Guidelines for Drug Selection in Patients on the Ketogenic Diet

The following data has been compiled as guidance to be used when prescribing for children who are on the ketogenic diet.  Whilst best efforts have been made to ensure accuracy and completeness of the list, USERS MUST ENSURE THEY CHECK DETAILS WITH MANUFACTURERS, PHARMACISTS OR MEDICINES INFORMATION DEPARTMENTS AS APPROPRIATE.

The information given relates to details declared by manufacturers.  The ingredients that are listed are those that have been deemed to be particularly important to those individuals that may be on the ketogenic diet, with quantities also being listed with the intention of being a guide to aid in prescribing for these patients.  Dietitians will need to be made aware of the use of the drugs, which could make a significant contribution to dietary energy (kcals).

In some cases, where the carbohydrate content may be deemed particularly high, it may be appropriate to seek alternatives.

 

Drug Brand name Manufacturer Form Strength Relevant Ingredients Comments
Aciclovir N/A Alpharma Tablets 200mg Lactose

Sodium starch glycollate

Company cannot give out exact quantities as confidential information.
Alfacalcidol One Alpha Leo Pharma Capsules 0.25mcg Glycerol: 25mg/capsule
Capsules 0.5mcg Glycerol: 22.3mg/capsule
Capsules 1mcg Glycerol: 25mg/capsule
Oral drops 2mcg/mL Sorbitol: 452mg/mL
Alimemazine Vallergan Sanofi-Aventis Liquid 7.5mg/5mL Sucrose: 67.8% per 5mL As liquid sugar gran liquors.
30mg/5mL Sucrose: 67.8% per 5mL

 

As liquid sugar gran liquors.
Amiloride Amilamont Rosemont Oral solution 5mg/5mL None relevant
N/A APS Tablets 5mg Lactose

Maize starch

No quantitative data provided.
N/A Alpharma Tablets 5mg Lactose

Maize starch

No quantitative data provided.
Azithromycin Zithromax Pfizer Capsules 250mg Lactose: 151.55mg/capsule

Maize starch: 47mg/capsule

Suspension 200mg/5mL Sucrose: 3.87g/5mL
Beclometasone Beclazone IVAX Inhaler (MDI) 50mcg None relevant
100mcg
250mcg

 

 

Drug Brand name Manufacturer Form Strength Relevant Ingredients Comments
Bowel cleansing solutions Klean-Prep Norgine Oral powder (sachets) 3.5g Contains maltodextrin in the vanilla flavouring (0.329g of vanilla flavouring per sachet).
Budesonide Pulmicort AstraZeneca Inhaler (MDI) 50mcg Contains sorbitan (an ester containing sorbitol) Contact AstraZeneca if further info required.
200mcg
Calcium Sandocal 400 Novartis Effervescent tablets 400mg calcium None relevant
Calcium- Sandoz Alliance Syrup 2.7mmol/5mL Sucrose: 1.5g/5mL
Calcium carbonate Adcal Strakan Chewable tablets N/A Pre-gelatinised starch: 166.7mg/tablet
Calcichew Shire Chewable tablets 1.25g Sorbitol: 390mg/tablet Also contains mono-di-fatty acid glyceride: 0.8 micrograms/tablet.
Calcichew Forte Shire Chewable tablets 2.5g Sorbitol: 780mg/tablet Also contains mono-di-fatty acid glycerine: 1.6 micrograms/tablet.
Calcium carbonate & colecalciferol Adcal D3 Strakan Chewable tablets N/A Pre-gelatinised starch: 167mg/tablet

Corn starch: 0.64mg/tablet

Sucrose: 1.5mg/tablet

Calcichew-D3 Shire Chewable tablets 1.25g calcium carbonate; 5mcg colecalciferol Sorbitol: 390mg/tablet Also contains mono-di-fatty acid glyceride: 1.0 micrograms/tablet.

 

 

Drug Brand name Manufacturer Form Strength Relevant Ingredients Comments
Calcium carbonate & colecalciferol Calcichew-D3 Forte Shire Chewable tablets 1.25g calcium carbonate; 10mcg colecalciferol Sorbitol: 390mg/tablet Also contains mono-di-fatty acid glyceride: 0.6 micrograms/tablet.
Carbamazepine Tegretol Cephalon Tablets (chewtabs) 100mg Sorbitol: 303.7mg/tablet
Tablets (chewtabs) 200mg Sorbitol: 607.4mg/tablet
Liquid 100mg/5mL Sorbitol 70% solution: 1250mg/5mL
Cefixime Suprax Aventis Suspension 100mg/5mL Sucrose: 2.52g/5mL
Cefradine Velosef Bristol-Myers Squibb Capsules 250mg Lactose: 32mg/capsule
Capsules 500mg Lactose: 64mg/capsule
Suspension 250mg/5mL Sucrose: approx 3g/5mL
Cetirizine Zirtek UCB Pharma Tablets 10mg Lactose: 66.4mg/tablet
N/A APS Tablets 10mg Lactose No quantitative data provided.
Clarithromycin Klaricid Abbott Suspension 125mg/5mL Sucrose: 2.7g/5mL Also contains maltodextrin: 0.3g/5mL.
Tablets 250mg Starch: 0.065g/tablet
Clobazam Frisium Aventis Tablets 10mg Lactose: 72.3mg

Starch: 33mg

Assume quantities are per dose unit.

 

 

Drug Brand name Manufacturer Form Strength Relevant Ingredients Comments
Clonazepam Rivotril Roche Tablets 500mcg Lactose: 40mg/tablet

Maize starch: 103.883mg/tablet

Pre-gelatinised starch: 5mg/tablet

Lactose as monohydrate.
Tablets 2g Lactose: 121.5mg/tablet

Pre-gelatinised starch: 20mg/tablet

Lactose as anhydrous.
Codeine

 

N/A Alpharma Tablets

(codeine phosphate)

15mg Lactose

Maize starch

Pre-gelatinised maize starch

Company cannot give out exact quantities as confidential information.
Tablets

(codeine phosphate)

30mg Lactose

Maize starch

Pre-gelatinised maize starch

Company cannot give out exact quantities as confidential information.
Tablets

(codeine phosphate)

60mg Lactose

Maize starch

Pre-gelatinised maize starch

Company cannot give out exact quantities as confidential information.
N/A APS Tablets 15mg Lactose No quantitative data provided.
N/A Thornton & Ross Linctus BP 15mg/5mL Sucrose: 3.9g/5mL
Syrup

(codeine phosphate)

25mg/5mL Sucrose: 4.2g/5mL
SF oral solution 15mg/5mL Glycerol: 250mg/5mL
Co-trimoxazole N/A Alpharma Tablets 400/80mg Maize starch Company cannot give out exact quantities as confidential information.
Cyclizine Valoid Amdipharm Tablets 50mg Lactose: 60mg/tablet
Dexamethasone N/A Organon Tablets 0.5mg Lactose:  up to 150mg

Potato starch: 30.4mg

Exact quantity of lactose to be confirmed.
Tablets 2mg Lactose: up to 150mg

Potato starch: 30.06mg

Exact quantity of lactose to be confirmed.
Diazepam N/A APS Tablets 2mg Lactose

Maize starch

Pre-gelatinised starch

No quantitative data provided.
Tablets 5mg Lactose

Maize starch

Pre-gelatinised starch

No quantitative data provided.
Diclofenac N/A APS Tablets E/C 25mg Lactose

Maize starch

Pre-gelatinised starch

No quantitative data provided.
Tablets E/C 50mg Lactose

Maize starch

Pre-gelatinised starch

No quantitative data provided.
Dioralyte N/A Aventis Sachets 4.875g Glucose: 3.56g Assume quantities are per dose unit.
Relief sachets Starch: 6g Assume quantities are per dose unit.
Domperidone N/A CP Pharmaceuticals Tablets 10mg Lactose: 79.3mg/tablet

Pre-gelatinised maize starch: 2mg/tablet

Sodium starch glycollate (type A): 1mg/tablet

Docusate sodium Dioctyl Schwarz Pharma Capsules 100mg Sorbitol & glycerol in capsule shell but not in body Company has no quantitative data.
Docusate sodium Docusol Typharm Paediatric oral solution 12.5mg/5mL Sorbitol: 0.7g/5mL

Glycerol: 0.35g/5mL

Adult oral solution 50mg5mL Sorbitol: 0.7g/5mL

Glycerol: 0.35g/5mL

Erythromycin Erythroped Abbott Liquid 125mg/5mL Sorbitol: 1.1g/5mL
Liquid 250mg/5mL Sorbitol: 1.1g/5mL
N/A APS Tablets 250mg None relevant
Ethosuximide Zarontin Pfizer Suspension 250mg/5mL Sucrose: 3g/5mL

Glycerol: 625mg/5mL

Capsules 250mg Glycerol: 72.5mg/capsule
Ferrous sulphate N/A Alpharma Tablets 200mg Sucrose: approx. 90mg/tablet

Glucose: 26mg/tablet

Lactose

Maize starch

Pre-gelatinised maize starch

Company cannot give out exact quantities as confidential information.
Fluconazole Diflucan Pfizer Suspension 50mg/5mL Sucrose: 576.23mg/5mL
Suspension 200mg/5mL Sucrose: 546.27mg/5mL
Capsules 150mg Lactose: 149.124mg/capsule

Maize starch: 49.5mg/capsule

Capsules 200mg Lactose: 198.832mg/capsule

Maize starch: 66mg/capsule

N/A Alpharma Capsules 50mg Lactose

Maize starch

Company cannot give out exact quantities as confidential information.
N/A APS Tablets 50mg Lactose

Maize starch

No quantitative data provided.MEDICINES

 

Drug Brand name Manufacturer Form Strength Relevant Ingredients Comments
Fluconazole N/A Generics [UK] Ltd Capsules 50mg Lactose: 57.4mg/capsule

Pre-gelatinised starch: 10.2mg/capsule

N/A Pliva Pharma Ltd Capsules 50mg Lactose: 16.6mg/capsule

Pre-gelatinised maize starch: 32mg/capsule

N/A Sterwin Medicines Capsules 50mg Lactose: 49.708mg/capsule

Pre-gelatinised maize starch: 16.5mg/capsule

N/A IVAX Capsules 50mg Maize starch No quantitative data provided.
Folic acid N/A CP Pharmaceuticals Tablets 5mg Lactose: 52.5mg/tablet

Maize starch: 5.95mg/tablet

Lexpec Rosemont Oral solution 2.5mg/5mL Glycerol: 1.25g/5mL

Mannitol: 2.5g/5mL

Furosemide N/A CP Pharmaceuticals Tablets 20mg Lactose: 50mg/tablet

Maize starch: 6.93mg/tablet

Pre-gelatinised maize starch: 2.67mg/tablet

Tablets 40mg Lactose: 100mg/tablet

Maize starch: 13.86mg/tablet

Pre-gelatinised maize starch: 5.33mg/tablet

Frusol Rosemont Oral solution 50mg/5mL None relevant
Gabapentin Neurontin Pfizer Capsules 100mg Lactose: 14.25mg/capsule

Corn starch: 10mg/capsule

Capsules 300mg Lactose: 42.75mg/capsule

Corn starch: 30mg/capsule

 

Ketogenic Diet Table

 

Drug Brand name Manufacturer Form Strength Relevant Ingredients Comments
Gabapentin Neurontin Pfizer Capsules 400mg Lactose: 57mg/capsule

Corn starch: 40mg/capsule

Tablets 800mg Corn starch: 65.6mg/tablet
Gaviscon N/A Reckitt Benckiser Sachets Infant None relevant
Liquid Aniseed None relevant
Hydrocortisone Hydrocortone MSD Tablets 10mg Lactose: 191.2mg/tablet

Starch: 39.4mg/tablet

Tablets 20mg Lactose: 182.6mg/tablet

Starch: 42mg/tablet

Ibuprofen Brufen Abbott Syrup 100mg/5mL Glycerin: 0.5g/5mL

Sorbitol: 0.5g/5mL

Sugar: 3.3g/5mL

Nurofen Crookes Healthcare Orodispersible tablets (meltlets) 200mg 394mg of carbohydrate
Suspension 100mg/5mL
Tablets 200mg Sucrose: 113.1mg/tablet
Relcofen Alpharma Tablets 200mg Sucrose Company cannot give out exact quantities as confidential information.
Tablets 400mg Sucrose Company cannot give out exact quantities as confidential information.
N/A Alpharma Film-coated tablets 200mg None relevant
Film-coated tablets 400mg None relevant

 

Ketogenic Diet Table

 

Drug Brand name Manufacturer Form Strength Relevant Ingredients Comments
Ibuprofen N/A Alpharma Film-coated tablets 600mg None relevant
N/A Bristol Labs Tablets 400mg Lactose: 140mg

Maize starch: 14.39mg

Potato starch: 60mg

Pre-gelatinised starch: 2.39mg

Sodium starch glycollate: 20mg

Sucrose: 137.8mg

Assume quantities are per dose unit.
N/A Sterwin Medicines Capsules 200mg Lactose: 50mg/capsule

Maize starch: 50mg/capsule

Ipratropium bromide Atrovent Boehringer Ingelheim CFC-free inhaler 20mcg None relevant
Isphaghula husk Fybogel Reckitt Benckiser Sachets Original Sorbitol: 0.35mg/sachet
Itraconazole Sporanox Janssen-Cilag Liquid 50mg/mL Fructose (as cherry flavours 1&2)

Sorbitol

Sucrose

Also contains sodium saccharin. No quantitative data provided.
Capsules 100mg Sugar spheres No quantitative data provided.
Lactulose N/A Novartis Consumer Healthcare Liquid N/A Epilactose: 0.34g/5mL

Fructose: 0.04g/5mL

Galactose: 0.51g/5mL

Lactose: 0.34g/5mL

Tagatose: 0.14g/5mL

*This is the one recommended by KETOPAG.

 

Ketogenic Diet Table

 

Drug Brand name Manufacturer Form Strength Relevant Ingredients Comments
Lansoprazole Zoton Wyeth Capsules 15mg Maize starch: 18.2mg

Sucrose: 29.9mg

Assume quantities are per dose unit.
Capsules 30mg Maize starch: 36.4mg

Sucrose: 59.8mg

Assume quantities are per dose unit.
Fastabs 15mg Lactose: 15mg Lactose as monohydrate.

Also contains mannitol 1.5mg.

Assume quantities are per dose unit.

Fastabs 30mg Lactose: 30mg Lactose as monohydrate.

Also contains mannitol 3.0mg.

Assume quantities are per dose unit.

Levetiracetam Keppra UCB Pharma Tablets 250mg Maize starch: 58mg/tablet
Tablets 500mg Maize starch: 116mg/tablet
Loperamide Imodium Janssen-Cilag Liquid 1mg/5mL Fructose

Glycerol

Also contains sodium saccharin. No quantitative data provided.
Norimode Tillomed Tablets 2mg Lactose: 110.356mg/tablet
N/A Tillomed Capsules 2mg Lactose: 127mg/capsule

Maize starch: 40mg/capsule

Lorazepam N/A IVAX Tablets 1mg Lactose

Maize starch

No quantitative data provided.
Loratadine Clarityn Schering-Plough Syrup 5mg/5mL Glycerin: 500mg/5mL

Sucrose: 3g/5mL

 

Ketogenic Diet Table

 

Drug Brand name Manufacturer Form Strength Relevant Ingredients Comments
Metoclopramide N/A APS Tablets 10mg Lactose

Maize starch

No quantitative data provided.
N/A Rosemont Oral solution 5mg/5mL Glycerol: 1.15g/5mL

Sorbitol 70% solution: 0.25mL/5mL

Metronidazole Norzol Rosemont Suspension 200mg/5mL Glycerol Unclear data provided.
N/A Alpharma Tablets 10mg Lactose

Maize starch

Company cannot give out exact quantities as confidential information
Morphine sulphate Oramorph Boehringer Ingelheim Oral solution 10mg/5mL Sucrose: 1.5g/5mL

Corn syrup: 500mg/5mL

Concentrated oral solution 100mg/5mL None relevant
Unit dose vial 10mg/5mL None relevant
Multivitamins Abidec Pfizer Consumer Healthcare Liquid N/A Contact Pfizer for further information as needed.
Multivitamins & minerals Ketovite Yamanouchi Pharma Ltd Liquid N/A None relevant Contains methylcellulose
Tablets N/A None relevant Contains methylcellulose
Nystatin Nystamont Rosemont Suspension 100,000units/mL Glycerol: 0.25mL/5mL

Sorbitol solution 70%: 1mL/5mL

Omeprazole Losec AstraZeneca Capsules 10mg Lactose: 4mg/capsule Lactose as anhydrous
Capsules 20mg Lactose No quantitative data provided.

 

Ketogenic Diet Table

 

Drug Brand name Manufacturer Form Strength Relevant Ingredients Comments
Omeprazole Losec AstraZeneca Tablets (MUPS) 10mg Sucrose No quantitative data provided.
Tablets (MUPS) 20mg Sucrose: 14-20mg/tablet
Oxcarbazepine Trileptal Novartis Pharmaceuticals UK Ltd Tablets 300mg None relevant
Paracetamol Calpol Pfizer Consumer Healthcare Suspension 120mg/5mL Contact Pfizer for more information.
Suspension 250mg/5mL Contact Pfizer for more information.
Paldesic Rosemont Suspension 120mg/5mL Sorbitol solution 70%: 0.75mL/5mL

Sucrose: 3g/5mL

Suspension 250mg/5mL Sorbitol solution 70%: 0.75mL/5mL

Sucrose: 2.5g/5mL

N/A Sterwin Medicines Tablets 500mg Maize starch: 21.4mg/tablet

Soluble starch: 50mg/tablet

Phenobarbitone N/A Alpharma Tablets 15mg No data provided.
Tablets 30mg Lactose

Maize starch

No quantitative data provided.
Tablets 60mg Lactose

Maize starch

No quantitative data provided.
N/A APS Tablets 15mg Maize starch

Sodium starch glycollate

No quantitative data provided.
Tablets 30mg Maize starch

Sodium starch glycollate

No quantitative data provided.

 

Ketogenic Diet Table

 

Drug Brand name Manufacturer Form Strength Relevant Ingredients Comments
Phenobarbitone N/A APS Tablets 60mg Maize starch

Sodium starch glycollate

No quantitative data provided.
Phenytoin

 

Epanutin Pfizer Capsules 25mg Lactose: 66.857mg/capsule
Capsules 50mg Lactose: 90.71mg/capsule
Capsules 100mg Lactose: 96.15mg/capsule
Capsules 300mg Lactose: 61.88mg/capsule
Infatabs 50mg Total sugar content: 461.16mg/tablet
Suspension 30mg/5mL Glycerol: 0.388g/5mL

Sucrose: 1.044g/5mL

Phosphate Phosphate-Sandoz HK Pharma Effervescent tablets 16.1mmol phosphate/tablet None relevant
Potassium chloride KayCeeL Geistlich Syrup 1mmol/mL Sorbitol: 2g/5mL
Sando-K HK Pharma Effervescent tablets 12mmol/tablet None relevant
Slow-K Alliance Tablets (MR) 600mg Sucrose: 96.425mg/tablet
Prednisolone Deltacortril Pfizer Tablets 2.5mg Lactose: 33mg/tablet

Lactose monohydrate: 1.2-1.81mg/tablet

Maize starch: 28.8mg/tablet

Tablets 5mg Lactose: 31mg/tablet

Lactose monohydrate: 1.2-1.81mg/tablet

Maize starch: 28.8mg/tablet

N/A Alpharma Tablets 1mg Lactose

Maize starch

No quantitative data provided.

 

Ketogenic Diet Table

 

Drug Brand name Manufacturer Form Strength Relevant Ingredients Comments
Prednisolone N/A Alpharma Tablets 5mg Lactose

Maize starch

No quantitative data provided.
Tablets (E/C) 2.5mg Lactose

Maize starch

Also contains glycerides and sorbic acid. No quantitative data provided.
N/A Alpharma Tablets (E/C) 5mg Lactose

Maize starch

Sucrose

Also contains glycerides and sorbic acid.
N/A APS Tablets 1mg Lactose

Maize starch

No quantitative data provided.
Tablets 5mg Lactose

Maize starch

No quantitative data provided.
N/A CP Pharmaceuticals Tablets 1mg Lactose: 54.2mg/tablet

Maize starch: 6.53mg/tablet

Pregelatinised maize starch: 1.67mg/tablet

Tablets 5mg Lactose: 79.9mg/tablet

Maize starch: 10.3mg/tablet

Pregelatinised maize starch: 3.0mg/tablet

Primidone Mysoline AstraZeneca Tablets 250mg None relevant
Ranitidine Ranitic Tillomed Tablets 150mg Lactose: 3.0mg/tablet

Maize starch: 10.3mg/tablet

Sodium starch glycollate: 6.45mg/tablet

N/A Rosemont Oral solution 150mg/10mL Sorbitol solution 70%: 1g/5mL
Salbutamol Salamol IVAX Inhaler (MDI) 100mg None relevant

 

Ketogenic Diet Table

 

Drug Brand name Manufacturer Form Strength Relevant Ingredients Comments
Senna Senokot Reckitt Benckiser Syrup 7.5mg/5mL Sucrose: 3.3g/5mL
Tablets 7.5mg Lactose: 15.82mg/tablet

Starch: 24.35mgtablet

Sodium feredetate Sytron Link Pharmaceuticals Liquid 27.5mg iron/5mL Glycerol: 0.75g/5mL

Sorbitol: 2g/5mL

Sodium picosulfate Laxoberal Boehringer Ingelheim Liquid 5mg/5mL Glycerol 85% EP: 500mg/5mL
Picolax Ferring Pharmaceuticals Sachets 10mg Lactose: 4.5mg/sachet
Sodium valproate Epilim Sanofi-Aventis Crushable tablets 100mg Maize starch: 74mg/tablet
Enteric coated tablets 200mg None relevant
500mg None relevant
Liquid (sugar-free) 200mg/5mL Sorbitol: 647.5mg/5mL
Syrup 200mg/5mL Sorbitol: 647.5mg/5mL

Sucrose: 3.575g/5mL

Epilim Chrono Sanofi-Aventis Tablets (m/r) 200mg None relevant
300mg None relevant
500mg None relevant
Temazepam N/A APS Tablets 10mg Lactose No quantitative data provided.
N/A Rosemont Elixir 10mg/5mL Glycerol: 2.5mL/5mL

Sorbitol solution 70%: 1mL/5mL

 

Ketogenic Diet Table

 

Drug Brand name Manufacturer Form Strength Relevant Ingredients Comments
Terbutaline Bricanyl AstraZeneca Inhaler (MDI) 250mcg Contains sorbitan (an ester of sorbitol) Contact AstraZeneca for further information
Topiramate

 

Topamax

 

Janssen-Cilag Sprinkle capsules 15mg Sugar spheres No quantitative data provided.
Sprinkle capsules 25mg Sugar spheres No quantitative data provided.
Tablet 25mg Lactose

Pregelatinised starch

Sodium starch glycollate

No quantitative data provided.
Tablet 50mg Lactose

Pregelatinised starch

Sodium starch glycollate

No quantitative data provided.
Tablet 100mg Lactose

Pregelatinised starch

Sodium starch glycollate

No quantitative data provided.
Triclofos N/A Celltech Liquid 500mg/5mL Sucrose: 3.25g/5mL
Vigabatrin Sabril Aventis Sachets 500mg None relevant
Tablets 500mg Starch: 13.9mg Assume quantities are per dose unit.

 

 

Guidelines for Drug Selection in Patients on the Ketogenic Diet
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About Gabriel Machado

Gabriel Machado is engineer, blogger and fanatic for any health related subjects, specially on the realm of diet and nutrition. After having your life changed following a low-carb diet, became a keto-freak trying to spread the Ketogenic Lifestyle message to all over the world.

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