Lactose-Free Statin Drug Lescol

Statin drugs are prescribed to reduce cholesterol, making them some of the most commonly used drugs in America. Unfortunately, nearly every one of them uses lactose as an inactive ingredient.

Several years ago I had hopes that a new statin drug that didn't cause muscle pain, a common side-effect, might also be lactose-free. No such luck. Ezetrol (ezetimibe) does contain lactose now that it's on the market.

There is one brand name that doesn't. Lescol.

Lescol doesn't work for everybody and has side-effects of its own, as a correspondent recently wrote me. I tried to find a substitute, but no luck.

The alternative is to pay an additional fee and go to a compounding pharmacy. They make up prescriptions to order with offending ingredients removed. I wrote about them in Try a Compounding Pharmacy for Lactose-Free Medications and it's time I gave you a reminder.

The links I gave then are still good.

There seem to be two major trade organizations.

The Professional Compounding Centers of America (PCCA) has more than 3500 members, many of them outside American in Canada, Australia, Europe and New Zealand. To find a compounding pharmacist close to you, call them at 1-800-331-2498 or email customerservice@pccarx.com.

The International Academy of Compounding Pharmacists (IACP) represents more than "1,800 pharmacists, physicians, technicians and patients."

Osteopenia with Lactose Intolerance

As with so many other prescription medications, Boniva, so often prescribed for people who need additional bone density, uses lactose as its primary filler. That can create a problem, as in this questioner to The People's Pharmacy in the Los Angeles Times.

Q. I am 62 years old and just had my second bone-density test. I was told I have osteopenia and should take Boniva.

I have been lactose-intolerant, so I avoid dairy products. I have tried calcium, but it makes me constipated. I took Actonel but developed leg cramps. I took one Boniva tablet the nurse gave me as a sample, but I now have unbearable indigestion. Is there anything natural I can take?

A. Osteopenia is a controversial condition. The concept of pre-osteoporosis was created somewhat arbitrarily in 1992 for research purposes rather than to guide treatment. Extra vitamin D (2,000 to 4,000 IUs daily), exercise and lots of fruits and vegetables can help. There are also other medicines.

Lactose-Free Birth Control Pills. The Definitive List.

Birth control pills are normally a series of 28 tiny pills in a case. The first 21 pills contain the active ingredient that prevents ovulation. The other seven are placebo pills, designed with no active ingredient, but included just because experience shows that it's easier for women to take a pill every single day rather than skipping a week and having to remember to restart.

All well and good, a system that has worked for 40 or more years.

The only problem, for a small set of women, was that for some reason, the vast majority of birth control pills made in America contain lactose as an inactive ingredient. Lactose, being non-reactive and slightly sweet, is an extremely common filler for many medications. Most medications have a lactose-free variety. A limited choice, therefore, but still a choice.

That limited choice used to be Demulen. Unfortunately, Demulen went off the market and was replaced by a generic named Zovia. And Zovia contained lactose.

What choices do women have today?

Thanks to the good folks at Wegmans Food and Drugs, my local supermarket chain, and one that has been in the forefront of making lactose information available, I can answer that question. Christopher Woodring, Pharmacist Intern, created a list based on information from Clinical Pharmacology. Many thanks to him for his arduous effort. Thanks also to the Wegmans East Avenue pharmacists, Katie Barbone, Natasha Dedes, and Paul Taranto.

The only pills that appears to have all its pills be completely lactose free are Nordette and Portia. [This is a correction from the original posting. Cryselle does have lactose in the active pills.] You should consult your own doctor and pharmacist to see if either of these pill are right for you.

The Alternatives listed as contractve injections, which obviously do not put lactose into your stomach. They are not pills but I am including them in this listing for your information.

You can find the full list of all contraceptive medications at this page on my site.

Women should remember that the amount of lactose in any one pill is tiny. Unless you are extremely lactose intolerant the amount of lactose in any individual pill should not cause any symptoms. The best pill for you may contain lactose. Still, I understand that many women are seeking to avoid dairy in all forms and all doses. This information should be especially helpful for you.

Drug Type			Contains Lactose in
	Drug Name	Manufacturer	Active Ingredients	Inactive Ingredients
Low Dose Monophasic
	Cryselle	Duramed/Barr	Yes	NO
	Femcon Fe chewable	Warner Chilcott	Yes	NO
	Microgestin 1.5/30	Watson	Yes	NO
	Nordette	Duramed/Barr	NO	Yes
	Portia	Barr	NO	information Not available
Extended Cycle
	Loestrin-24 FE	Warner Chilcott	Yes	NO
Alternatives
	Depo-Provera		NO	not applicable
	Depo SubQ		NO	not applicable
	Mirena		NO	not applicable
	Nuva Ring		NO	not applicable
	Ortho Evra		NO	not applicable

Tracing Lactose Back to Its Source

New Zealand. It's given us the Lord of the Rings movies, the Flight of the Conchords, and lactose. And the lactose may be more ubiquitous than either of the other two.

TVNZ reported that:

A by-product of Fonterra's waste is now being sold to some of the world's biggest pharmaceutical companies.

Inhalation grade lactose, which is not needed in the processing of cheese, is the dairy industry's second largest product in Europe and the sixth largest globally.

Around 45,000 tonnes of high grade lactose is produced each year and it all starts in Taranaki using milk produced in the North Island.

I believe that. This statement, though, seems odd, as least as written:

The ingredient has attracted Dutch pharmaceutical giant DMV, who in 2006 paired with Fonterra to develop the product into the global market worth $US800 billion.

Maybe the total global pharmaceutical market is worth $US800 billion or maybe it's the global dairy market that's worth US$800 billion, but the lactose piece of it sure isn't.

And here's another strange comment:

Now, a third of every medicine tablet made contains lactose that produced in Taranaki.

Every medicine tablet made contain lactose. No. Don't worry about that. Lactose is just plain not in every medicine tablet made. Even if you read that as lactose is in a third of tablets made, that claim is not likely to be true. Maybe a third of the total volume of tablets made with lactose is lactose, but that doesn't seem right to me either. I find that line a mystery.

But I bet I know what happened. TVNZ got a press release from Fonterra and rewrote it as article, even though the writer had no idea of what the words meant. Depressing to find that as a problem everywhere in the world.