Many of us, including vegans, need to take medication at some time in our lives. However, many medications contain ingredients or excipients (the bits they add to make the medicine into a tablet etc.) which are not suitable for vegans.
In addition to this, all medicines have to undergo testing in non-human animals before they can proceed to testing in humans in order to gain a product license. I am often asked by well-meaning colleagues what the point of avoiding lactose is if the medicine is tested on animals anyway, and I always remind myself of the following statement from The Vegan Society:
“Veganism is a way of living which seeks to exclude, as far as is possible and practicable, all forms of exploitation of, and cruelty to, animals for food, clothing or any other purpose”1.
“As far as is possible and practicable”. So I have made it my aim to make it a little more possible and practicable to take medicines that are vegan friendly by providing some hints and tips to guide you through this complicated topic. It should go without saying (but I’ll say it anyway) that this document should be used to open up a discussion with your healthcare professional, be they doctor, dentist, nurse or pharmacist. It can be dangerous to stop or change medication that you are prescribed without discussing it with a healthcare professional. To add some perspective, I still haven’t managed to entirely rid my prescriptions of non-vegan ingredients – it isn’t always possible. I have decided to try to compensate for my decision through activism. You need to know what’s in your medicine in order to choose to accept it or change it, so here goes.
We need to ask a number of questions to ascertain if a medicine is vegan:
Does the method of manufacture of the medicine involve the use of non-human animals?
• Creon® – Contains porcine pancreatic enzymes2. Unfortunately all pancreatic enzyme replacement products are currently derived from non-human animals.
• Cholecalciferol (vitamin D3) – Manufacture involves the use of lanolin from sheep’s wool. Vitamin D2 (ergocalciferol) is vegan, but watch out for the excipients in the final product – they might not be.
This information can sometimes be obtained from the manufacturer’s product information (called the summary of product characteristics or SPC). You can access these at www.medicines.org.uk, but they are aimed at healthcare professionals so can be complicated. The manufacturer’s website, for branded products, may also be of use.
Does the medicine contain an excipient which is derived from animals?
Check the excipients listed in the SPC for the specific brand of medication at www.medicines.org.uk. .
See table below for some examples (If the excipient is listed under 'Can be animal or plant derived" please contact manufacturer for the product in question):
Suitable for vegans
Can be animal or plant derived
Not suitable for vegans
|Lactose||Derived from milk.|
|Magnesium stearate||Manufacture involves use of stearic acid (see below).|
|Stearic acid||Manufactured by hydrolysis of fat from either animal or plant sources4.|
|Gelatin (E441)||Extracted from animal tissues5.|
|Lanolin (E913)||Fat extracted from sheep’s wool5.|
|Glycocholic acid||Bile acid derived from mammals.|
|Lactic acid||Manufactured using either animal or plant sources4.|
|Pregelatinized starch||Manufacture involves the heating and drying of starch4.|
By now you have either:
• Found out that the product is not vegan – time to research alternatives (see below).
• Discovered that the product might be vegan (e.g. contains magnesium stearate) – time to contact the manufacturer and ask some questions.
• Happily, have concluded that the product is vegan – I like to phone the manufacturer at this point just to be sure. I have been caught out by an excipient I was unfamiliar with before.
The manufacturer’s contact details are at the very bottom of the SPC. Some will take up to two weeks to get back to you and others will tell you the answer there and then. You may want to get your pharmacist to do this for you.
If your medication was not vegan you can:
• Look at as many different SPCs as possible to see if a particular brand looks more promising – then start again from the top.
• Capsules are unlikely to be vegan due to gelatin.
• Tablets with sucrose in are promising as this is usually used in place of lactose. May be worth investigating these ones.
• Liquids are often vegan, other formulations like dissolvable tablets can also be worth looking at. The downside is that these are usually a lot more expensive.
• I personally think it best to avoid “specials” formulations – this is where a “specials” company will produce whatever you want as a liquid at an exorbitant price. I’m talking hundreds of pounds a month. I know opinion will differ on this one but I don’t think the steep cost of these is justifiable. Also, they might not actually be vegan – you would still need to investigate and they also aren’t licensed.
• If you buy medicines online you should look for this symbol so you know it’s a registered pharmacy:
• When you click on the logo it should link to the GPhC online register entry for that pharmacy.
So that’s it; I hope this information is enough to get you started, and at the very least open up a conversation with your pharmacist or doctor.
By Samantha Fry
MRPharmS (Member of the Royal Pharmaceutical Society) Clinical diploma, Hospital Pharmacist.
Enquiries welcome via The Vegan Society.
- The Vegan Society website - www.vegansociety.com accessed on 20/08/17.
- SPC for Creon® 10000 capsules. Last updated 23/01/17. Mylan Products Ltd.
- SPC for Clexane® pre-filled syringes. Last updated 09/06/17. SANOFI.
- Handbook of pharmaceutical excipients. Sixth edition. Rowe, R.C. et al. 2009.
- http://www.veganpeace.com/ingredients/ingredients.htm#P Accessed on 20/08/17. A useful list which is partly reproduced in the Queensland DOH guideline for patients.
The views expressed by our bloggers are not necessarily the views of The Vegan Society.