When 32-year-old year Sankara Menon* visited a neighbourhood dermatologist in Vashi, Navi Mumbai, he was taken aback that the doctor asked him whether he preferred a ‘vegetarian’ medicine before writing out a prescription. “I am a hard-core non-vegetarian,” laughs Menon. “But my wife’s a vegetarian. Though I have absolutely no issues in having any kind of medicine, I was intrigued by the idea of vegetarian medicines, for my wife’s sake.”
In nearby Kharghar, dermatologist Dr Shilpa Sankpal makes it a point to find out her patients’ preferences before prescribing any oral medication. “Vegetarian patients might question why I gave them a medicine made from animal products,” explains Dr Sankapal. “I tell them about the medicine beforehand, so that there are no issues later.”
Alternatives to medicines based on animal products (like gelatin capsules) might sound novel but they have been around for almost six years in India although they have picked up in popularity only recently, says Dr Chandrasekhar Barhate, editorial assistant, Indian Journal of Pharmaceutical Sciences, at the Indian Pharmaceutical Association. “Now, a lot of Indians have begun to ask about these capsules,” he explains. “This is due to increased literacy and companies’ marketing techniques.”
Most Vitamin E products that are derived from fish-oil sources, and Calcitriol (a medicine prescribed for patients suffering from osteroporosis) are made from sheep bones, says Dr Barhate. But while such animal components in medicines are almost irreplaceable as they help enhance the effectiveness of these medicines, gelatin is added to capsules to maintain the rubbery texture of the shell that encases the actual medicine. It is used as a binding agent.
Efforts have been underway to find a substitute for this mammalian gelatin. Healthcaps India, a Punjab-based company that specialises in making empty capsules, is currently in the midst of a project that involves the manufacture and export of Hydroxy Propyl Methylcellulose (HPMC) capsules — synthetic capsules that are not derived from animal products. When contacted, technical head at Healthcaps India Kaushal Kumar refused to divulge details of the project, although he explained that once the project is rolled out, Healthcaps India will be perhaps the third company in India to manufacture HPMC capsules. The website of ACG Associated Capsules Pvt Ltd, another company that produces empty hard capsules, describes ‘high performance versatile HPMC capsules’ called Naturecaps, that ‘meet the dietary or cultural needs of customers that follow a vegetarian lifestyle’. However, when contacted, the company refused to comment.
Contrary to Dr Barhate’s statement, Kumar opines that there is no market for HPMC capsules in a cost-based market like India, where these capsules cost three times more than their readily available gelatin counterpart. HPMC capsules, explains Kumar, are more popular in Europe, where fear of viral diseases like Mad Cow disease has shut down many gelatin plants. “Because of this, Asian gelatin (derived from cattle in Asian countries) is also in huge demand as it is totally safe,” he says. This has also pushed scientists to develop alternatives for gelatin.
Manufacturing HPMC capsules is no easy feat as it calls for a drastically different and modified manufacturing environment, explains Kumar. However, scientists have already begun to envision a scenario where there is a shortage of animal product-based gelatin, though Kumar quickly adds that he does not foresee such a crisis in the immediate future.
Medically speaking, HPMC capsules and gelatin capsules are more or less the same, says Dr Barhate. “But unlike gelatin, HPMC does not dissolve quickly and has the tendency to swell. Because of this, there is a slight delay in releasing the drug to the body.”
Although the capsules’ packaging clearly mentions the word ‘gelatin’ as per the Drug & Cosmetics Act, homeopath and vegan Dr Nandita Shah wonders how many people are aware that gelatin is an animal product. “Personally, I wouldn’t take it for many reasons,” says Dr Shah, while stressing that she would never recommend not taking the medicine if a patient is in dire need of it.
“Like food, why can’t drugs also carry a green and red label so that we know the source of the medicine in one glance?” asks Sankara Menon. “I know we are supposed to read the ingredients of medicines we are prescribed, but honestly, who does that?” However, according to a 2002 media report, a Delhi High Court order which made vegetarian and non-vegetarian labelling compulsory for medicines was contested by the government, who argued that “the HC directive would not be in patients’ interest. Nor would it help the drug industry”. The drug industry too did not support the call for better labelling, explaining that it was not a “pragmatic requirement” and that “a disclosure of their (the drug’s) animal origin would sensitise the patient when his life is in danger.”
An official from the Food and Drug Administration, who declined to be named, explains that while food supplements come with coloured labels, medicines, unlike food, are life-saving drugs and are used for remedial purposes. “They are not taken for leisure. They are taken by compulsion,” he explains.
*Name witheld on request