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490 mg of Dapsone per week, 4 bottles red wine @ 14% alc vol & occasional bottles of pear cider, is the alcohol going to affect Dapsone?

angel1980 profile image
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NorthernSoul profile image
NorthernSoul

Dapsone is hepatically metabolised so theoretically yes. I don't know what the recommendations are, however. Ask your dermatologist or a pharmacist- they should be able to help.

Just a question though- 4 bottles of wine plus (let's say) 4 bottles of pear cider is about 48 units a week- is this for one person? It's a pretty hefty intake (more than twice the recommended for a bloke)...

in reply to NorthernSoul

Well said, I was thinking that,

Jacks profile image
Jacks

Did you know, depending upon how it has been produced, wine can contain substantial amounts of gluten? In the EU all wine is clarified with gluten (it used to be gelatine but BSE stopped that). Some countries use fish. As well as clarifying, gluten is used to seal the oak barrels that wine is aged in.

I hope your husband is doing a bit better these days.

NorthernSoul profile image
NorthernSoul in reply to Jacks

I've been avoiding oak-aged wine but I didn't realise that many wines were also clarified with gluten... :s Is it present enough in large enough quantities to trigger a reaction? I don't think I've had one yet...

meanioni profile image
meanioni in reply to NorthernSoul

Milk is often used to clear wine too.

in reply to NorthernSoul

drvino.com/2011/11/30/glute...

It says here that wine where gluten is used as finings has been tested to contain >10ppm and it says about the filler used to seal some barrels.

The other thing that coeliac have to be aware of is that old sherry barrels are used with some mature malt whiskies.

royalmilewhiskies.com/categ...

I'd also like to say that I think that it's great having a medical student who is also a coeliac as a member of GFG.

Jacks profile image
Jacks in reply to NorthernSoul

I mentioned the gluten/wine issue because I wasn't able to take Dapsone for my DH as I was too anaemic (still am) so I had to go away and cope with a GF diet and topical steroids. Although I had a lot of control on a GF diet I still itched my way through the early days.

I discovered the gluten/wine issue by accident early in my CD/DH diet when I was again covered in DH - the only thing I'd consumed was my share of a bottle of red wine. I've had the same reaction to other wines since so have stopped drinking red. The skin is the giveaway. I understand it's the total amount of 'trace' gluten that we coeliacs consume in a day - even if we don't have manufactured GF food. I had a glass of Pinot Grigo with OH the other day and I was fine.

Bit of an explanation here - whizz down to GF wine:

glutenfreepages.com.au/CMS/...

Lexy profile image
Lexy in reply to Jacks

Hi Jacks, I too find red wine (almost all of them, although particularly Australian ones) cause a skin reaction, followed by itchy spots later. I find French reds, at least Bordeaux which my hubby and I really enjoy, seem to cause slightly less/sometimes no reaction. However, I rarely have more than one glass and tend to stick to white wines, usually French or Italian, sometimes Chilean or South African. I'm wary of Australian whites simply because of my reaction to the reds...perhaps it's unjustified? Anyway, thanks for the info! Much appreciated!

NorthernSoul profile image
NorthernSoul

Excuse me? I was just pointing it out- it's very easy to not realise how many units one is consuming, especially with wines etc. when % vary so much. As long as the OP knows how much they're drinking, it's clearly up to them if they continue to drink it- I'm certainly not going to lecture them for it.

And what on earth are you talking about- 'being qualified'? Is it only healthcare professionals who are permitted to discuss healthcare-related issues? Because that's pretty much against the entire premise of this forum... If someone casually mentioned they were consuming gluten whilst discussing an unrelated topic and someone here suggested that might be a bad idea would you react in the same way? Of course not.

If you have some kind of problem with me or what I post then message me about it. I'm not going to clog up this thread with anything unrelated to the original topic of discussion.

Irene profile image
IreneAdministrator

Just to say that everyone is welcome to voice an opinion on this site, providing they keep within the guidelines, being polite and not misdirecting people.. Having a variety of views to look over provides a good base for forming your own opinion.

My first response when reading the question was that this quantity of alcohol probably wasn't a good idea to be taking with any drug. This is my 'personal opinion' . Some of my colleagues would strongly argue against my view, possibly whilst quaffing some wine! There are some widely published guidelines on what 'sensible drinking' limits are and as long as people are aware of these, the decision to drink sits with them. I didn't get the feeling that anyone was pushing home their view. I think the info on how the body deals with this drug and drinking alcohol alongside is valuable. Likewise the recommendation to discuss this with a pharmacist.

I always make a point of chatting to a pharmacist whenever I'm taking new meds. The new medicine reviews as also useful for highlighting issue with some drugs and diet. My passion is cheese and even this is has to be taken into account where some drugs are concerned.

The issue with gluten and wine barrels seems to come around regularly. I did have some info on this and will try to fish it out and post here. Interestingly the sulphites seem to sometimes cause a bigger problem for some wine drinkers.

suzieque profile image
suzieque

Hi ,I'm new to this site . I do not suffer with C.D, but my sister does.My question to you is what is Dapsone used for ? My sister hasn't looked too well of late and I worry that her C.D isn't been managed correctly. Does she need to take any supplements to help with her nutrition,?

Thanks

Sue xxx

NorthernSoul profile image
NorthernSoul in reply to suzieque

Hi Sue,

First of all- welcome! Secondly, dapsone is an antibacterial drug which also has anti-inflammatory properties and is used in this case to treat a very itchy unpleasant rash called dermatitis herpetiformis (DH). DH is linked to coeliac disease and involves the deposition of antibodies under the skin. Often it resolves when a gluten free diet is followed but it can take a while to settle, which is where dapsone comes in. If she doesn't have DH then your sister doesn't need dapsone.

The best person to ask about your sister's nutrition is a dietician so if you haven't already, get her to ask her GP to refer her to one. A gluten-free diet can be a bit restrictive, especially during the initial 'what the hell do I eat?' phase so it's important that she's getting everything she needs. Once her gut is healed, she should be able to be both gluten free and get all her vitamins etc. through dietary means alone. Supplementation isn't often needed provided she doesn't have any other underlying health conditions (osteoporosis, for example).

If she's still feeling unwell, it might be worth keeping a food diary in the meantime and double-checking all her shop-bought food to make sure there isn't any gluten sneaking into her diet. Coeliacs can often have thyroid problems so that might be worth checking out too. Your GP should be able to help with that and anything else that might be the cause of the issue.

I hope that was useful and do point her in the direction of this site if she'd like to chat about it all!

suzieque profile image
suzieque in reply to NorthernSoul

Thanks for your interest and advice. I should of mentioned that it is 10 years since my sis was diagnosed . She seems to manage her C.D quite well and is very vigilant when eating out .She sees her dietician once a year , that doen't seem regular enough to me .She has had numerous blood tests ,the last one two weeks ago for a full blood count, thyroid included,.and all came back normal. It's just that lately she is complaining of feeling very tired,more than she usually is, she looks pale and drawn . I feel that it is down to C.D and something is being missed from her nutrition. Do any of you take vitamins to keep you vitalised??

Cheers

Sue

xxx

meanioni profile image
meanioni

No need to be patronising, Tony. NorthernSoul has medical training and experience. Being qualified is irrelevant - she has more medical knowledge than most if not all on this forum. and I, for one welcome that.

You make a valid point about gluten in alcohol too.

The whole point of this forum is a helpful exchange of views. So no need to get personal.

Elspeth profile image
Elspeth

I was told that red wine contains hystamines which are the opposite of anti-hystamines so that could exacerbate any intollerance condition or allergy?

If this is true that could affect the way the Dapsone works and therefore make the DH still bad? Anyone any thoughts on this?

NorthernSoul profile image
NorthernSoul in reply to Elspeth

Red wine does contain histamine but in very small quantities. A recent study showed that histamine levels don't seem to have much correlation with the kind of 'red wine headache'-type reactions that some people seem to get after drinking red wine which suggests something else (possibly sulphites) might be to blame.

As for exacerbating an existing allergy- no I don't think it would have an effect. Oral histamine either causes a reaction or it doesn't. It gets broken down and doesn't build up in the body in the way you were postulating.

People don't actually know how dapsone works in DH. It might be something to do with interfering with an enzyme involved in the way neutrophils (a type of immune cell) work. They do indeed produce histamine.

The main way in which red wine, or any alcohol, could interfere with dapsone's action is via modulating its metabolism in the liver.

FionaGFG profile image
FionaGFGAdministrator

Tony

The actual question was,

'490 mg of Dapsone per week, 4 bottles red wine @ 14% alc vol & occasional bottles of pear cider, is the alcohol going to affect Dapsone?' not can I drink alcohol with it. The query was about the affect of alcohol with Dapsone.

I think all of the early comments to this question provide valuable answers.

Please bear in mind that it's important to treat all members of this group with respect and talk to them online as you'd like to be spoken to. We expect all members to be non-judgmental, non-abusive and openminded.

FionaGFG profile image
FionaGFGAdministrator

Thanks for spotting the typo Tony. Of course we'd love all members to be non-abusive and respect all points of view.

Jacks profile image
Jacks

My fault entirely for bringing up the gluten clarifying, maybe I should have sent that as a PM. I know Angel's husband is having a rough time with Dermatitis Herpetiformis and red wine was something that set mine off.

Jacks profile image
Jacks

I was at a lecture by one of the main coeliac Professors in the UK. Brilliant lecture for which he received an award but, to support Tony's words, I lost count of the number of times he said "We just/still don't know ..."

Fifitricks profile image
Fifitricks

Well hellooooo to all you lovely people you have answered a question that I have been wondering about and that is ........is there gluten in wine because I have a reaction to wine so have been drinking Vodka instead now PLEASE do not tell me that the dam stuff is in Vodka lol. I have said it before and will say it again thank you to this site I love it. :O) xx

I have found this all fascinating reading. Gluten is not found in wines or spirits (as quoted by Coeliac UK) but saying that I am a coeliac who also has DH and my DH flares up if I have whiskey (something to do with production I'm told) The question asked about the interaction with the drug Dapsone and I think the best place to go is to a pharmacist and ask there. Coeliacs are well known for not being able to tolerate all sorts of stuff that we can allegedly have which is due to having a sensitive tum.

Towels profile image
Towels

Hi I am a coeliac, I have been drinking red wine for a few years now as I had to give up beer. I joined the Coeliac UK and have been guided by them as to NO Gluten. In wine . I also have DH. I now have osteoporosis and have been put on Aladrenic acid for my bones, do you know if this is OK to take with my condition DH ?