Last updated in 2019! This article on lactose in medications was written for us by the lactose intolerance expert, Steve Carper of Planet Lactose. Please note that this is a FACT based article and does not speculate whether lactose in your medication is causing an issue for you. Every body is different. If you believe you are having any type of a reaction to a medication, you must speak with a physician.
Lactose is a sugar, a slightly-sweet sugar. It is only about one-seventh as sweet as sucrose, ordinary table sugar. Oddly enough, this is a good thing to many in industry. Lactose allows a bit of pleasant sweetness to be added to products, without overwhelming them with an overly-sweet taste. Commercial bakers can sprinkle lactose on the tops of bread and let it caramelize to a beautiful golden-brown. Food processors can add lactose (or whey, which is mostly lactose) to add taste and texture to foods without affecting the primary taste of the food.
Best of all, lactose is made from whey, and whey is a waste product in the cheese-making process, so it’s really cheap.
That’s why lactose is used so often in pill-making. The extremely tiny amount of actual working ingredient in a medication needs to be surrounded with fillers that bulk it out to be large enough to handle. A substance that is mostly tasteless but with just enough sweetness to balance out the bitter taste of many medications is great. That lactose can be formulated to break down in the stomach to release the medication makes it nearly ideal.
Lactose Set to Star in Even More Medications
Literally hundreds of branded prescription medications use lactose as a part of their formulations. If you add in generics and over-the-counter drugs, you probably have thousands of medications that include lactose.
And there will soon be more rather than fewer pills that use lactose.
Phil Taylor on DrugResearcher.com wrote Roquette wins US patent for Starlac in novel dosage form about a new and improved way to dispense medications.
French company Roquette has been awarded a US patent for a dissolve-in-the-mouth drug delivery technology that makes use of its novel Starlac excipient.
Use of the excipient could allow the creation of tablets that are hard and resistant to damage during handling, yet still disintegrate quickly in saliva after dosing.
The US patent, awarded to Roquette earlier this month, covers a solid dose form based on lactose and starch, the constituents of Starlac excipient, alongside one or more active pharmaceutical ingredients (APIs).
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Xavier Duriez, senior project manager at Roquette, told in-PharmaTechnologist.com that almost all ODT products on the market use mannitol as a diluent, but that in some cases Starlac could be used as a good alternative.
“Starlac is preferred for ODT and chewable formulas where palatability is a ‘must’,” he said, adding that the excipient provides a creamy mouthfeel that mannitol doesn’t provide.
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Starlac, a mixture of 85 per cent lactose and 15 per cent natural corn starch, was first introduced in 2002.”
Of course, the mere granting of a patent doesn’t mean that any products using Starlac will hit the market any time soon. But unless there is a serious bug with the project, it’s too good an idea not to come to pass.
How Much Lactose Is in Medications?
What does this mean for those who are lactose intolerant? Not as much as you might think. Only a tiny amount of lactose is present in any one pill. One study I read estimated that the average pill had 25 mg of lactose. You’d need to take 12,000 such pills to equal the lactose in an eight-ounce glass of milk at that rate. [Editor Note: By our calculations, this is actually 500 pills.]
Some people might still have symptoms from this tiny amount, especially if they have to take many such pills each day, as the elderly or those with serious illnesses must do. If you must take the medication, your doctor might suggest taking a lactase pill along with the medication to see if that helps. [Editor Note: Consult a physician if you are having any type of a reaction to a medication.]
Is it a Concern for Milk Allergies?
Those with a milk allergy also need to be somewhat concerned, but with the same caution. Medical-grade lactose is extremely pure and not likely to be contaminated with the dairy protein that causes problems. But possible contamination with milk protein is still possible. Extremely sensitive or anaphylactic people should certainly talk with their doctor before taking any pills with lactose. [Editor Note: Anyone with a milk allergy, regardless of the severity, should consult their physician before taking any medications with lactose.]
In most cases, there are alternative medications or brands without milk. Ask your doctor when they are writing the prescription and the pharmacist when they are filling it.
69 Comments
I’m vegan and I need to take a cholesterol medication Atorvastatin which contains lactose. Are there any medications for this that are vegan friendly.?🤔 Vicki.
Hi Victoria, here is a list of all the manufacturers who produce generic versions of atorvastatin -> https://www.drugs.com/availability/generic-lipitor.html
They each may use different filler ingredients. Your local pharmacies have access to the ingredients for each one that they carry. Not all will be available in your local area since there are a lot of manufacturers! It’s important to work with your doctor to find the best drug option for you. Doctors also have access to drug ingredients electronically, and should be able to help you choose the best option.
Are there any anti anxiety meds that do not have lactose? I just started small dose but felt “off.
My pharmacist had me call the manufacturer as she would not know. I did, and it has lactosemonohydrate.
Benzodiazepines are a class of anti-anxiety medications that often contain lactose monohydrate or lactose. They include types that often end in “pam” and “lam,” plus a few others. Some doctors prescribe antidepressants such as SSRIs and SNRIs for anxiety disorders. There are more dairy-free options in those classes of medication. https://www.medicalnewstoday.com/articles/323666#types-of-anxiety-medication
Some alternative practitioners recommend rhodiola rosea, which is an herb and does not typically contain milk as an additive -> https://pubmed.ncbi.nlm.nih.gov/18307390/
This is for informational purposes only and should not be construed as medical advice or recommendations.
Hi guys love reading all this info, really helps. I’m struggling to find an answer. Lactose in pills, I understand it’s the sugars & process. I am allergic to the whole cow, I do think this is what’s causing me issue for new tablets, I could never have the sugar pills in the contraceptive pill growing up. Same as whey protein, I can’t eat because it’s from cow, am I right or going crazy 😜
@ Alisa Fleming-
I have a dairy allergy and intolerance to lactose. But for the most part- add to your article about using compounding pharmacies for making a drug ; if they can’t get it lactose free. It will be more expensive but if it’s something they need, it’s an option.
I came upon your site by accident . How lucky I am as I’ve had the most awfull reaction to heart pills . In bed recovering and so ill.. Icouldnt believe it was those tiny pills . Now I have to contact go which I am reluctant to do . They are all so busy and strikes make us afraid of being illat present. There is a lack of help for medication problems even though my doc is really good . I’m going to try lactase and hope it helps but now afraid to take heart pills .
Please keep in mind that medications are drugs and can have side effects. If you are experiencing side effects, it’s important to report them to your doctor.