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Suggest treatment for lactose intolerance

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Posted on Tue, 2 Sep 2014
Question: I take the following medicines which have as one of their
ingredients: LACTOSE. ( Singulair for asthma,losartan for blood pressure,nebilet for heart rate & seretide. I have developed lactose intolerance as I've gotten older. I've recently been
having severe symptoms of lactose intolerance each time after I take these meds. I wonder if
the cumulative affect of the lactose in each pill is triggering a lactose
reaction. Is there any alternative meds without lactose?? at least one or two of them without lactose!!
exist blood pressure medicament without lactose that i can use?? if yes what its name?
please help..am really suffering ..thanks
doctor
Answered by Dr. Shafi Ullah Khan (9 hours later)
Brief Answer:
Need work up, too early to discontinue/change meds

Detailed Answer:
Thank you for asking
I seriously doubt the ingredient of lactose in a few medications is causing the intolerance.Its not possible with so little of lactose.
Plus how do you know it is lactose intolerance. Did you have some lactose tolerance or milk tolerance or breath hydrogen test?
The symptoms of diarrhea and bloating and flatulence are mostly the adverse effects of the medications and could be of some other functional bowel like IBS. but last thing on earth would be a lactose possibility.
Replacing such nice medicines for a suspicion of lactose intolerance is not wise. Lactose in milli and micrograms cant cause that.
Just eliminate the diet containing lactose products like milk ice cream, and cheese, bread and baked goods, cereals, salad dressings, candies, and snacks,whey, curds, milk by-products, dry milk solids, and nonfat dry milk also contain lactose.
Also get the labs assessed. Seeka gastroenterologist and let them do some work up rule out other suspicions like IBS and functional bowels which are more likely. No need to change the medicines until proven otherwise.
I hope it helps.Take good care of yourself and dont forget to close the discussion please.
May the odds be ever in your favour.
Regards
Khan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shafi Ullah Khan (21 hours later)
hi dr. XXXXXXX
i already have intolerance lactose i did the exam of lactose and it shows that i have it then my gastro told me to keep away from dairy products and i already did and he tolds that my body needs at least 20 days to eliminate the quantity of lactose that i have inside anyway now its 40 days that am back from doc. but my symptoms of lactose or in other word my crise of lactose its the same so i was thinking that maybe its because of my medicines i use LOSARTANE, SINGULAIR , SERETIDE , NEBILET and all of them contains Lactose..is that possible to be very sensitive to lactose ??? do u agree with that ?? exist medicines without lactose ? BP medicine without lactose for example ????
doctor
Answered by Dr. Shafi Ullah Khan (1 hour later)
Brief Answer:
possible, lactose free meds list provided

Detailed Answer:
Thank you for asking
Its theoretically possible and despite 40 days of elimination diet still persistence makes the odds more likely.
There are many antihypertensives without lactose. following are some
Yes, there are ACE inhibitors without Lactose.
There also are other medication for high blood pressure too that are not necessarily ACE inhibitors.
Here is a list, copy paste from the link below (second link opens a doc file):

Vasodilator antihypertensive drugs
Apresoline tablets (hydralazine)
Tracleer tablets (bosentan)
Centrally acting antihypertensive drugs
Aldomet tablets (methyldopa)
Adrenergic neurone blocking drugs
Alpha-adrenoceptor blocking drugs
Cardura XL tablets (doxazosin)
Hypovase tablets (prazosin)
Drugs affecting the renin-angiotensin system
Angiotensin-converting enzyme inhibitors
Carace 5mg, 10mg, 20mg tablets (lisinopril)
Carace 10 Plus and Carace 20 Plus tablets (lisinopril, hydrochlorothiazide)
Lopace 2.5mg, 5mg, and 10mg capsules (ramipril)
Zestoretic 10 & 20 tablets (lisinopril, hydrochlorothiazide)
Angiotensin-II receptor antagonists
Co-Diovan tablets (valsartan, hydrochlorothiazide)
Diovan tablets and capsules (valsartan)
Micardis tablets (telmisartan)

-Drugs affecting the renin-angiotensin system
Rasilez tablets (aliskiren)
Angiotensin-converting enzyme inhibitors
Tritace tablets and Tritace Titration Pack (ramipril)
Zestril tablets (lisinopril)
-- Nitrates, calcium-channel blockers, and other antianginal drugs
- Nitrates
Imdur Durules (isosorbide mononitrate)
2.6.2: Calcium-channel blockers
Adalat capsules (nifedipine 10mg)
Adalat 5 capsules (nifedipine 5mg)
Adalat LA 20 tablets (nifedipine)
Adalat LA 30 tablets (nifedipine)
Adalat LA 60 tablets (nifedipine)
Adizem-SR capsules (diltiazem)
Adizem-XL capsules (diltiazem)
Angitil SR/XL capsules (diltiazem)
Cardene capsules (nicardipine)
Dilzem SR 60mg, 90mg and 120mg capsules (diltiazem)
Dilzem XL 120mg, 180mg, 240mg capsules (diltiazem)
Exforge tablets (amlodipine, valsartan)
Half Securon SR tablets (verapamil)
Istin tablets (amlodipine besilate)
Nimotop tablets (nimodipine)
Securon SR tablets (verapamil)
Slozem capsules (diltiazem)
Tilsiem LA capsules (diltiazem)
Tildiem Retard tablets (diltiazem)
Univer capsules (verapamil)
Viazem XL capsules (diltiazem)
-Other antianginal drugs
Ikorel tablets (nicorandil)
- Peripheral vasodilators and related drugs
Hexopal and Hexopal Forte tablets (inositol nicotinate)
Paroven capsules (oxerutins)
Pletal tablets (cilostazol)
Praxilene capsules (naftidrofuryl oxalate)
Trental tablets (pentoxifylline)

For asthma try bronchial thermoplasty and allergen immunotherapy. Discuss the options with your allergist and immunologist.
follow the link , it has all lactose free medications list. It will guide you to find lactose free meds.
http://www.galactosemics.org/2003conf/Guide%20to%20Finding%20Lactose%20Free%20Medications.pdf

I hope it helps.Take good care.CLose the discussion please.
Regards
Khan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shafi Ullah Khan (46 hours later)
i stopped motilium 10 days ago after using it 3 months and a half and am feeling a little depressed and i am not sleeping well..does this medicine makes any side effect even after i stoppnig it?? and if so how much time needs to stop affecting me ??
doctor
Answered by Dr. Shafi Ullah Khan (3 hours later)
Brief Answer:
Not domperidone

Detailed Answer:
Thank you for asking
Sleeping difficulties and depression is least likely a correlation with domperidone plus 10 days is more than enough to get all the domperidone out of your system.
Here are some general principles to help your sleeping troubles. seek a sleep disorder specialist if problem persisted and a psychiatrist for depresion.
Develop regular sleep habits; this means keeping a regular sleep and wake time, sleeping as much as needed to feel refreshed the following day, but not spending more time in bed than needed
Avoid staying in bed in the morning to catch up on sleep
Avoid daytime naps; if a nap is necessary, keep it short (less than 1 hour) and avoid napping after 3 pm
Keep a regular daytime schedule; regular times for meals, medications, chores, and other activities helps keep the inner body clock running smoothly
Do not read, write, eat, watch TV, talk on the phone, or play cards in bed
Avoid caffeine after lunch; avoid alcohol within 6 hours of bedtime; avoid nicotine before bedtime
Do not go to bed hungry, but do not eat a big meal near bedtime either
Avoid sleeping pills, particularly over-the-counter remedies
Slow down and unwind before bed (beginning at least 30 minutes before bedtime (a light snack may be helpful); create a bedtime ritual such as getting ready for bed, wearing night clothes, listening to relaxing music, or reading a magazine, newspaper, or book
Avoid watching TV in the bedroom or sleeping on the sofa and then going to bed later in the night
Avoid stimulating activities prior to bedtime (eg, vigorous exercise, discussing or reviewing finances, or discussing stressful issues with a spouse or partner or ruminating about them with oneself)
Keep the bedroom dark, quiet, and at a comfortable temperature
Exercise daily; this is best performed in the late afternoon or early evening (but not later than 6-7 pm)
Do not force yourself to sleep; if you are unable to fall asleep within 15-30 minutes, get up and do something relaxing until sleepy (eg, read a book in a dimly lit room, watch a non-stimulating TV program); avoid watching the clock or worrying about the perceived consequences of not getting enough sleep
Cognitive behavioural therapies help the issue too.it includes
Sleep hygiene education
Cognitive therapy
Relaxation therapy
Stimulus-control therapy
Sleep-restriction therapy
Try Acupressure too, it works like charm on insomnia issues.
Avoid caffeinated beverages in the late afternoon or evening, since the stimulant activity of adenosine antagonism can promote hyperarousal
Avoid alcohol in the evening, since this can worsen sleep-disordered breathing leading to frequent arousals; furthermore, while alcohol promotes sleep early in the night, it leads to more sleep disruption later in the evening
Avoid large meals near bedtime, particularly with gastroesophageal reflux disease or delayed gastric emptying.
Exercise in the late afternoon or early evening (at least 6 hours before bedtime) can promote sleep. However, vigorous physical activity in the late evening (< 6 hours before bedtime) can worsen insomnia.
I hope it helps.
Good Luck
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3613 Questions

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Suggest treatment for lactose intolerance

Brief Answer: Need work up, too early to discontinue/change meds Detailed Answer: Thank you for asking I seriously doubt the ingredient of lactose in a few medications is causing the intolerance.Its not possible with so little of lactose. Plus how do you know it is lactose intolerance. Did you have some lactose tolerance or milk tolerance or breath hydrogen test? The symptoms of diarrhea and bloating and flatulence are mostly the adverse effects of the medications and could be of some other functional bowel like IBS. but last thing on earth would be a lactose possibility. Replacing such nice medicines for a suspicion of lactose intolerance is not wise. Lactose in milli and micrograms cant cause that. Just eliminate the diet containing lactose products like milk ice cream, and cheese, bread and baked goods, cereals, salad dressings, candies, and snacks,whey, curds, milk by-products, dry milk solids, and nonfat dry milk also contain lactose. Also get the labs assessed. Seeka gastroenterologist and let them do some work up rule out other suspicions like IBS and functional bowels which are more likely. No need to change the medicines until proven otherwise. I hope it helps.Take good care of yourself and dont forget to close the discussion please. May the odds be ever in your favour. Regards Khan