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OBy Emi Gosling, Principal Consultant, e-MAS Medicine Advertising Service. ur customers and patients Inactive ingredients fall into classes are becoming increasingly such as diluents, binders, glidants, mindful of what they’re lubricants, disintegrants, sweeteners, putting into their bodies. colourings, coatings (for example, Be it for health reasons, in support of to allow for slow release of the active teams needed to contact the product sponsor – the company that supplies the medicine in Australia. Now there’s a simpler and faster way The TGA’s website includes a list of all medicines, herbal products, supplements and OTC products that can legally be sold in this country: the Australian Register of Therapeutic Goods (ARTG). Here you can find a wealth of information about a product, and now the information on this register has become more transparent. It isn’t yet perfect (consultants and writers are working together to improve its readability) but from May 2020, information about active and inactive ingredients for all medicines is available for each medicine’s ARTG summary. To find the medicine’s ARTG summary, simply use the ‘Search ARTG’ box (link) by entering either the medicine name, or the medicine’s AUST number, which can be found on the label. The ARTG summary doesn’t include details of the source of an ingredient – for example, whether an ingredient is of animal origin, or whether it’s natural or synthetic. Therefore, it cannot answer the frequently asked question, ‘Is this medicine vegan friendly?’ Neither does the summary offer details of manufacturing aids (eg, filtering aids), the specific components of an ingredient (such as whether a herbal extract is a source of caffeine), nor ingredients within the flavour, fragrance or colour mixes used. The medicine sponsor company will still need to be contacted for this information. Its contact details are on the medicine label. For any information about a medicine or possible allergens, the company will always be a reliable and helpful source. Anyone can now easily check all the ingredients contained in their medicines. The availability of this information will help pharmacy assistants and their customers make more informed choices about what’s important to them in the products they use. Remind your customers that the medicine hasn’t changed; it’s simply that the TGA is sharing more information to help consumers in discussions with their health professionals. religious beliefs or due to allergies and sensitivities, knowing exactly what’s in a medicine is very important. Older patients taking multiple medicines are likely to be upping their intake of inactive ingredients. While a little bit of, say, starch or lactose, might not cause an issue, a larger amount could trigger an allergic reaction. When a medicine has been prescribed by a doctor or pharmacist, or a supplement or topical product recommended by a pharmacy assistant, a suggestion is usually made based on the active ingredient or the combination of active ingredients the product contains. Each medicine has an active ingredient – it’s what makes it a medicine in the eyes of the TGA. This ingredient must meet strict safety and quality standards set out by the TGA before it can be dispensed and supplied to Australians. But what’s that ingredient making my syrup green? Where’s that from? Medicines are made up of active ingredients and inactive ingredients. If a dose of medicine contains a minuscule 150mg of active ingredient, what makes up the remainder of the dose? On average, a medicine tablet weighs about 300-500mg, so there’s a difference between the amount of active drug and the weight of the tablet. Try measuring it sometime! That green syrup has active ingredients (usually measured in mg/ ml), with other components added that make what’s known as the syrup base – and give it the green colour. Be it a tablet, pill, capsule, syrup, suspension, foam or cream, all will have additional ingredients that allow for a convenient way to get the medicine to its desired site of action. These inactive ingredients also allow for the medicine to be compressed, to flow smoothly through manufacturing lines and to remain stable once packaged. Even most of those ‘all-natural’ creams have a base within which the active medicines are dispersed. ingredient) and even the capsule casing itself. Isn’t the information on the label? Unlike foods and cosmetics, listing of all the ingredients on the label is not required for most medicines. Only the active ingredients need to be made clear to the buyer. In Australia, some inactive ingredients (also known an excipients) will, however, be mentioned on the label. As you read this, manufacturers are taking steps to improve their medicine labels, with new, updated labels already appearing in-store and online for many of the popular brands. Much of the information regarding common allergens is included on the label – for example, packaging must declare if eggs or peanuts are likely to be in the medicine. Upcoming improvements to labelling will additionally alert customers or pharmacy staff to the presence of many more allergens, including all the tree nuts and soya. The full list of labelled allergens can also be found on the TGA’s website. Where to get more information For patients with rarer allergies or sensitivities, or those undertaking avoidance diets, the information on the label may not suffice. Some people are sensitive to some substances that cause no health issues for the general population. Until recently, the only way to find out exactly what a product contained was to examine the consumer medicine information (CMI) leaflet, or product information leaflet if it was a prescription medicine. Unfortunately, though, most OTC and complementary medicines don’t have these readily available. To establish whether, for example a cough syrup contained fructose, consumers and pharmacy WHAT’S TRENDING 9 “Unlike foods and cosmetics, listing of all the ingredients on the label is not required for most medicines.” RETAIL PHARMACY ASSISTANTS • JUN 2020