Food Allergies and the Pharmacy

Pharmacy Basics: NDC numbers and Package Inserts

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Pharmacy Basics will be a reoccurring segment about, what else, Pharmacy Basics. This post is very long but very important, please read it all. You may get bored. Feel free to pause in the middle to watch your favorite sitcom or look at pictures of cute kittens, but come back because the information is worth it.

First up, what your pharmacist needs to know.

Tell the pharmacist and pharmacy techs about any food allergies. It has been my experience that people automatically assume medication allergies but rarely divulge food allergies when asked about allergies.

Even if the pharmacy staff doesn’t specifically ask you about food allergies, you tell them. Also tell them that you are aware that certain medications contain food allergens and they are NOT usually caught by the interaction system.  We’ll talk about that in an upcoming post.

What’s an NDC number?

An NDC is the 11 digit number found on each bottle of prescription (and some over-the-counter OTC medications) that specifies the exact medication you have received.

Why does it matter?

Each manufacturer may have different inactive ingredients (which may include food allergens) as compared to other manufacturers of the same medication. For example, Drisdol, a brand name Vitamin D Supplement, contains soybean oil, while certain manufacturers of it’s generic do not.

How does an NDC number work?

An NDC is broken into three sections. The first 5 numbers represent the actual manufacturer. The middle four numbers represent the medication name and strength. The final two numbers represent the package size.

levothyroxine bottle

How do you know which NDC you have received?

Ask the pharmacist! The number may not be listed on the label provided by the pharmacy. However, the NDC dispensed is kept on record in the pharmacy’s computer system.

How will this help me?

Now that you know the NDC number, ask for the package insert. Make sure that the pharmacist understands that the package insert must be for the same NDC that you received–the actual medication that is in your bottle. NO SUBSTITUTIONS.

The package insert is the information packet that comes with the medication. It contains prescribing information, adverse reactions (aka side effects) and lots of other data about the medication.

How do I use the Package Insert?

There are two sections in the package insert that I believe are important for food allergies:

1. Warnings/Contraindications

2. Inactive ingredients (possibly found under “Description”)

levo package insert

The warnings/contraindications sections will sometimes specifically state avoidance if the patient is allergic to a particular food. BUT NOT ALWAYS! Read the inactive ingredients. Highly refined soybean oil, for example, is exempt from the FALCPA, The Food Allergen Labeling & Consumer Protection Act. Soy is one example of a food allergen that is commonly found in gel capsules.

Keep in mind that if the pharmacy needs to “partial fill” or “owe” you medication because they did not have enough in stock, this process should be repeated.

Just like food recipes change, ingredient lists change. Get in the habit of checking the package inserts, better yet ask the pharmacy staff to add a note to your profile requesting that a package insert be included with each fill (if available). If not available then the pharmacist can usually look this information up in one of his/her on-line sources.  This will take time. BE PATIENT! Third option is to call the manufacturer; the pharmacist can provide this number.

The pharmacy staff will be more than happy to help keep you and/or your child safe. That’s what we do! TRUST ME: Pharmacists and techs will go out their way to help a customer that is patient and friendly.

 

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Author: Tiffany PharmD Food Allergy Pharmacist

I am the sister of a milk protein allergy individual and the mother of a son who has multiple food allergies. E is ANA with eggs but also severely allergic to soy, peanuts, and tree nuts. I also happen to have a Doctorate in Pharmacy with experience in various pharmacy settings. I have informally advocated and educated pharmacists/pharmacy techs about food allergies and how those allergies come into play in a pharmacy setting for years. I finally decided to make that advocacy formal.

3 thoughts on “Pharmacy Basics: NDC numbers and Package Inserts

  1. Pingback: Pharmacy Basics: The Orange Book | Food Allergies and the Pharmacy

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