The following are explanations of various halacha (Jewish law) issues regarding specific products.
I. Gelatin capsules - Gelatin is a raw material derived from animals. Unless it is produced under strict kosher supervision (i.e., kosher-slaughtered animals or kosher fish), or produced from a gelatin substitute (such as plant capsules), the product is non-kosher. Swallowing a capsule is considered shelo k'derech achila, and some patients may use such medicine even when not in danger. People with minor discomfort or in good health should consult a rabbinic authority before using such gelatin capsules.
II. Tablets - With tablets, the most common potentially non-kosher ingredients are magnesium stearate, calcium stearate and stearic acid. These active ingredients serve as lubricants, enabling the medicinal powder to 'flow' adequately as it passes through the processing equipment. Stearic acid also allows the tablet to release easily from the machine during the final compression stage. These stearic acid ingredients may come from animals or plants. However, under normal circumstances, less than 1.6% stearate provides sufficient lubrication, making them batel b'shishim and permitted. Therefore, even if a person with minor discomfort or in good health needs to take tablets, the only kosher concern is whether the stearate is batel.
If a tablet is definitely non-kosher or contains potentially non-kosher ingredients (such as polysorbate 80, triacetin), a patient—though not in danger—may use such shelo k'derech achila medicine. However, a person with minor discomfort who finds it necessary to use non-kosher medicine for treatment should consult a rabbinic authority. The same applies to a sick adult or child who, though not in danger, needs to use a non-kosher flavored chewable tablet.
III. Syrups and liquids - These products are considered k'derech achila because they contain flavoring that makes them taste good. The most questionable ingredient in these products (but by no means the only one) is glycerin. This ingredient is not a panacea; if present, it is usually listed as an inactive ingredient, derived from animal, vegetable or petroleum. Unfortunately, it is difficult to determine which one is used, because distributors selling glycerin sell both kosher and non-kosher products to drug manufacturers. Therefore, one is best off buying cough syrups, children's liquid medicines and other medicines that have a hechsher or are confirmed by checking the label to contain no glycerin or other potentially problematic raw materials.
What about a person with minor discomfort, or someone whose life is not in danger but who finds it necessary to take a good-tasting liquid medicine containing glycerin, when this medicine is non-kosher? The solution is to mix one teaspoon (5 ml) of the medicine with at least two fluid ounces (60 ml) of water, juice or soda. The potentially non-kosher glycerin will become batel b'shishim (a ratio of 1:60).
IV. Vitamins - Ideally, a person should choose kosher-certified vitamins. Currently, Star-K and other kosher bodies have certified some vitamin companies, listed in Star-K's approved list of over-the-counter medicines. Many kosher-brand vitamins are marketed in the United States through multi-level marketers and distributors via various channels including toll-free hotlines, so they can be bought anywhere. However, if a particular vitamin or nutritional supplement is not kosher-certified, the following guidelines apply:
Multivitamins often contain non-kosher ingredients not listed on the label. In particular, natural vitamins A and D may come from non-kosher sources. In addition, vitamin E, beta-carotene and natural or synthetic vitamins A and D may be mixed with non-kosher gelatin. Kosher brands are recommended. Under normal circumstances, a person cannot eat a non-kosher-certified chewable multivitamin.
Prenatal vitamins taken by pregnant women are a type of multivitamin. As noted above, multivitamins may contain non-kosher vitamin ingredients. Fortunately, there are now many kosher prenatal vitamins available.
A single vitamin (such as vitamin C) or tablet supplement should ideally have kosher certification. If the ingredients and inactive components are determined to comply with kosher rules, the product may also not require kosher certification (i.e., it is permitted).
V. Homeopathy and herbs - In homeopathic medicines, the source of the medicine's ingredients is called the mother tincture, which may be non-kosher. For example, Lachesis (in ancient Greek mythology, the goddess who governs the lifespan of humans) comes from snakes and red wood ants. The non-kosher mother tincture is usually batel b'shishim in the diluent (an ingredient used to dilute the mother tincture). The non-kosher ingredient is batel; if the potency is double or higher, or 1C or higher, it is a non-kosher ingredient.
Of course, one must determine whether the diluent can be approved. The most common diluents are lactose and alcohol. These ingredients raise concerns under Jewish law and ideally require kosher certification. If the homeopathic remedy is not certified and is based on lactose or alcohol, when using shelo k'derech achila medicine (such as swallowing tablets or sublingual absorption, entering the bloodstream directly rather than being swallowed) whose mother tincture is either kosher, or non-kosher but batel b'shishim, one should consult a rabbinic authority.
Herbs generally contain a herb, a solvent (used for extraction), and inactive ingredients. If the inactive ingredients are kosher, this product can usually be used.
VI. Dairy - Often, medicines contain lactose, dairy ingredients as fillers. If a person has eaten meat, they must wait at least one hour before using these dairy products. This is of course true if it is shelo k'derech achila. This is closely related to prescription medicines that obstetricians and gynecologists prescribe for women, because they often contain lactose.
VII. Sabbath - A person with minor discomfort may not take medicine or supplements to help relieve discomfort on the Sabbath. However, some people classified as choleh (whether in danger) may need to take all necessary medicines. Some people take medicine to avoid serious illness (such as those with high blood pressure or high cholesterol) and may need to take medicine on the Sabbath even without sakana. On the Sabbath, a person may need antibiotics to treat an infection. On the Sabbath, a pregnant woman may take all necessary medicines and vitamins. Someone in good health may, on the Sabbath, consume a product that alters the body's normal function (such as caffeine tablets to refresh the mind and dispel drowsiness).
