Additives in medication

Why aren't all ingredients listed on the label?
What DO they have to list on the label?
What about artificial and other colours?
How can I find out if my medication contains nasty additives?
Colours in medications
Why can't I understand the names of the colours in my medication?
Other additives that can cause problems
Help! My medication contains nasty additives - what can I do?
Reactions to active ingredients
Medication Guidelines for the RPAH Elimination Diet - summary
Reader Questions and Reader Reports
What you can do: tell someone
References and further reading



  • Medications, supplements and dental products often contain additives that are regarded as ‘inactive’ ingredients yet they can cause troubling reactions in adults and children
  • Many of these additives do not have to appear on the label or may appear in ways you do not recognise
  • Your doctor, pharmacist or dentist may not know about the effects of these additives
  • It is up to you to protect yourself and your children

Why aren't all ingredients listed on the label?

The Australian TGA (Therapeutic Goods Administration) says there isn't enough space on the label. Yet you can see medicated lollies with inadequate labelling on supermarket shelves next to unmedicated lollies that list full ingredients. If food manufacturers can do it, so can drug manufacturers.

In Europe, the packet insert for medications must carry warnings regarding adverse effects of certain additives. In Australia, the equivalent CMI (Consumer Medicine Information) leaflet does not have to list these warnings about additives.

  What DO they have to list on the label?

For a non-prescription oral medicine the following ingredients must be listed:

  • All active ingredients
  • The following non-active ingredients: saccharin, sugars, preservatives, gluten or lactose [but not colours, flavours or synthetic antioxidants]

If you find a preservative listed on the CMI but not the label, let us know and/or complain to 1300 134 237 (the very supportive Adverse Medication Events Hotline).

  What about artificial and other colours?

Declaration of other non-active ingredients (excipients) including colours is considered commercially sensitive to the sponsor of the product and may only be disclosed by the sponsor. As far as I can see, this approach contravenes the 1985 UN Consumer Bill of Rights (the right to safety, the right to be informed, the right to choose).

  How can I find out if my medication contains nasty additives?

  • Look on the internet: you can do a Google search for the exact name of your medication (e.g. “LPV capsules”). If provided, look in the CMI (Consumer Medicine Information) leaflet or Datasheet. The list of ingredients is usually at the end. If you are lucky, the CMI will include a list of the additives used in words you can understand.
  • Ask your pharmacist – although many failsafers complain that their pharmacists haven’t a clue about additives
  • Contact the manufacturer – go to their website and click on Contact Us

Colours in medications

Q. If the label says "no tartrazine or other azo dyes" is it safe?

A. No. There are many other colours that can cause problems, see table below.

Q. Are there any safe colours?

A. Yes! Natural colours Iron Oxides (172) and Titanium Dioxide (171) are well tolerated and are used increasingly in medications.

  Why can't I understand the names of the colours in my medication?

Pharmaceutical companies often use Colour Index (CI) numbers, names or other ways of describing colours. Colours can be hidden behind proprietary brand names for example the Opadry range of drug colorants made by Colorcon. Opadry colorants may include artificial colours and/or natural colours but you can’t tell by the name. There are many different Opadry colorants. The CMI may list the ingredients in the Opadry colorant, for example Opadry Blue Y-5-10544 contains FD&C Blue No. 2 which is artificial colour (132). However, when a CMI lists Opadry Blue and Opadry Yellow (e.g. for Sertraline-GA tablets in Australia) that is not enough information. You would have to investigate further. If the Opadry ingredients aren’t listed you will need to ask your pharmacist or the manufacturer.

Colours that can cause problems




Alternative names



Index C.I.





Yellow #5




Quinoline Yellow

Food Yellow 13





Yellow 2G






Sunset Yellow

Orange Yellow S

Yellow #6











Acid Red 27, Food Red 9





Ponceau 4R

Brilliant Scarlet






Food Red 14, Acid Red 51

Red #3




Red 2G






Allura Red

Food Red 17

Red #40





Indigo Carmine

Blue #2




Brilliant Blue


Blue #1




Green S

Acid Brilliant Green, Food Green, Lissamine





Fast Green FCF

Green 1724, Solid Green, Food Green 3

Green #3




Brilliant Black

Brilliant Black PN





Brown HT

Chocolate Brown






Annatto extracts, bixin, norbixin



Other additives that can cause problems


200-203 sorbates

210-213 benzoates

214- 219 hydroxybenzoates, parabens

220-228 sulphites

280-283 propionates

249-252 nitrates, nitrites

Synthetic antioxidants

310-312 Gallates

319-320 TBHQ, BHA, BHT

Added flavours and perfumes

Strong flavours especially fruit or mint whether artificial or natural can cause intolerance reactions from asthma to behaviour problems in children. Inhaled salicylates in strong perfumes (e.g. in masks used for anaesthetics) could also cause reactions in sensitive children, see more in reader reports.

Sugar free sweeteners

Called polyols, these additives may be used as sweeteners, humectants, stabilisers or texturing agents. They can cause gas, flatulence, abdominal distention and/or diarrhoea when consumed frequently, in large quantities or by sensitive consumers including babies and young children. For example, an outbreak of so-called 'pink diarrhoea' that was reported in a medical journal turned out to be due to sorbitol in a vitamin supplement. Polyols do not cause the other side effects of additives and are safe for some people.

420 sorbitol

421 mannitol

953 Isomalt

965 Maltitol or hydrogenated glucose syrup

966 Lactitol

967 Xylitol

968 Erythritol

1200 Polydextrose


What kinds of reactions could I expect?

The same kinds of reactions as can be caused by additives in foods:

  • Irritability, restlessness, short fuse, tantrums
  • ADHD-type symptoms, oppositional defiance
  • Difficulty falling asleep, frequent night waking
  • Mood swings, anxiety, depression, panic attacks
  • Inattention, difficulty concentrating, fatigue
  • Eczema, urticaria and other itchy skin rashes
  • Swelling (angioedema) e.g. of the lips often associated with rashes
  • Reflux, colic, stomach aches, bloating and other irritable bowel symptoms including constipation and/or diarrhoea, sneaky poos, sticky poos, bedwetting
  • Headaches or migraines
  • Asthma, breathing difficulty, cough (especially from sulphite preservatives but others including benzoate preservatives and colours can be to blame)
  • and many others

Unlike true allergies, reactions to additives and drugs are usually delayed or build up slowly over days or weeks. How bad can it be? Very. See the reader report below: Two years of behaviour problems related to unlisted artificial colour in fluoride tablets.

  Help! My medication contains nasty additives - what can I do?

Some options

  • Don't take the medication unless it is essential (if your medication is essential e.g. for asthma you must take it)
  • Ask your pharmacist for an alternative with no nasty additives if possible
  • Ask a compounding pharmacist (under Compounding in the Yellow Pages) to make up additive free medication
  • Empty out coloured capsules and take the contents with a spoonful of failsafe icecream or maple syrup
  • Rub colouring off hard pills in running tap water (not for laxatives or slow release tablets: a failsafer reports "I did this when taking a laxative Coloxyl (senna) which includes a softener as well and developed severe abdominal pain" Coloxyl is not RPAH-recommended, see laxative list /support/frequently-asked-questions/medications-and-supplement-questions)
  • Ask for our children's flavour-free paracetamol recipe

Reactions to active ingredients

As well as additives, active ingredients in your medication may cause adverse reactions too. All medications have side effects that may be listed on the CMI. Some are riskier than others, e.g: the US FDA estimates that Vioxx painkillers may have contributed to 27,000 heart attacks and sudden cardiac deaths between 1999 and 2003; Stilnox sleeping pills have been associated with suicides. More information in further reading below. People who are sensitive to salicylates or amines in foods need to avoid salicylates or amines in medications too

Salicylate containing drugs

People who are sensitive to salicylates need to avoid any prescription or over the counter medication which contains salicylic acid or salicylates or lists sensitivity to aspirin as a warning or contraindication on the CMI. This includes many painkillers (except paracetamol), oil of wintergreen, arthritis creams, sports creams like Dencorub, Vicks Vaporub, teething gel and oral gels like Bonjela and Ora-Sed, wart removers, acne cleansers and some insect repellents. Nurofen and other non steroidal anti inflammatory drugs (NSAIDs) while technically not salicylates can affect consumers who are salicylate sensitive. Herbal remedies like Echinacea and herbal preparations such as bioflavonoids in multivitamin supplements can cause salicylate reactions.

Amine containing drugs

People who are sensitive to amines should avoid any medication which mentions taking MAIOs (monoamine oxidase inhibitors) as a warning or contracindication on the CMI. Drugs that can contain amines include over the counter cold tablets, decongestants, nasal drops or sprays, some pain relievers, general and local anaesthetics and monoamine oxidase inhibitors.

Medication Guidelines for the RPAH Elimination Diet - summary

from the RPAH Elimination Diet Handbook, p117-118
*    Avoid non-essential medications
*    Don’t take anything containing aspirin
*   Avoid colours, flavours, preservatives
Pain Relief

Paracetamol e.g. Herron, Amcal
Codeine e.g. Panadeine, Panadeine Forte, Codeine phosphate

AVOID: Aspirin-containing products, colours, flavours, preservatives

Anti-inflammatory drugs

AVOID: ALL NSAIDs such as Ibuprofen, Nurofen are unsuitable since they can cross-react with Aspirin

Dental anaesthesia

Suitable products: Xylocaine (lignocaine) ampoules (plain, no adrenalin)

Most other dental local anaesthetics have added preservatives because they contain adrenaline or octapressin (which is used to constrict blood vessels and minimise bleeding)

AVOID: local anaesthetics containing adrenaline, octapressin and added preservatives

General anaesthesia

The most important thing is to give all this detail to your doctor and anaesthetist as early as possible and discuss it thoroughly.

SUITABLE PRODUCTS: All intravenous induction agents. All gas anaesthetics.

Most problems with intolerance reactions from general anaesthesia are due to premedications or postoperative pain killers.

AVOID: If you have a history of intolerance reactions following general anaesthesia, avoid unnecessary premedications and/or postoperative opiates

Preservatives to avoid

200-203 sorbic acid, potassium & calcium sorbates 
210-218 benzoic acid, sodium, potassium & calcium benzoates, parabens 
220-228 sulphur dioxide, all sulphites, bisulphites, metabisulphites 
249-252 all nitrates & nitrites 
280-283 propionic acid, sodium, potassium & calcium propionates

  Reader Questions and Reader Reports

key words for search using CTRL F: Amoxycillan, Amoxil, antibiotic, anaesthetic, colour, compounding, contraceptive, dental, doctor, epilepsy, Fergon, fluoride tablets, hives, ibuprofen, iron, iron oxide, iron supplement, Losec, Nilstat, Opadry, Panamax, paracetamol, parabens, benzoate, penicillin, perfume, pharmacist, preservative, Robitussin, supplement, tooth mousse

Q. My dentist wants me to use GC Tooth Mousse - I phoned the supplier to ask whether there are preservatives or colours and she said it contains propylene glycol, titanium dioxide and xylitol sugars. I seem to react to very small amounts of any preservatives, colours or flavours so I believe I would be in trouble if I used this mousse (it has to be left on every night to help my gums and teeth). What are your views?

A. The list of ingredients from the supplier didn't seem long enough so I searched the internet for "GC Tooth Mousse ingredients". According to the Material Safety Data Sheet the product contains three hydroxybenzoate preservatives. Also known as parabens or preservatives (214-219), these preservatives are known to affect people who are sensitive to artificial colours and salicylates. The European MSDS warns "Do not use this material on patients with a proven or suspected milk protein allergy and/or with a sensitivity or allergy to benzoate preservatives". This product is NOT FAILSAFE.

Feedback: ‘Well I have tried the "plain" GC Tooth Mousse three times and have reacted each time with the usual symptoms. It appears to stay in my system for two days. I react with insomnia, then my body gets "the jumps". I have even gone back to having the jumps in my legs and arms during the day (two days after using the tooth mousse)!’

[797] Behaviour and night terror induced by potassium sorbate (202) in Panamax (June 2009)

When my son had a nasty chest infection/bronchitis I gave him crushed up Panamax paracetamol 4-hourly for a couple of days, as well as the inners of amoxil capsules.

A couple of days later, his behaviour was absolutely shocking and it culminated in him having a night terror one evening, the most severe one he has had since being failsafe since last September.

I knew something was going on, and I decided to check up about Panamax – and discovered it has potassium sorbate (202) in it. We have not yet done any challenges on additives as we already avoid dairy and salicylates, so decided to pretty much stay additive-free. However, we do seem to be okay with moderate amounts of pure MSG and amines.

I strongly suspect that his behaviour and night terror were induced by the preservative 202. What angers me more is that I was completely unaware of the existence of the preservative in this product, due to the lack of these medicine companies having to label their products. Our kids are already sick when we need to give these drugs to them, and they need to get better, but how can they when their body is also trying to fight against an artificial preservative?

Even when I asked at the chemist for a preservative-free paracetamol, they were not able to tell me what was in the products they sold. If only we could have good information about what is in these medical items, ie. through labelling. I don’t accept the excuse that there isn’t enough room on the packaging – if a box of soap can list its numerous chemical ingredients, so should a box of pain relief or any other medicine.

Please use our experience in your endeavours to fight for better information labelling on medicines – it’s our kid’s future. – Joanne, Vic

Update: this reader was using an old box of Panamax. The formulation hasn’t changed but the labelling has: Panamax boxes now list potassium sorbate on the label. For young children, ask for our recipe for additive-free children’s paracetamol. (We would like to hear any other reports of reactions to sorbates – email This email address is being protected from spambots. You need JavaScript enabled to view it.)

[261] Unlabelled sulphites in paracetamol (June 2003)

I have done some investigating and was horrified to find that the brand of paracetamol at the hospital that I work at, Febridol, has sulphite preservative in it. This could be a problem for asthmatics admitted to the hospital! Many other brands I looked at also contained sorbates and benzoates as preservatives. Herron tablets are colour free, gluten free and preservative free (see product updates.) - from the failsafe group

Q. I seem to be reacting to NEO-MERCAZOLE tablets with the following ingredients: lactose, maize starch, sucrose, magnesium stearate, talc, microcrystalline cellulose, gum acacia, ferric oxide, propyl hydroxybenzoate, gelatin. They are coloured pink. The pharmacist at the company that distributes the neo-mercazole said the colour was ferric oxide (Fe2O3) also known as Iron (III) oxide, Pigment red 101 or Diiron Trioxide; colour index (C.I.) 77491. Colour 101 isn't on the list of nasty additives. Does that mean I can discount colour as a cause of problems?

A. Under TGA (Therapeutic Goods Administration) regulations colours do not have to be listed on medication labels - due to lack of space - leaving consumers to rely on dodgy word-of-mouth advice from suppliers or pharmacists. The pharmacist who advised you was either ignorant or misleading. Pigment red 101 is not the same as Food Colour 101 (riboflavin, a B vitamin). Ferric oxide, the colour used in your medication, is also called iron oxide or food colour (172). Iron oxides are available in red (and pink), yellow and black. Although iron is toxic in large doses, the small amounts of iron oxide used as colours are considered safe - in the past many failsafers have consumed iron oxide as the colour in Macro M Vitamins. The additive most likely to cause problems in the list above is propyl hydroxybenzoate (also known as preservative 216). Benzoates include preservatives 210-213 especially sodium benzoate (211) in foods and drinks, and parabens or hydroxybenzoates (216, 218) in drugs. All benzoates can cause the same adverse effects. See also question above. Please report all adverse reactions to additives in medications in Australia to the adverse medicines events line on 1300 134 237.

Q. The doctor gave him Nilstat, but it is bright yellow, which puts me off a bit. Is it safe?

A. I did a Google search for Nilstat. On the Australian CMI for Nilstat Drops it says "The colouring agent in NILSTAT tablets is Quinoline Yellow CI 47005." Yet on the Nilstat datasheet in New Zealand it says "Opadry Yellow Y-2144A (hypromellose, macrogol 400, iron oxide yellow CI 77492, titanium dioxide)". Which one is right or are they different? It is possible that Nilstat tablets are failsafe in New Zealand but not Australia. You would have to contact the manufacturer. Nilstat drops contain cherry flavour so are not failsafe.

Q. My 12 yr old son has taken penicillin for tonsillitis twice in the last two months. Both times I have noticed my son’s behaviour became much more moody and disobedient. The medication was LPV capsules. Could there be a problem with the drug itself or am I looking for an unlisted culprit?

A. I did a Google search for <LPV capsules> in May 09 and found the CMI (Consumer Medicines Information) leaflet at The "inactive" ingredients are listed at the bottom of the CMI. They include three artificial colours which are listed by names and Colour Index (CI) numbers but are also known as colours 110, 127 and 133 all artificial colours we recommend to avoid. At that time, the CMI claimed "LPV does not contain gluten, sucrose, tartrazine or any other azo dyes" but this is incorrect as sunset yellow (110) is an azo dye. I notified the manufacturer and they promised to change it. You can see more information and a list of Colour Index numbers on our Medications factsheet.

Q. My daughter recently went from taking 10mg Losec to 20mg (half twice a day). I noticed the colour of the tablets is quite different. When I contacted the manufacturer they told me that the darker colour in the 20mg is due to the fact that it has iron oxide red and iron oxide yellow in it (although they did say there is also a small amount of iron oxide red in 10mg) do you know anything about these colours and whether they are OK or should be avoided?

A. Iron oxides (red, yellow and black) are all variations on natural colour 172. They are considered to be well tolerated by failsafers and were consumed without problems for years in the RPA-recommended Macro M vitamin supplements that have since been discontinued.

Q. My 4 year old son has a middle ear infection prescribed Amoxycillin Syrup and since taking it his behaviour has been awful, yelling at us, talking back, not listening etc. Is there something in this medicine which could cause this reaction?

A. At the time of writing (2004) Amoxcil syrup contains sodium benzoate and peach, strawberry and lemon flavours which are probably very strong. Either the benzoate preservative or the strong flavours or both could cause the behaviours you are talking about. We receive constant reports of reactions like this to children's medicinal syrups. It is ridiculous that parents can't easily buy safe medications. I would be very grateful if you could report this reaction, see below.

Q. My 12 yr old son has taken penicillin for tonsillitis twice in the last two months. Both times I have noticed my son’s behaviour became much more moody and disobedient. The medication was LPV capsules. Could there be a problem with the drug itself or am I looking for an unlisted culprit?

A. I did a Google search for “LPV capsules” and found the CMI (Consumer Medicines Information) leaflet at The "inactive" ingredients are listed at the bottom of the CMI. They include three artificial colours which are listed by names and Colour Index (CI) numbers but are also known as sunset yellow (colour 110), erythrosine (colour 127), and brilliant blue (133). The CMI claimed "LPV does not contain gluten, sucrose, tartrazine or any other azo dyes" but this is incorrect as sunset yellow (110) is an azo dye. I contacted the manufacturer and they have promised to change it. (3/6/09)

Q. My failsafe 3 year old was going great until he had to go to the doctor for an infected eyelid from a mossie bite. Now he is once more driving me crazy - restless, won't listen, wants to be naughty. The antibiotics contain tutti frutti, orange and menthol flavourings and sodium benzoate (preservative 211). Both the pharmacist and doctor told me there was no alternative better suited to the elimination diet.

A. There are alternatives. You can ask your doctor for white tablets or capsules (for adults), and crush or empty the ingredients out of the capsule, mix with a teaspoon of golden syrup or a dessertspoon full of additive-free vanilla icecream, this is the best because the cold numbs the taste buds. For children you would need to discuss the dose (eg half, quarter of a tablet or capsule) with your pharmacist; or you can ask a compounding pharmacist to make up medication to order, search under Compounding in the online Yellow Page, see comments below.

Q. My son had a severe outbreak of hives while taking Robitussin ME for a cough. The doctor was surprised with the reaction to the Robitussin, but as soon as we discontinued using the product the hives went away.

A. It is very difficult to find the ingredients for over-the counter remedies so I don’t know what’s in Robitussin ME. However, this is the second time we have heard about severe reactions to Robitussin ME, so it is definitely worth reporting, see the end of this factsheet.

Q. Our pediatrician recommended Fergon elixir iron supplement. I was wondering if my daughter can take this while on the elimination diet? This supplement contains Glucose liquid, Ethanol and Saccharin Sodium.

A. You can't trust labels on pharmaceutical products, because they don't have to declare all additives. The real contents of Fergon, as listed on the CMI (Consumer Medication Information) leaflet, available from your pharmacy or at active ingredient: ferrous gluconate, other ingredients: glucose liquid, glycerol, ethanol (alcohol), saccharin sodium, gluconolactone, apricot superarome and purified water. The strong apricot flavour ('super-aroma') is not failsafe. All strong fruit flavours are very high in salicylates. For more details, see the Supplements factsheet on the website.

Q. I recently started my two year old son on an elimination diet as advised by my paediatrician to see what effects foods are having on his behaviour. We were going quite well over the last four weeks until his doctor prescribed antibiotics for an ear infection and his behaviour started to deteriorate. My paediatrician also put my son on an iron supplement Ferro-Liquid (Ferrous Sulfate Oral Liquid Solution 30mb/ml) and Roche Pentavite Liquid which says it has no artificial colours or preservatives but has a citrus fruit flavour. Since his ear infection he has had a cough from a runny nose at night and in the early hours of the morning.

A. Many doctors, dentists and pharmacists do not seem to understand that children's flavoured vitamin, antibiotic and other medicinal syrups are never failsafe and will prevent the diet from succeeding. The antibiotic syrup probably contained strong artificial flavours, benzoate preservatives and possibly artificial colours. The Ferro liquid contains both sulphite and benzoate preservatives that could be causing your son's cough and nasal problems. FGF iron tablets do not contain these additives. Ask your pharmacist about the correct dose of supplements for your child, it is usually half the adult dose for children under 12 but you should check. See the vitamins and supplements factsheet on the website for how to get tablets into kids.

Q I've noticed that my brand of contraceptive pill has artifical colouring. I really don't want to be consuming this every single day! Do you know of any brands of the contraceptive pill that are failsafe or where I might find out?

A. Contraceptive pills aren't great for women with food intolerance because female hormones can make symptoms of food intolerance worse, i.e. premenstrually and when taking oestrogen in medication. For pills without artificial colour, you can browse through the Consumer Medicine Information (CMI) sheets for ingredients of oral contraceptives at

Q. I have been on the failsafe for one month. Yesterday I took 2 Ibuprofen for menstrual cramps. Last night I woke up with my heart pounding and little muscle tics and twitches all over my body. I felt agitated and depressed, and have felt bad all day. I am trying to figure out what caused this reaction. Ibuprofen is a non-steroidal anti-inflammatory drug, not aspirin, and it doesn’t have salicylates in it. What caused the reaction?

A. People who are sensitive to aspirin (which is a non-steroidal anti-inflammatory drug) and salicylates generally react to other NSAIDs as well. Although Ibuprofen doesn't list salicylates as an ingredient, you need to avoid this and any medication which says ‘if you have an allergy to aspirin you should tell your doctor’ on the CMI leaflet.

[591] Help from compounding pharmacists (November 2007)

Additive-free antibiotics from compounding pharmacist : Our 3 month old breastfed baby has to take oral antibiotics so I explained to our local pharmacist that I wanted no added colours, preservatives or flavours. He had no idea what was in antibiotics other than the active ingredient, conceded that I knew more about it than he did, and gave me a contact for a compounding pharmacist. They made me up a liquid that is just the antibiotic suspended in water, with nothing else added and made it concentrated so that I could give her less at one time. It tastes bitter but she takes it squirted into her mouth with a syringe with no problems. – by email

Additive-free supplements from compounding pharmacist : When my son needed an iron supplement with Vitamin C, I spoke to our compounding chemist - a very useful person, I think everyone with dietary issues should have one! He went through everything and came up with three alternatives - two were the supplements listed on your web site, the third was to put his skills to work and make up a special mixture in the necessary dose for my child. I think I need to get a tattoo on my eyelids that says ‘if child requires medicine - speak to Compounding Chemist’. [Search the Yellow Pages online under Compounding, there are 66 Australia-wide]. – by email

[670] Behavioural reaction to medications in hospital (September 2008)

Recently my failsafe 6-year-old son went into hospital to have grommets in and his adenoids removed. Right up until he went into the operating theatre he amazed us with his great behaviour and how he dealt with the whole process. The minute he woke up he was so aggressive, rude, would not co-operate and was back to our little monster again. We couldn't wait to slink out of the hospital with him and get home. The next day he was still agitated and demanding. Do you think the anaesthetic and medication he received for this procedure could cause these sort of reactions? I know kids do react to going into hospital etc but the change in him from before and after was so dramatic I just have to wonder if it could affect him. – by email, NSW (General anaesthetics are usually OK but medications before and after the procedure can cause bad side effects. You can discuss this with your anaesthetist beforehand, see the free introduction to Friendly Food on Problems with anaesthetics include preservatives, worse when injected, and amines in the drug itself).

[671] Extreme reaction to local anaesthetic (September 2008)

On the second day of school, my 12-year-old cut his knee badly exposing the tendons. The doctor said he had to really pump him full of anaesthetic as it was so bad. The effects seemed to really throw him out. Instead of getting physical though as he would have a few years ago, he brought it into himself. He just sobbed his heart out and couldn't talk. He had very bad headaches and the shakes. He slept non-stop for about two days before we started getting him back on track. At school the teacher said that my son had been so happy before but after his accident he turned into into a sullen, seldom speaking young lad. - by email, Qld (Local including dental anaesthetic injections usually contain preservatives that can cause worse problems when injected than consumed by mouth. It is possible to get preservative-free local anaesthetics if you ask).

[799] Warning: Perfumes in masks for kids’ anaesthetics (June 2009)

I work in an operating theatre. One day last week we had a few kids on the list and I asked what the awful smell was. The result after process of elimination was, it was the oxygen masks. It seems that the kid size oxygen masks now come scented. I'm referring to the masks they hold over the face as the patient is going to sleep. I asked why they are scented and apparently it's supposed to be less stressful for the kid if it can smell something nice.

SO, to the parents of kids that are sensitive to smells, make sure you ask the anaesthetist about the masks if your child needs an operation. I don't know if we've still got unscented ones, I couldn't find any (but that doesn't mean anything). I made a point of letting them know it could cause major issues for kids with problems and all I could get as a response was, "but it's non allergenic". AARRGGGHHHH!! We've got cherry and strawberry, which don't really smell like they should. - Jane, by email (Like the fruit they represent, strong fruit flavoured perfumes will be high in salicylates).

[798] 2 years of behaviour problems related to unlisted artificial colour in fluoride tablets (June 2009)

On August 27 2008 we emailed you some information following concern about the ingredients of a certain brand of fluoride tablets 0.25mg. Our daughter, now 6 yrs, has been taking this particular brand of fluoride tablets for the past two years or more, following a recommendation by our dentist. Please note that our daughter has always had good healthy teeth and was only recommended them since we live in an area that has a non-fluoridated town water supply. The tablets by the way were sold by the same dental surgery.

We have been involved with your network for some time now, whilst trying to overcome our daughter’s intolerance to the numerous additives found in foods and other products. Although we have worked with a dietician and followed all the recommended advice in relation to elimination diets and food challenges, we never seemed to achieve the results we hoped for.

It was only a fortnight ago that it occurred to us to check the ingredients of the fluoride tablets. There was no information on the actual bottle and no information available on the manufacturer's website, so I called their Consumer Information Service. I requested they forward a list of ingredients to me, to which they promptly refused, stating such details were confidential for ‘proprietary reasons’. Only through sheer persistence was I able to get the ingredients list ... it was not sent to me, it was read out over the phone.

I was initially given the colouring agent as CI 15985. I complained that this number was used within the industry but not widely known by consumers. They reluctantly told me CI 15985 was also known as FD&C yellow. Further prompting was required to get the equivalent term Sunset yellow. Finally they told me Food additive 110 is also another name for it.

We can see we had been making a huge mistake and stopped the tablets immediately. Over the past two weeks we have seen our daughter’s behaviour and learning abilities progressively improve to the point where she is a different little girl; happier, more co-operative and less oppositional.

We are now very angry that we mistakenly trusted a recommended pharmaceutical product that effectively has contributed to diminishing our daughter’s general well being.

Since the launch of the Kids First Campaign calling for the phasing out of additives such as 110, I was curious to find out if I could get the same information from the manufacturer and called their Consumer Information Service once again.

This time I was not so successful. I asked the representative where I could find information about the tablets on their website. I was pointed to another website which listed the product (copy of page supplied) but still no declaration of ingredients. When questioned, she replied that the tablets do not contain sugar or alcohol. I told them I needed a full list of ingredients to be emailed to me. Only after much persistence and placing me on hold to check with her ‘colleague’, did she take my email address, agreeing to forward the information I had asked for.

She also asked me for a contact number should the need arise. Sure enough, about two hours later I received a call from the representative, informing me that she had since been advised by her ‘supervisor’ she was not allowed to send the information after all.

Next I asked to speak to her supervisor. I asked the supervisor why the representative was told not to send the information after saying that she would. The supervisor replied "oh she's just new here and didn't know." The supervisor went on to say that their product is listed with the Therapeutic Goods Administration and they are not required by legislation to reveal the ingredients. After pursuing that matter further with her I was informed the only way to get the information is to go to a GP or a registered health professional who can then request the information from the manufacturer direct. She informed me that our GP could request the information by writing to her (the supervisor).

Despite the fact that we were able to source the ingredients in the first instance and have since stopped using the tablets, there is an underlying major issue that clearly needs addressing. As parents we are continually battling to find out the necessary information about such additives and preservatives to ensure the health and well being of our children, only to find that manufacturers hide behind terms such as ‘proprietary information’ or ‘trade secret’. I hope you find this information equally disturbing. I would like to know what we can do to evoke change in the regulations around the labelling of food and medicines. – Darren, Vic

[568] Epilepsy and additives (August 2007)

I am a new convert to failsafe eating and I am a sufferer of epilepsy. We initially began the diet for my son's problems but having read the information on the effects of additives I am also taking care to follow it myself. My doctor recently changed my medication back to Lamictal and I was surprised and annoyed when I found the drug has had blackcurrant flavouring added to it so that it can be dispersed in water or chewed. This hasn't always been the case. A number of years ago I was taking this tablet and it was free of artificial flavours. I continue to swallow the tablets whole as they are not large or difficult to swallow and find this new format totally unnecessary. I am very disappointed with the fact I have no option to take a tablet that does not contain flavourings as I need this medication for seizure control. I believe many sufferers of epilepsy are sensitive to additives and I remember as a child of 12 when I first started having seizures that I made a connection with dark coloured icy poles and the simple partial seizures I suffered. I voluntarily stayed away from the raspberry flavours.

Many of the anti-convulsants used for seizure control are coloured to differentiate the strengths of the tablets so this problem is not just peculiar to my medication. I would be interested to know if you can help in this area.

  What you can do: tell someone

Please report if you notice a reaction to additives in medication to any or preferably all of the following.

It is the only way we can get change – slow but better than nothing.

1. Adverse Medicines Events Line

This is a national phone hotline run by the Mater Hospital, Brisbane, staffed by pharmacists, which operates Monday to Friday from 9am to 6pm (AEST). It allows people to report any adverse reactions, medication errors or 'near misses' with prescription medicines, over the counter drugs, and complementary medicines. The toll free number, from anywhere in Australia, is 1300 134 237. These people are extremely supportive and your complaint will be filed in a database but there will not be any immediate effect.

2. The manufacturer – through their website, click on Contact Us

3. Tell us so we can share it with others (This email address is being protected from spambots. You need JavaScript enabled to view it.)

4. The health commissioner in your state (this is a new service)

Australian Capital Territory

Community and Health Services Complaints Commissioner

Telephone: 02 6205 2222


Email: This email address is being protected from spambots. You need JavaScript enabled to view it.


New South Wales

Health Care Complaints Commission

Telephone: 02 9219 7444

Telephone: 1800 043 159 (freecall)

Fax: 02 9281 4585

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New Zealand

Health and Disability Commissioner

Telephone: 0800 11 22 33 (national freephone)

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.


Northern Territory

Commissioner for Health and Community Services Complaints

Telephone: 08 8999 1969

Telephone: 1800 806 380 (freecall)

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.



Health Quality and Complaints Commission

Telephone: 07 3120 5999

Queensland Toll Free 1800 077 308 (outside the Brisbane area)

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South Australia

South Australia Health and Community Services Complaints Commissioner

Telephone: 08 8226 8666

Toll free in SA 1800 232 007




Office of the Health Complaints Commissioner

Telephone: 03 6233 6348

Telephone: 1300 766 725

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Office of the Health Services Commissioner

Telephone: 03 8601 5200

Telephone: 1800 136 066 (Toll free)

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Western Australia

The Office of Health Review

Phone: (08) 9323 0600

Country Free Call: 1800 813 583

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.



References and further reading

Labelling requirements for medicines in Australia

The Therapeutic Goods Order No. 69 “General requirements for labels for medicines” (TGO69) is the standard (under the Therapeutic Goods Act 1989) which specifies the information that must be included on the labels of medicines supplied in Australia. A copy of TGO69 is available on the TGA website at:

Additive health warnings for European medications

Health warnings are required on packet inserts for European medications when certain additives are used in medications. The warnings apply to the use of azo dyes such as tartrazine (E102), sorbate, benzoate and sulphite preservatives and antioxidants BHA (E320) and BHT (E321). They include potential ‘allergic reactions’, ‘mild irritation to the skin, eyes and mucous membranes’, ‘bronchospasm’ (difficulty breathing) and possible ‘severe hypersensitivity reactions’. European Commission Volume 3B Guidelines: excipients in the label and package leaflet of medicinal products for human use July 2003.

Additive warnings for European foods

From 2010, foods in the EU that contain any of the so called Southampton Six artificial colours (102, 104, 110, 122, 124, 129) must include a warning on the label "may have an adverse effect on activity and attention in children"

Additives permitted in Australian Food

The Southampton Study

This study showing that additives can affect children’s behaviour and learning ability - not only children with ADHD, but children in the general population – led to a voluntary ban on artificial colours in the UK. McCann D and others, Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial. Lancet. 2007 3;370(9598):1560-7

How additives affect children

The main behavioural effects of additives are irritability, restlessness, inattention, sleep disturbance: Rowe, K.S. and Rowe K.L. (1994) 'Synthetic food colouring and behaviour: a dose response effect in a double-blind, placebo-controlled, repeated-measures study'. Journal of Pediatrics 1994;125:691-8.


About 30 per cent of adults report adverse reactions to fragranced products. In 2007, fragrances were named "allergen of the year" by the American Contact Dermatitis Society to highlight the 'real but potentially avoidable' problems caused by these allergens. Fragrance ingredients have been listed by the US National Academy of Sciences as one of six categories of neurotoxic chemicals that should be more thoroughly investigated as primary causes of disease in humans (along with insecticides, heavy metals, solvents and food additives). More information: Read the Label: Fragrances by Pat Thomas, The Ecologist Magazine

Salicylates in medication

One of the most commonly used teething gels for babies has been linked to a potentially fatal disease. British authorities say the active ingredient - choline salicylate - in Bonjela may put children at risk of Reye's syndrome, a rare brain and liver disease.

Don't take the medication unless it is essential

‘Giving either “over-the-counter” or prescription medications unnecessarily to young children is an increasing concern’: Oberklaid, F Giving Medication. Childcare and Children’s Health Series, RCH, 2005

Food Intolerance

Clarke L, McQueen J, Samild A, Swain A. The dietary management of food allergy and food intolerance in children and adults. Aust J Nutr Diet 1996;53(3):89-94.

Dengate S, Fed Up: Understanding how food affects your child and what you can do about it, Random House Australia, 2008

Sugar free sweeteners (polyols)

Pink diarrhoea: Hill RE and Kamath KR, "Pink" diarrhoea: osmotic diarrhoea from a sorbitol-containing vitamin C supplement. , Med J Aust, 1982;1(9):387-9 and more information about polyols - Sugarfree Factsheet 

Side effects of medication

No drug is completely safe. In the US, medical treatments are the third leading cause of death, after cancer and heart disease. A major contributor to these statistics is the unintended side effects of prescription drugs. The safety of new drugs is not guaranteed by FDA approval: within seven years after release, one in five new drugs will have been withdrawn or be the subject of a black box warning, due to serious side effects. For example, the US FDA estimates that Vioxx painkillers may have contributed to 27,000 heart attacks and sudden cardiac deaths between 1999 and 2003. Stilnox sleeping pills have been associated with suicides

Third leading cause of death - Starfield B, Is US health really the best in the world? JAMA 2000;284(4):483-484.

Medication side effects - Lazarou J and others, Adverse drug reactions in hospitalised patients, JAMA 1998;270(15);1200-1205.

Safety of new drugs not guaranteed - Lasser, Timing of new black box warnings and withdrawals for prescription medications, JAMA 2002;287(17):2215-20.

Vioxx -

Stilnox -

Introduction to food intolerance

The information given is not intended as medical advice. Always consult with your doctor for underlying illness. Before beginning dietary investigation, consult a dietician with an interest in food intolerance. You can see our list of experienced and supportive dietitians 

© Sue Dengate updated July 2015