Excipients are neccessary in tableting...

Your tablet isn't just the named "active" component. "Inactive" excipients are needed to hold it together etc.

These include sugars and inorganic salts to disperse the drug in, enabling easier apportioning of the drug to each tablet.

Sugars and cellulose derivatives are used to bind the tablet together, giving it mechanical strength.

These and alginates are used to aid disintegration of the tablet after it is swallowed.

Colloidal anhydrous silicon and other silica compounds are used to improve the flow of powders during manufacture and as anti-caking agents.

Residues may persist, of compounds such as solvents used in the manufacturing process.

Film coatings are made of natural and synthetic polymers. They protect tablets, cover bad tasting drugs and sometimes slow release of the tablet contents.

Enteric coatings to ensure the drug is not released until past the acid environment of the stomach, are made of substances such as cellulose acetate phthalate, insoluble in acid.

Colouring agents, flavours and antioxidants can be used.

...But not always inert and harmless.

An early tetracycline had to be removed from the market as out of date it was toxic and caused kidney failure. This was due to a reaction between the tetracycline and an excipient.

Tartrazine is a yellow colouring agent which has caused allegy and hyperactivity in children. Quinoline yellow, sunset yellow, carmoisine, ponceau 4R and allura red have also been linked to behavioural problems in children.

Aspartame is a sweetener which is believed to be quite toxic.

Many tablets have lactose as a filler. Gluten was present in some, but probably not now.


When to think of this

If you appear to have multiple allergies, particularly to various chemicals, you need to be very cautious when trying any new medication.

If a drug appears to have disagreed with you, it may not be the drug itself but a reaction to an excipient. It may be worth trying another brand of the same drug, if the alternate brand looks different (colour, shape, container - so it most likely comes from a different manufacturer.)

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