Carbs in Medicine

by Leighann on February 9, 2011

Some time after diagnosis I realized that there may be carbs in OTC and prescription medicines when my daughter was on an antibiotic that came in a huge bottle. I asked the pharmacist if they knew the carb count and of course the bottle didn’t have any information.

I wonder why medicines aren’t required to have nutritional information like food items do. It would really be helpful.

The pharmacist told me that if there is a pill or tablet option, it will likely have less sugar than when in liquid form. For instance the children’s chewable Tylenol would have less than the liquid suspension formula.

I began reading labels and I’ve noticed that some children’s medications are made with artificial sweeteners, some with sucrose (sugar). There is also a big difference between chewable vitamins and the gummy ones, which of course are the ones that Q always wants and I never buy.

We’ve had an issue with our daughter going really high at bedtime every time she goes to her grandparent’s house to spend the night. They have a dog and cat so I try to remember to give Q some allergy medicine before she goes.

I have asked the CDE several times why she thinks Q is going high. Since my mom knows how to count carbs and give insulin (she babysat Q during the day until she went to school) that is not the issue. The CDE said that the adrenaline of being excited might cause high BG’s and also an allergic reaction could cause them. So I thought the preemptive allergy medicine would help.

The last time she spent the night, I was settling down to enjoy a diabetes-free night when of course my mom called. Q was in the 300’s at bedtime after being in range at dinner. I forgot to pack the ketone meter so I had to run it over. Ugh!

I realized that the ingredient in the generic Claritin was sucrose. SUGAR. How much? Who knows. But it sure couldn’t have helped that she got a big spoonful of it.

I purchased the generic for Zyrtec in tablet form and we are giving that a try.

Now I have to wonder if occasional strange high lunchtime BG’s at school weren’t the result of the allergy medicine. Though I have no way of putting two and two together because it’s not like I wrote in our log book that Q had allergy medicine on a particular day. (But I will try to remember to note it in the future.)

Lorrie shared a link on Facebook to a list of carbohydrate content of medications. Though the list is not complete, it is helpful.

Have you noticed high blood sugars if your child is around a pet?
What about after taking a particular medication?

Please read the disclaimer. None of this constitutes medical advice.
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{ 11 comments… read them below or add one }

1 Shannon February 9, 2011 at 6:09 am

I had the same frustration when my son, Zach, was put on Amoxicillin in liquid form, and the pharmacists were pretty clueless, had to get online to find out. They sort of blew it off, like, well just bolus him some (OK, I’d like to be a little more specific than that). Also, generic liquid children’s tylenol had the same effect, he’d spike big time, but fortunately he can now swallow a pill (but with a sore throat liquid works so much faster!). Thanks for the link you posted with all the medications listed!

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2 Amy February 9, 2011 at 7:10 am

I’ve thought about this, too.
I’ve always assumed that a lot of the med carb counts are negligble, but then again we have a lot of room for error, since our ratio is currently 60 carbs/unit of insulin…
I’ve also thought about toothpaste.
The little things we completely lose track of…

Maybe Tylenol etc. affects blood sugar in it’s own way. Worth research, I guess. I know it will throw a Dexcom off, reading wise, so it would be interesting to see how it affects other things as well.

Lots of potential for post ideas…

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3 Heather February 9, 2011 at 9:38 am

I was just looking into this topic, so thank you for sharing/posting. I followed the FB link, and it’s good to know that it’s pretty much negligible. I was under the impression that we were giving a “spoonful of sugar” with each dose, but it seems to be a bit more reasonable than that! Whew!

:O)

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4 Lisa February 9, 2011 at 10:01 am

Great post!!! I had a similar situation a couple of months ago and after spending 30 minutes on the phone with Tylenol customer service they finally gave me carb information for the childrens suspension liquid, 1 gram for 1 ml. So when I’m giving Ayden 10 ml to easy his leg pains he was waking up very high. No wonder after getting 10 grams of carbs with no bolus. The reps at Tylenol tried to give me some BS about it being proprietary information that they won’t release without detailed information from the requestor, which is why it took me 30 minutes to get it. Needless to say I was not happy and strongly encouraged the company to change it’s procedures.

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5 amy February 9, 2011 at 11:39 am

Interesting. My CDE told me not to worry at all about the “little amount of carbs that may be in over the counter or prescription medications.” THAT’s why I love the DOC!

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6 Renata February 9, 2011 at 12:33 pm

It’s interesting isn’t it, because some people might find that the OTC med doesn’t really affect their kids BG’s at all. It’s important to pay attention and see how your kid reacts. Marty spent the first 6 years of his life being allergic to RD40 (red dye). And his reaction was serious stomach to toilet issues, no being hyper. At any rate, at that time there was only one pharmacy that I could find that would carry the dye free Motrin and could offer me antibiotics that were dye free. Can you imagine? Now it’s easy to find dye free in the US. But I do remember that dye free motrin was liquid and very very sugary tasting. At that time I never needed to read the lable for him with carbs.

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7 Trev February 9, 2011 at 6:40 pm

Those hidden ingredients. Didn’t know that about that particular allergy med. I’ll will be more on alert! Thanks.

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8 Erica April 6, 2012 at 12:00 pm

It was about 6 years ago that I went looking for this information, and I couldn’t find anything! I even called the FDA to tell them that they need to make this a mandatory listing on all medicine. The doctor and pharmacist said that blood sugars could be elevated because of illness (true), but I want to see the big picture and have all of the facts that are available (and they should be available). Thanks for posting the AAP list! It is very helpful and I have also found some carb counts via Calorie King (book, iTunes app or website).

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9 Amy March 7, 2013 at 12:11 pm

When I click on the link, it appears on a page where I have to create a login to view. Is this information available anywhere for free or could it be emailed to me?

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10 Leighann March 7, 2013 at 12:24 pm

Darn! They’ve taken it down. Try this article, there is a pretty comprehensive list: http://pediatrics.aappublications.org/content/97/4/506.full.pdf+html

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11 Becky April 24, 2013 at 10:47 am

Thanks. I’ve been giving my 2 yr old ibuprofen for her fever and of course there is no info about carbs on the bottle. Her dr also said to not worry about it. But my child is really sensitive and I’ve noticed that high fructose corn syrup is one of the ingredients. Nice. So she gets spikes from the illness and the med.

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