November 21, 2013

It Has What?!? Milk Protein in Asthma and Allergy Medications

I learned something new this month and it scared me.

I have always heard reminders about the importance of checking labels for not just food but everything: soaps, bird feed, fertilizer, chalk, drugs.  And I thought I had always been good about reading through labels.  However, while checking my Facebook feed, I scanned over a status update from Allergic Living that highlighted its feature on milk protein in asthma medication.  I stopped.  I reread the sentence.  Uh oh.  I've never questioned whether my own asthma management medication could be a source of danger for my kids!!

In our emergency med pack, I was toting Auvi-Q epinephrine injectors for my kids and an inhaler
for me.  Little did I know my inhaler contained milk protein that could put my kids' lives at risk.

After reading through the whole article and scouring through more information online, I discovered that Advair and Ventolin do in fact contain milk protein in the form of lactose dry milk powder.  In addition to these two products, milk derivatives are also present in popular allergy and asthma relief drugs such as Singulair, Flovent, Claritin tablets, and Prednisone -- yes, Prednisone, the drug that is often given to prevent a biphasic reaction after anaphylaxis.  Seriously, how did I not know this??  How did I miss this all these years?

Here's how:  While 2004's Food Allergen Labeling and Consumer Protection Act (FALCPA) made it mandatory for all food products to be properly labeled to identify the presence of the top 8 food allergens, the same rules do not pertain to non-food products.  Prescription drugs, over-the-counter drugs, health and beauty products, and pet supplies (including pet food) are just several of "non-food products" that fall outside of the FDA's regulatory net.  (For a more in-depth look at what the act affects, check out Kid with Food Allergies summary on FALCPA.)

So drug manufacturers are not required to label food allergens on their packaging.  The FDA does require medications to be accompanied by patient package inserts.  These inserts are written in microscopic font on a one-page, single-spaced, double-sided document that is notoriously lengthy and technical.  This information is nearly impossible to get through without a medical degree and magnifying glass, even if you are looking for your kids' allergen buzz words with eagle eyes.  What's more, patient package inserts do not have to list ingredients or food allergens.  The inserts include sections on how the drug works, indications, contraindications, warnings and side effects, and dosage recommendations, and it is the drug manufacturer's discretion to list food allergens. 

I checked the package labels of my asthma management meds which I last filled in spring, the time of the year when I endure a full-on attack by grass and tree pollens.  No mention of milk ingredients.  There was a mention of a mysterious white aerosol and instructions to rinse my mouth thoroughly after each use...These warnings should have been red flags to me to dig deeper over the ingredients.

How to find out if your asthma medication contains milk:

  1. Check out this list of asthma medications that contain lactose (milk) compiled by the Allergy Asthma Information Association (AAIA).  Please keep in mind that this list is from 2006 -- most certainly there is updated information out there.  
  2. Remind your physician or child's pediatrician about their food allergies when they are about to be prescribed medication.  Contact your allergist about medications you or your kids are prescribed.  Are they free of your (children's) allergens?
  3. Do your homework online.  Search your medication by name to see if it is milk-free.
  4. Please, please have your kids wear some sort of allergy alert identification (medical bracelets, wristbands, dog tags).  If an emergency occurs and you or they cannot advocate for themselves, these medical alerts could prevent them from receiving treatment that will make an asthma attack or anaphylactic reaction even worse.

Do you manage asthma and a milk allergy?  When did you find out that asthma treatment medications contain milk products?


  1. So I know a family that has every food allergy combined. Is there anyway that they could get help from an allergy specialist without having to pay much? I really want to help them out.

  2. Allergies are the worst! I am allergic to so many thing it is insanely inconvenient. Parties are the worst because I don't know what is in the food that everybody brings. I can definitely relate to this article.

  3. Thanks for all the great advice. I want to get allergy testing in Fredericksburg because we have a lot of things that could be causing problems and I want to find out what it is.

  4. A good friend of mine has asthma and is also allergic to milk. She never thought that it could be her inhaler. She went back to her doctor and told him her allergies again and the doctor that he had prescribed the wrong inhaler. Now, she is feeling better.

  5. I am John Smith. My son, 7 years old, was suffering from chronic allergy since many years. I consulted many doctors but in vain. Recently, one of my friend gave me a reference of this society specially dedicated to the patients suffering from asthma and allergy, Columbus Asthma Society. I consulted their main doctor Dr. Summit Shah and now my son is recovering rapidly owing to their allergy shots. I would strongly recommend you guys to check Columbus Asthma Society and get the best treatment for all asthma related problems.


  6. We use generic Singulair but upon Googling it, it contains Lactose Monohydrate (milk sugar) are right, how did we all miss this? Why didn't the doctor tell me this? And should we continue using it since my son seems to be ok with it?

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  8. I don't have allergies myself but my wife does. She often has an unpleasant experience when outside. It seems like she's allergic to everything. We plan on finding an allergist to help her soon.
    John Bond |

  9. My husband has asthma and my son has a milk allergy. I'm so grateful I read this article! If my son had started having an asthma attack or something similar I probably would have reached for my husband's medicine without think of the potential lactose ingredients. I'm so grateful I read this before anything happened. Thank you!

    Rosie |

  10. This is more than a little bit of a shock. I have so many people in my life who have an allergy to dairy as well as asthma. This will help many people in my life, thank you very much.
    Cynthia | |

  11. I am certain that I have allergies. I am a Medicaid patient, so I am a bit worried about my allergy coverage medications wise. Has anyone else run into this scenario?


  12. I never knew there could be milk protein in allergy and asthma medicine. I'm have to check mine to see. Could the milk protein in it cause my lactose intolerance to be acting up? I'm definitely going to have to find out about that because that's a big problem I have. I'll definitely see an allergy doctor as well to make sure I'm taking the right allergy medicine that doesn't have milk protein, if that is what's causing problems.
    -Seamus |

  13. I would have never guessed that your own asthma medication would have milk protein in it. I'm really happy you read and found that it does before any harm was caused. I'm going to have to start reading more to make sure I keep my kids safe.

    Brooke Bowen |

  14. As a kid, I was never an expert on allergies. I thought being allergic to something meant you didn't like the food people said they were allergic to. When I was in first grade, I didn't like chocolate (crazy, I know). One day when my teacher offered me a chocolate candy, I told her I was allergic. I didn't understand why she became so worried about it and sent a newsletter out to all the parents, asking that they not allow their children to bring snack or treats with chocolate. As a mother of a child with severe peanut allergies, I understand it a lot more and am thankful for allergists who help keep people with severe allergies safe! Thank you to all the allergists out there!
    Emily Smith | Allergist

  15. Is there a way to check if your allergic to all these things? I don't want to have to find out the hard way by having to take an emergency medical visit. I know there is only so much that I can do to prevent having an allergic reaction.

  16. Situations like these are very difficult getting caught in a dilemma whether to prioritize your asthma or milk allergy. Quite helpful and we need to always read the label.

  17. I had no idea that there was milk ingredients in asthma medication. I have struggled with asthma and food allergies my entire life, and I've always assumed that reactions I had during asthma attacks were just symptoms of the attack. I'm going to talk with my doctor and is if I can make an changes in my inhaler and is if some of my symptoms will change.

    Sara Welsh |

  18. Having allergies and asthma is not fun. I agree that I will have to check all the labels to make sure that any asthma medication I might get will not contain items that I am allergic to. I want to have fun and run outside with my kids. but it becomes really hard to do so with my condition. I will have to find a medication that I can use.

  19. I think my son is either allergic to his toothpaste or toothbrush. I don't know what is causing it, but it seems like it's pretty serious. I'm getting kind of worried.

  20. I read it completely. It is very good. People has the thinking that life is very difficult with having problem of Asthma and allergy. I think the supplements and milk can help us to get rid of these problem. I also had the same thought that milk is a very healthy food for all of us. We must take it properly.We had the medicines for asthma and you can Buy Asthma Medicine Online not only for asthma.
    Buy Allergy Medicine Online

  21. I have a moderate allergy to latex. This allergy functions like asthma. As I have gotten older the allergy has gotten worse. I feel like I would be best served with an Epi-pen. This sounds crazy for me to present this to a doctor though. I feel like they may think I am being demanding. I hope this makes sense to someone.