For those with celiac disease or non-celiac gluten sensitivity, going gluten-free usually tames many small aches and pains (and even large ones). But that doesn't mean we don't occasionally require an over-the-counter pain reliever ... and when we do, that pain reliever needs to be gluten-free.
But which ones are safe on the gluten-free diet? Unfortunately, it's impossible to tell just by reading the packaging in the drug store — manufacturers often include a gluten grain (wheat, usually) as an inert filler or ingredient in both prescription and non-prescription medications, and they're not required to disclose its presence.
However, calling them and asking usually produces answers. Here's the list of common brand-name pain relievers available in the U.S., plus what their manufacturers say about their gluten-free status:
- Advil. This ibuprofen-containing pain reliever comes in four varieties: Advil, Advil Film-Coated, Advil Liqui-Gels and Advil Migraine. According to the company, "Advil Liqui-Gels and Advil Migraine contain a wheat derivative, and are not gluten-free." It's not clear whether regular Advil and/or Advil Film-Coated products are produced in the same facility, which would subject them to gluten cross-contamination.
- Aleve. Aleve's active ingredient is naproxen sodium. The product's manufacturer, Bayer Healthcare L.L.C., says in a statement that "we do not add any gluten to our products. However, we cannot guarantee that they are 100% gluten-free as this product is produced in a facility that manufacturers or packages other items which may contain gluten." These products could be made on the same equipment, according to a customer service representative. Read more on this: Should You Eat Foods Made in a Shared Facility or on Shared Equipment?
- Bayer Aspirin. Bayer Healthcare's statement for Aleve also applies to Bayer aspirin — the products are produced in a facility that may also process gluten, and could be made on the same equipment as gluten-containing products.
- Excedrin. Novartis Corporation makes Excedrin headache/migraine relief and pain relief medications, along with various other prescription and non-prescription drug products. According to a customer service representative, Novartis does not add gluten to any of its products, but "because we multi-source ingredients for our products, we don't guarantee they don't contain gluten."
- Mucinex. These products, made by Reckitt Benckiser, really are aimed at people with coughs, colds and the flu, but some formulations of Mucinex do include pain relief and headache relief ingredients. According to the company, Mucinex, Mucinex DM and Mucinex D contain no gluten ingredients, but "we do not test for or certify them to be gluten-free." Read more on this: What Does the Statement 'No Gluten Ingredients' Mean on a Food Label?
- St. Joseph. The maker of Tylenol, McNeil-PPC, Inc., markets aspirin products under the St. Joseph name. Two products appear on Tylenol's extensive gluten-free list (see below for the rest of the list): St. Joseph enteric-coated and St. Joseph adult chewable aspirin tablets.
- Tylenol. Tylenol, with its active ingredient actetaminophen, may be the best-known pain relief and headache relief treatment available over-the-counter. There's good news: manufacturer McNeil-PPC, Inc. does test for gluten, and maintains a long list of products that are gluten-free. According to the company, these products have been tested and do not contain detectable levels of gluten: Infants Tylenol Drops in both cherry and grape; Children's Tylenol Meltaways in grape punch and bubblegum burst flavors; Children's Tylenol Suspension Cherry Blast; Junior Tylenol Meltaways in grape and bubblegum burst flavors; extra strength Tylenol caplets; regular strength Tylenol tablets; Tylenol arthritis pain caplets; Tylenol eight-hour caplets; Tylenol PM caplets; Simply Sleep caplets; Tylenol sinus severe congestion; Tylenol cold severe congestion caplets; Infants Motrin drops in both regular and dye-free; Children's Motrin suspension in grape, berry, bubblegum and dye-free versions; Children's Motrin Cold Suspension in berry; Motrin IB caplets and tablets; Imodium advanced chewable tablets; and Imodium AD caplets.
Okay, But What About Store Brands?
Yes, many of us enjoy the cost savings we can see from buying the store brand of an over-the-counter pain reliever like acetaminophen or naproxen sodium.
However, stores can change suppliers at will for their over-the-counter drug products, and a brand that once was gluten-free can shift into unsafe status without any warning or notice to the consumer.
I've seen one or two store brand pain relievers that prominently state "gluten-free" on the packaging (these are becoming more common as the gluten-free diet itself becomes more common). If you can find one of those, you should be safe to take it (just check the packaging every single time).
However, if you can't find a gluten-free-marked store brand, then I strongly recommend sticking with one of the safe brands listed above. Yes, you'll pay a little more (or a lot more, unfortunately), but at least you'll know you won't get glutened by it. If you're already feeling sick, you don't want to add insult to injury by accidentally ingesting gluten.
Feel better soon!