Add allergen labels to medications

Opinion editor’s note: Editorials represent the opinions of the Star Tribune Editorial Board, which operates independently from the newsroom.

•••

For two decades, consumers have been able to quickly determine by looking at a food label if a product contains a major allergen, such as dairy, eggs, peanuts or wheat.

So why don’t the same labeling requirements apply to medications, which also are used widely and taken by mouth?

It’s a vexing oversight that the Congress needs to remedy swiftly. Fortunately, Minnesotans are at the forefront of pushing for this commonsense change. Rep. Dean Phillips, a Democrat who represents the west metro and is running for president, has introduced a legislative fix. But additional advocacy, particularly from the state’s congressional delegation, will be necessary to get the bill passed.

The legislation is the ADINA Act, with the acronym standing for the Allergen Disclosure in Non-food Articles. It’s not a coincidence that Adina also happens to be the first name of a young girl from Maple Grove whose frightening experience at summer camp inspired Phillips to act.

Adina Togal, now 12, has celiac disease, a condition that can cause an immune reaction when a person eats gluten, which is found in wheat, barley or rye. She also has a dairy allergy and another autoimmune disorder that can cause a reaction in the esophagus in response to foods or environmental allergens, according to Johns Hopkins Medicine.

The treatment is a diet that’s completely free of these triggers, said her parents, Seth and Jennifer Togal. That’s why it was not an easy decision for them when the camp’s medical team called during the summer of 2022 and asked if Adina’s strep throat could be treated with antibiotics.

In addition to the active ingredient, pills can contain other substances used as fillers or stabilizers. The problem, as a 2019 study detailed, is that these components could be harmful to those with conditions like Adina’s.

The study found that “93 percent of medications contain allergens, including lactose, dyes, and peanut oil. Almost all medicines contain ingredients that some people might not be able to tolerate, such as gluten,” according to MedicalNewsToday.

An estimate of food allergies’ prevalence underscores the concern about these ingredients’ presence in pills. About 6% of American adults and 5.8% of children have a food allergy, the U.S. Centers for Disease Control estimates. Some studies suggest the prevalence is even higher.

The Togals frantically researched the antibiotic that had been prescribed at camp to see if it contained substances that might trigger a reaction. They researched the drug online and called multiple local pharmacies but weren’t able to determine conclusively if there was gluten or dairy in it.

The Togals authorized giving Adina the antibiotic. Unfortunately, within 12 hours, Adina was in “severe distress,” they told an editorial writer. She was constantly throwing up and had headaches, fatigue, dehydration and low blood pressure. She required hospitalization before, thankfully, making a full recovery.

It shouldn’t be this hard for parents like the Togals to protect their kids. They contacted Phillips’ office soon after the harrowing experience. He followed up by introducing the ADINA Act.

If enacted, prescription and over-the-counter medications would have to list major allergens in plain language on the label, just as food products do. The House bill had 31 cosponsors, as of Thursday, a list that is commendably bipartisan. Regrettably, it lacks another member of this state’s House delegation.

There’s a companion bill in the Senate introduced by Richard Blumenthal, D-Conn. It currently has no cosponsors. The Star Tribune Editorial Board urges Minnesota’s two senators — Amy Klobuchar and Tina Smith — to get involved. With Phillips not running for re-election to Congress, the next advocate for kids like Adina should come from the state’s congressional delegation.

It’s difficult to understand potential arguments against the ADINA Act. Yes, there would be some cost to update labels, but that hasn’t been too burdensome for food manufacturers complying with this requirement. The cost also pales in comparison to harm that an allergic reaction can cause. A California girl with a dairy allergy died in 2019 after using a prescription toothpaste containing a milk protein.

PhRMA, the drug manufacturers trade group, said it is reviewing the language and the legislation’s potential implications.

While the House considers Phillips’ bill, there’s a related issue for lawmakers to address.

Lana Plashchynskaya’s 3-year-old daughter Terra needs to take thyroid medication. She also has celiac disease and is lactose-intolerant. She recently had to stop taking her thyroid medication, her mom said, after reacting to it.

There are thyroid medications that are “truly gluten-free and lactose-free,” said Plashchynskaya, who lives in Jordan. But the family is fighting to get insurance to cover these alternatives. Lawmakers should consider remedies to address this as well.

Plaschynskaya backs the Adina Act, too. “The goal of this bill is not to stop production of medication,” she said. This is simply about ensuring that Americans know what’s in the medication they’re taking. “We as parents shouldn’t have to go to excruciating lengths to dig information out that should be readily available,“ she said.