title: Inert medication ingredients causing nonadherence due to religious beliefs.
abstract: OBJECTIVE
  To report 4 cases of medication nonadherence due to presence of inert ingredients forbidden by the patients' religion.
  
  
  METHODS
  We describe 4 cases in which religious concerns about prescribed medications' inert components led to discontinuation of these medications. These inert components are gelatin and stearic acid, which might be derived from pork or beef products. In these 4 cases, patients of Muslim, Orthodox Christian, and Seventh Day Adventist faiths, who consider it against their religion to consume pork products, stopped their medications on discovering this possibility. This led to relapse of their illnesses.
  
  
  CONCLUSIONS
  These cases demonstrate that, for some patients, inert medication components that are forbidden by their religion may lead to discontinuation of medications. This could lead to relapse of symptoms and might even lead to hospitalization. Therefore, it is important for prescribers to inform patients of this possibility when treating patients whose religious background might conflict with these inert medication components.
  
  
  CONCLUSIONS
  Patients with religion prohibitions against consumption of pork and/or beef products might stop their medications when prescribed those with pork- and beef-derived gelatin and/or stearic acid. Prescribers should discuss this possibility with their patients, perhaps as part of informed consent.
authors.affiliation: Creighton University/University of Nebraska, and Substance Abuse Treatment Center, Omaha Veterans Affairs Medical Center, Omaha, NE, USA. syed.satter@med.va.gov
authors.forename: S Pirzada
authors.initials: SP
authors.lastname: Sattar
authors.forename: Mohammed
authors.initials: M
authors.lastname: Shakeel Ahmed
authors.forename: Farhan
authors.initials: F
authors.lastname: Majeed
authors.forename: Frederick
authors.initials: F
authors.lastname: Petty
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D002417:Cattle; D033003:Eastern Orthodoxy; D005079:Excipients; D005260:Female; D005780:Gelatin; D006801:Humans; D007514:Islam; D008297:Male; D008875:Middle Aged; D033303:Protestantism; D012008:Recurrence; D012068:Religion and Medicine; D013229:Stearic Acids; D013552:Swine; D016312:Treatment Refusal
chemical_list: D005079:Excipients; D013229:Stearic Acids; C031183:stearic acid; D005780:Gelatin