More physicians and pharmacists are advocating for patients to be made aware of animal byproducts contained in common medications, according to new research in the Journal of Osteopathic Medicine. Common medications, including widely used blood thinners and hormones, are often derived from animal byproducts and prescribed without consulting the patient about their beliefs.
"Patients deserve to know what their medications are made of, yet this information is rarely shared," said Sara Reed, student doctor at Lincoln Memorial University (LMU) DeBusk College of Osteopathic Medicine and an author of the paper. "Putting the patient first means communicating with them about the medicine recommended for their care, and in some cases, prescribing an alternative option."
Common Animal-derived Medications
Heparinoids are a class of medication primarily derived from pigs. These drugs are routinely used as a blood thinner to prevent blood clots and are given in many settings, including following surgery, a heart attack, or to prevent the further development of clots.
Also common are conjugated estrogens, which may be used to treat moderate to severe hot flashes and other symptoms of menopause. They are equine-derived hormones.
"Generally, patients who are prescribed various hormone treatments may want to consult their physician regarding the contents," said Mary Beth Babos, PharmD, professor of pharmacology at LMU, and lead author of the paper. "For example, there are no completely animal-free oral thyroid hormones on the market."
Existing Guidelines
While the U.S. does not have formal recommendations, other nations have published guidelines to address pharmaceuticals of animal origin. The United Kingdom's first guidelines were published in 2004 and Australia's guidelines were published in 2007 and updated again in 2019. However, guidelines from the FDA remain unavailable.
Cultural Competency
Because some patients adhere to religious doctrine that recommends avoiding certain animal byproducts, the study authors reviewed prior medical research to identify the stated positions of leadership of the major world religions. According to their findings, many religions discourage the use of products derived from animals when not required to save human life.
- Jewish and Muslim leaders agree that the use of products derived from pigs--normally prohibited by both religions--are acceptable only when needed to protect human life.
- The Hindu Council of Australia does not consider bovine products, including medications derived from cows, acceptable.
- Sikh leaders and leaders of the Hindu Vaishnav sect object to the use of medication or surgical dressing derived from animal sources, which is waived in emergency situations or in routine treatment where no alternative exists.
- Many Buddhists of the Theravada sect and Christians of the Seventh Day Adventist sect who practice vegetarianism as part of their faith may individually reject animal-derived medical products.
- Leaders of the Jehovah's Witness sect emphasized that adherents to this faith would reject blood-derived products.
"In the absence of governmental guidance, we hope this research will help physicians and prescribers start the conversation with patients about whether they accept animal-derived products," said Reed. "Ultimately, it is the patient who should determine if a medication is appropriate for their lifestyle."
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About the Journal of Osteopathic Medicine
The Journal of Osteopathic Medicine, founded in 1901 and known for 119 years as The Journal of the American Osteopathic Association, is the premier scholarly, peer-reviewed publication of the osteopathic medical profession. JOM conducts peer review of academic research manuscripts from a wide variety of medical specialties, covering the full spectrum of clinical settings in which osteopathic physicians practice. All submissions are vetted by a distinguished group of Section Editors led by Editor-in-Chief Ross Zafonte, DO, and supported by a full Editorial Board.
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