as much as possible. In pathologies such as lactose intolerance, hereditary fructose intolerance, celiac disease and ethanol intolerance, it seems that there are safe quantitative limits for patients.

Conclusions: The maximum tolerated amount of excipients in all pathologies and clinical situations is not clear, so further studies are needed to know what amount is safe, the pharmacist could provide information on the best alternatives for each drug to improve the clinical care of the patient.