You have to be careful when you receive prescription medication because many of them have fillers that can raise your blood glucose.
A case in point is that I was just prescribed an antibiotic. I called the pharmacy and asked what fillers were used in their antibiotics. The filler of course was some derivative of sugar. But sugar is not the only problem. A manufacture can use corn fillers, rice fillers and wheat fillers (under dozens and dozens of different names). This is often to make the capsule full. I don't understand the need to fill up the entire capsule but that's the way it is. When it comes to a tablet the problem is exacerbated because the fillers are necessary to hold the tablet together. Pressed sugar seems to be a cheap and common ingredient used in these tablets. Also, ingredients like rice flour,corn flour, and wheat are common in most tablets. You have to really be careful not to sabotage your ketogenic diet through thoughtlessly ingesting prescription medication, without taking the time to figure out how it will affect the total daily carb count of your diet.
It took me a while to find a manufacturer for the antibiotic I was prescribed that was made with inert and non-net carbohydrate fillers. That delayed my starting the antibiotics for four days.
To find a net carb free medication it necessitates a bit of work on your part. After speaking with my pharmacist, I went online and looked up "carb content of generic fill in your drug of choice". I then found the manufacturers phone number, asked for customer service and requested the net carb content of the medication. It took me six tries before I found a manufacture that produced a zero net carbs antibiotic that I could use.The problem was that my physician prescribed the tablet form of the antibiotic. It was necessary to get the NDC (The NDC, or National Drug Code, is a unique 10-digit, 3-segment number. It is a universal product identifier for human drugs in the United States. The code is present on all nonprescription (OTC) and prescription medication packages and inserts in the US.) number of the medication and call my pharmacist again to see if he could special order it. He did have this DNS available from his supplier and was able to order it for me. But it is necessitated that I call my physician and ask her to re-issue a new prescription in capsule form instead of tablet form for the pharmacist.
The way the system is set up, it is almost impossible for a pharmacist to do the research necessary for you to get carb free medication. This took me quite a few days to find the medication. (The reason for this is that many times when you call customer service, a recording will ask you to leave your number and they will return your call at their soonest convenience. This often ends up being the following day.) The time constraints on a single pharmacist to provide this service are impossible.
With practice this becomes easier to do as you learn how to deal with customer service in these pharmaceutical conglomerates. It is easy to become frustrated when these personnel's are prevented from giving you the percentage of carbohydrates in a product. (They either don't know because the precursor ingredient has come from an overseas distributor or there is a sense that the mixture is proprietary not as far as the active ingredients, but the filler ingredients).
Maybe now is the time to discuss the problem facing America that many of our core medications are no longer manufactured in the United States. The problem is not so much with manufacturers that are in industrialized nations but drugs that are made in countries that the FDA cannot police with any regularity or can verify where all the precursor ingredients come from. Countries like India* and especially China. The truth is, if China really wanted to damage the United States all they'd have to do is interfere with the supply of necessary prescription medications coming to this country.
This serious problem is one that most Americans are unfamiliar with. We really need to be vigilant and understand where our medications come from. After all the danger of ingesting necessary medication that have efficacy problems or the inability to acquire common medications because of shortages caused by political realities in the world is problematic. We need to let our government know that's steps must be taken to secure and keep our drug supply safe and available.
*After being on Anastrozole (Generic Arimidex) for a year I picked up a prescription and the dosing label had been glued askew. It showed a "made in India" on the manufacturers label. I called my pharmacy right away and asked why I was receiving medication made in India? He replied that this was what his supplier had sent. I made it clear that I no longer wanted any drugs manufactured by a third world country. Only by industrialized western countries where there was reliable over site!!! He then offered me the generic made by TEVA (the inventor of this drug) in Tel Aviv. Since then I am very careful to ask where my drugs are manufactured. Lesson learned.