What else is in that?

AIMS Journal 2014, Vol 26, No 1

AIMS is often asked about the content of drugs by those with allergies or who practise abstinence diets (for example, vegetarians), for religious food observances and by those who want to know what they are taking into their bodies.

Unlike laws for food labelling in the UK, there is no similar requirement for medicine. Drug information sheets are included with all medicines and we recommend that you read them carefully before taking the drug and tell the doctor any information that may be relevant.

However, it is likely that you will only be shown this information sheet by hospital staff if you ask to see it. Medicines are only required to give details of 'active ingredients' they contain, which must be listed on the drug information sheet. Medicines will also have 'inactive ingredients', which are components of the drug that generally do not increase or affect the therapeutic action of the active ingredient. Inactive ingredients are used to make the tablets or solutions that contain the drugs and to make those that need to be swallowed palatable (such as coating of tablets). Examples include binding agents, dyes, preservatives and flavouring. It is possible that these inactive ingredients may cause allergic or adverse reactions.

It is extremely difficult to find out whether any medicines have active or inactive ingredients that are made from animal products or other ingredients that may be unacceptable to some people. If you are told a drug is synthetic, it may still be animal derived.

Chemical synthesis is often very complicated and using an animal source may make the production easier and hence cheaper, or there may be no suitable chemicals to use in the production process that can be obtained from plants. If a drug has been manufactured abroad, such as in China, details of the source may not be available.

The advice given to AIMS by a drugs company is to phone them direct to find out what was used to make each individual drug you wish to know about. You would need to do so for each different batch of drugs, because the ingredients could vary between batches of the same drug, although the quantity of the active ingredient would stay the same.

Please note that medical staff and midwives are unlikely to know whether the drug contains 'ingredients' that you wish to avoid or not. The information is not on the patient information sheet (there are no requirements for it to be) and neither is it in the British National Formulary (the book and website they use to obtain information about drug constituents - see www.bnf.org). Ask for written information if staff claim knowledge.

It may be worth speaking to a pharmacist, either your local one or the hospital pharmacist, as they are likely to know more about the drug - although their sources of information are likely to be the same. Again, check their knowledge and ask for written information.

Be aware, also, that you may be obtaining information about a drug with a certain brand name, however, the NHS may prescribe you another, cheaper version containing the same drug, but with different inactive ingredients. If so, you will have to start your checks all over again.

There are three useful websites where you may find information an American one https://www.drugs.com and two UK ones http://www.medicines.org.uk/emc/ and http://www.mhra.gov.uk/.