We filled an Albuterol HFA inhaler today and we had to select one brand (Proair HFA) over another because the patient's insurance only covered that one. While being rung up she protested that she didn't want Proair, she specifically wanted Ventolin HFA because she has a gluten allergy and needed to get away from all gluten-containing products. The Proair apparently caused some sort of facial swelling or other reaction of some sort.
Now, I'm no expert in this area but my inspection of the package insert revealed that the inhaler contains albuterol, propellant and "no other excipients". I seriously don't think there could be anything gluten related in there. But this customer was so insistent and so positive this reaction was connected, she wanted us to request a prior auth. for the Ventolin. And observing a long line of impatient people forming behind her I thought sure, go for it.....
Reminded me of the guy who wanted a refund on his Erythromycin after one dose because it upset his stomach. After our negative response to that, he declared he was going to call his insurance company to get that copay back. Sure, go for it!
Sometimes, you just have to punt.