The Pharmaceutical Journal
Vol 272 No 7293 p415
3 April 2004

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· Veterinary pharmacy
· Indemnity insurance
· Methadone
· Excipients
· Self-prescribing
· Pharmacist prescribing
· Sugar in medicines
· NMS

Letters to the Editor

Sugar in medicines

Not such a problem

From Dr J. I. Wells, MRPharmS

Sucrose in liquid medicines, if it were not for consumer pressure, would still be the best choice of sweetener for a whole raft of technical, physiological and organoleptic reasons. Indeed most so-called sugar-free medicines contain a sugar, but not sucrose. Sorbitol and hydrogenated glucose syrup are but two examples. Hemant Patel (PJ, 20 March, p348) is promulgating a myth. Consider the following:

· Methadone DTF contains sucrose, not as Syrup BP (85%w/v) but at a loading of 18%w/v
· A normal diet is 3,000kcal
· 100ml methadone DTF supplies 72kcal from sucrose (ie, 2.4 per cent)
· Methadone causes anorexia
· Sucrose causes tooth decay, but the medicine is no different from a sweetened cup of tea or coffee
· The usual dose of liquid medicines is 5ml (ie, 0.12 per cent)

In the same issue (PJ, 20 March, p341), a spokesperson from the Neonatal and Paediatric Pharmacists Group laments the “poor tasting medicines for children”. It is well known that children prefer sweeter medicines more than adults do. However, medicines are taste-masked by suitably trained adult personnel who are exposed to risk through the consumption of low levels of active compounds — there is no point in taste-masking a placebo. I would question how many ethics committees in children’s hospital would sanction the exposure of children to a similar risk in taste-masking trials.

James Wells
Rosemont Pharmaceuticals
Leeds

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