2022 12 28 Children's Medicine Shortage

foreign webinars we're here in the Starke main offices in Baltimore Maryland our special guest today is Rabbi David Heber and I'm uh rabbit C Goldberg welcome Rabbi Heber hello how are you thank you for having me on today okay let's uh make it like that look like that want to thank everyone for joining us this webinar is being recorded as all our webinars are and you can find the archives on on our Starkey website or on our Vimeo Channel and also they are on um on the podcast that that you subscribe to you can look for the kosher conversation you'll find them there as well uh today's discussion is about about the current shortage of children's medicines and uh we have Robert Heber who's known as an expert in the cashis of of medicines I want to say Rabbi Heber um like in honor of this webinar I came down with I'm a little bit under the weather um so I have here my uh my Starkey certified tea and I have my uh my ludin's OU cough drops which actually there is some something interesting about these right they now they just have OU they used to have the oud but those in the know knew that it was really part of then also right I think it was I think it was dairy equipment their equipment right it was dairy equipment at that time but now they dropped that and they have just the uh the uh the regular hectare okay we have on our on the on the bottom right of your screen you see a chat uh box and we invite everyone to uh chat with us we enjoy taking your questions and uh and uh hopefully we can get to uh to them I just want if a couple people could chat with us to make sure that you can hear us because just uh if you have a couple people just to let us know that we're coming through okay Ari says show them and Sandra says loud and clear and Muncie okay very great sorry behavior um start us off with this with this topic uh okay I sure want people to know that you're a rabbi Heber not Dr Heber right that's correct that's correct so really this this issue um is obviously a serious issue we've been hearing about it in the news and um you know there is a shortage of various medications both um prescription medications over the counter medications I think really the purpose of this is something that Mrs Katz on the front desk uh alerted me to and she's saying she's getting more calls from people asking questions now again we're not a doctor's office and we don't we don't if somebody is is has an issue with the medication um you know they need to speak to their Healthcare Professor to their physician as far as what to take if medicine a is not available uh call a healthcare um guidance for that what we're here is is when they give they've been taking medicine a and we'll get into the locus of the conscious of it and Minnesota has worked for them and they know it's kosher or permissible and now they go to medicine B that the doctor's recommending they now have the question of if it's kosher and I want to immediately jump in and say that a medication which is taken for a an infection or for any other what's called someone whose life is a danger or potentially in danger and we have a whole list of of these um on our website but of course that would include heart issues high blood pressure issues um even the psychological medication you know medication for um um psychological issues and so on are very off are are typically and we say that if a Doctor is recommending something else then there's really nothing more to ask even for an infection even even an amoxicillin um it's for an infection when people call up we say it's been given for an infection it's 100 fine um uh you know take it obviously a person has a choice between if they know right in front of them there's a choice between caution and kosher one is prescribed by the doctor they could request it the doctor maybe give me a tablet instead of a capsule or the pharmacist you know that's certainly a better route to take but that that's you know when they're buying it again the bottom line somebody needs something for an infection or or any other serious issue they take it no questions asked where where the shilohs are coming in and where we are helpful and the purpose of our conversation today is when somebody let's work with for example has a mehush a makush is a discomfort a runny nose or I guess throw a Goldberg maybe your situation right now would be a discomfort you're not sick you came in you came in um you I don't have a choice yeah okay well so even even you're at the very you're which is the next level someone who's ill but life is not your life is not a danger you're you're a good health so now you're you're you're given over-the-counter medications just to feel better so though this is where we got into the issue of of cautious because a medicine if a person is just let's say let's talk about discomfort person has a runny nose a little bit sore throat a little headache so their guidelines in what you can take and what you can't take it's not a slam dunk to say well everything's fine don't feel well it's 100 permissible there are various factors and that relates to a how sick a person is and B what type of medication they're taking is it is it a liquid is it chewable is it swallowable and those factors you know you ask America raw and they will weigh those out before telling you you could take this so just for example and and a a gelatin chewable product is not Kosher let's say you have a gummy which is contains gelatin or some chewables um or similar types of items they taste good they are and you're not really serious you're just having discomfort so you're eating typhus to get rid of the headache and you're eating it regular to get rid of headaches no hectare for that so just for example if a store ran out of product a for your runny nose or headache and now you're the only thing they have available is is product b or it could even be the same product but a different brand and and this one is chewable gelatin you can't take it so that that's where we're running into these Shadows now the next question is what about swallow we'll talk about a little bit later but that's just that's one extreme example of where a person would have to be careful when they're switching such a medication so the way we uh we presented it was that uh you know there's a shortage of Tylenol Children's Tylenol and Children's Motrin I think that that people are uh finding that there is there's a lack of it I mean I mean just from uh do you know why that is why is why is there a shortage just I'm just curious It's not Allah um that's a good question uh it relates to um I think some of the issues of um you know how the flu has come back there's a greater flu this year than there was or other illnesses I think during you know during the corona people were indoors and were you know there was very very little it was abusing flu as one example but there was very little flu that went on in the in you know 2021 2020 2021 when you know people were masked and indoors and avoiding crowds and you know there were even a lot of a lot of that going on people were reluctant to go out Etc there were less less Gatherings and so on so there was less flu that went on um I'm talking about the end of course from Corona was really the end of the end of the flu season of 2020 I'm talking about now March of 2020. but then already the winter was pretty much done but 2020 2021 it was very very little flu that went around and even last year um because many public schools were closed or messed up or working virtually so you know kids were around each other in a typical year they're all over each other and the flu comes so I've heard one of the issues is that again this is one of the issues I'm not not an expert in this area at all but the resistance was you know when you go a couple years without this back and forth and now it could come with a search so in November for example I heard a statistic that in November there was a surge already usually flu season comes maybe a bit later but I I think by mid-november already the numbers of the flu were higher way higher than they than they are certainly not only by that time but even later so already those who follow you know the medical industry and the pharmaceutical industry industry who follow uh you know these types of trends saw that already in November were you know hey there's a lot going on and now people start to buy and then even people maybe start to hoard when you hear right there's more need for it so so if I bought if but is it that Tylenol and Motrin or kosher and now they're missing so I have to go to something that's not Kosher is that the question so maybe yeah guidelines by the way I just want to finish the previous question and finish they're also you know some some factories also had certain shutdowns or or short shutdowns on inspections or some of that going on and therefore companies who produce you know 24 7 all the time had to take a break in some of their action um and of course that caused the pileups that's second answer now let's get to your to your next question um yes Tylenol so let me explain Tylenol um and Motrin Tylenol Motrin are made by the McNeil Corporation they do not have a formal hair um there's a liquid product and there's there's pills there's both um there is um so so we've we've investigated Rebecca best every year pays a Time um investigates and you know for pesach and when he does the pesach list he asks certain big companies right exactly what type of let's talk about the liquid first you know what type of Glycerin are you using now that's not so much of a pesach issue um as it is a issue that relates to year round um but he's they come back and they have told him you know the people that he knows you know in the company that the glycerin that is used in Tylenol and Motrin is is is vegetable grade there are three ways to make glycerin animal vegetable and petroleum petroleum is kosher vegetables kosher animals not Kosher now parenthetically of course you have to produce the vegetable could be made on animal equipment technically and and so on we're not going to get into that issue for purposes of medications we're going to assume that the vegetables kosher That's the basis for that again only when you're dealing with um when you're dealing with medicines so if let's say the brand the brand you know it was cautious we have information directly from them now you go to your Supermarket or you go to your Pharmacy and you see Tylenols not there the brand name which is what you're used to buying every time you go and now it's not there anymore now you need to switch to let's say the in-house brand of Walmart um you know Rite Aid uh whatever it might be well we don't have information on the private label Brands it's not easy people have asked us to try to get that information I just want to mention why that's difficult but maybe I'll wait for the next uh question to answer that but that's the bottom line now and that's why we're getting these questions I'm used to getting Tylenol and Motrin let's say baby Tylenol infantile and all um liquid liquid motion children's liquid Motrin and now it's not there I got to buy this off brand what's the story and the answer to that is we don't know because we don't have information from the manufacturers of the store brands and therefore now it's a Suffolk history because it has glycerin and a glycerin could be trife it's considered it's considered there right it's a normal way to to to to eat you know you're consuming something that has um that has a taste to it um and therefore how do you take it so the next step is you have to move on to it um which also I guess we'll get to in you know what to do when you have um when you have a problem with the medication so we need to talk about store brands as well as being Movado but before you before your next question I want to point out one thing there is a kosher brand of pain reliever out there it's called kosher meds it's kosher certified under the OU they have a children's ibuprofen original Berry flavor that product was made by um reviewed you know uh totally with the Mesquite present obviously that's that's the gold standard of medications if you could take that what type of if you get if you could get that it's not available I know it's available in in I mean I haven't followed the trend is it is it actually in the store but you know in the in the major kosher markets New York uh Muncie Lakewood pharmacies you know have had it in the past if you can get that um it's probably it's available online also um well we're talking about Tylenol Motrin right we're talking about um you know the the we've received information which we always say we have to do because nothing country's available so here yes something culture is available it's called kosher meds that's the brand name and it's called the children's ibuprofen original Berry flavor and it has an OU on on the label there are some there are just there are some uh generics that are Kosher like star k also right I mean not maybe not right so we we don't give an ibuprofen though we have we have a we have a certification on on antacids uh we certify various private label brands of of antacids and we we have a Mesquite to visit the plant and we review you know the ingredients Etc like any other star k food plant and those bear star k also will uh lactose intolerant type of products um we certify and uh you know we we do have a line in certain stores of that and that you know should be available so that's because again that those off brands are made in a plant that shows and you know we review their labels and again obviously private label manufacturers making various different labels and we're certifying it but when we're not in a in a private label plant then it's very hard to get information let me just think let's just take some of these questions that are coming in Eva is asking does add we still produce kosher medications of course we remember had we from you know it's been around forever do they yeah are they still in business do they have any of these products I believe so um you could check if you want to know all these are available there's a website koshervitamins.com that has anything anything kosher out there in the vitamin industry as well as the medicine industry pretty much they're going to have uh koshervitamins.com koshervitamins.com okay again we have we have companies that we certify you can go to directly those that we certify many Amway products with shackle products those are more vitamin type products we certify Sami uh again we certify some of these other nutritional supplements but also some of these you know anti-acids and so on that we we give action to but we don't ibuprofen we don't give any extra two or you know aspirin or um okay let's just take one more question before you get back on track so CR is asking is using dye free less problematic because it doesn't have any dyes or colors I guess yeah dyes are pretty simple ingredient in in the world of kosher I mean when you get a natural dye like Carmine that's not Kosher but they're not using Carmine the medications um so dye dyes are really you know simple um I would say probably there's not much difference cautious wise because when they're putting in the dye um it doesn't um you know they're not putting in something not kosher that's there so I think flavors are a big concern by medications or vitamins Mayco on flavors okay Adam is asking what about grape flavor is that more of a problem this is a question a lot of people want to know right so when they see great yeah they you know they they they turn away from it right so of course the question is based on grape juice is not Kosher unless it's made these companies it's made with you know with as we know how to make wine all the various conditions um that are involved in that you have a team of of you know there but flavors by and large medications are not using a grape juice they're using an artificial flavor um they could even be using a natural grape flavor Believe It or Not sometimes contains no grape juice also uh and therefore they're not it's not likely that any level of grape juice or any any grape juice is certainly the grape juice is not bottle but I I would eventually guess the odds of any grapes going in there are very slim so indeed in a medicine product a great flavor versus the cherry flavor is not going to be any worse the grape flavor because it's probably no grape juice in there so the answer to Adam's question is that no you do not really need to be concerned more about grape than other flavors okay let me let you get back on to the points that you wanted to make which was as far as well as far as um you know the point about about liquid medication that is has glycerin in it okay so let's say it's got It's got a grape flavor it's got a cherry flavor or glycerin in it so again flavors need there are many there it's probably the most one of the most uh fascinating um uh um industries that we see in the world of conscience our flavor companies because flavor companies have you know hundreds if not thousands of raw materials and they mix them in their chemists are mixing and matching them so that when you eat uh let's take that cough drop you have right there right there's a flavor I don't know what flavor is the the OU the serving age certainly knows what's in there they're only allowing a caution flavor to go in um that company again I don't know anything about the company as far as anything internal but I would venture to Guess that they're buying the flavor from a flavor company that could have any good it might be you know you flavor company it might be a star k flavor company it might be uh you know other agencies flavor company and we send in you know there and the flavor companies are complicated due to the level of ingredients the spray dryers is heat and and so on with all that said in medicines right behind them and it said that we could one could be lenient not to worry about the flavor um flavors typically go into a product at less than to almost always or less than she should there is an aspect known as um a video of time up which means when something gives off a taste it's prohibited but the odds in a medication of having a flavor component that's strafe that would answer it you know even bitty Avid is Slim now we don't like to go on biddy evidence which is true or we give actually we certainly don't but with medications or behind him in his pasta and that since people need the medicine it's almost ill you could be Simon on the fact that the the the flavor is bottle it's the likelihood of it not being bought the position even with every other time is it all of that is very very slim and therefore what can we make all the flavors so the flavor is no problem the glycerin though is a problem glycerin is a sweet tasting item it's not a video time in other words if either time it means it's put in for flavor and it gives a powerful flavor these flavor chemicals you could put in a minuscule amount and it's powerful glycerin has a sweet time but it's not a Vela time but which means it will be bottle of shisham the problem is they add the glycerin at sometimes as high as 20 15 to 20 which means you have one-fifth right or maybe a little less one-sixth glycerin that's not enough you need you need shishim which means you need 60 times kosher than the typhus so if you purchase a medicine that has glycerin in it we tell you to do as follows you could mix it in order to make sure that the glycerin in the product is bought the machine so what are the numbers you need 60 times the glycerin when you buy the medicine it's already one-fifth only maximum one-fifth glycerin if you mix it at a one to twelve ratio so let's go to something what does that mean for those people who don't enjoy math as much as I do what that means is you take one part glycerin against 12 Parts kosher so you have 12 times the amount of juice 12 times the amount of water 12 times the amount of soda versus this liquid because the liquid is one-fifth maximum one-fifth glycerin you now have one twelfth one twelfth times one-fifth is one sixtieth the amount of Glycerin in your finished product is now about the position looking at it mathematically two ways as we've discussed numerous times you take one teaspoon and you mix it in two ounces now what does that mean a teaspoon or six teaspoons of the fluid ounce you take one teaspoon and you mix it in two ounces so again that's one teaspoon two ounces is 60 times for those people we I know recovery of a worldwide audience here so this may be easier even for us Americans who don't use uh um milliliters but a teaspoon is five milliliters you take five milliliters of Glycerin excuse me five milliliters of medicine and you mix it in 60 milliliters of juice water soda better known as CC's one cc is if water is equal to one um one one cubic centimeter is equal to a gram which is equal to a milliliter and you take one you take five CC's which is a teaspoon and mix it into 60 CC's right five milliliters and 60 milliliters and now it's about so the reason is when you took the five milliliters of dose only one of those milliliters was glycerin because we said it's only one fifth so it's one to sixty so it's one one teaspoon to two ounces correct okay so okay so uh here's a question on Behavior so if I'm going and I'm buying an off brand uh because I have a cough and I want cough medicine or I don't have a headache and I don't want to take a pill so I want to take you know off brand so I can do that what what what do you do if you're trying to give this to a child or an infant that you know you can barely get them to take down uh you know what you want and now you're telling them to take you know to take what is it 12 times as much am I right right then what happens to the spoon it's not a lot it's only two ounces it's two ounces remember your kid your kiddish Club holds five ounces so at least your kid is cup holder four ounces maybe if it's small but five people 5.1 ounces so yeah yeah Mikhail says it is difficult to get my child to take medication and he's inclined to throw it up adding extra volume is problematic when we've tried mixing with beverages as juice or Coke we've had issues when the child doesn't finish and then you don't know how much they've had yeah I know it's a big problem here because again we allow you to do this it's not aim of Allen is Sir which means because it's a Suffolk is so we don't know the glycerin might be kosher so vitamins poskin our rabbit administrator that that's not called aim of Island okay but what if you can't do it so now you need to speak to your Rob and this will depend on um how ill the child is and the need um people have asked us what's the right who is the most Glycerine trade most glycerin culture I always say I don't know I don't know in the world you know how to determine if it arrive could you go by the companies you go by how much is available in America do you even go by I'm venturing to Guess that that probably the medicinal world you know in the in the ink and paint world there's probably more trade glycerin used than there is in the in the food industry why it's just a guess that's a guess because in the food industry people maybe try to avoid I'm not here to say what a right I'm here just to say that do you count the glycerin in the world that's used for paint in your calculation of rice I never know people ask me what's the majority the answer I don't know if I first got to figure out how to calculate the majority and even if I luckily wasn't our vitamin and determine remember you're telling us that it's a child if the child is ill and it has to take off brand they should ask their roof you're my roof so let's say you're my rub right I would determine how ill the child is and how necessary it is right that's that's what I would do in other words at the end of the day you're gonna you're gonna come on to to you know to as far as of you know this glycerin and and you're dealing with issues of potential Drive possibly right and the illness of the child and where the child is at so that's a that's a matter of has to make that call based on on the on the level of illness of the child and um you know at the very least I at that point I may say at least for long term contact the company send them an email and ask them what the story is I'm gonna give you one example right a rhesus pinworm medication okay I can't tell you how many shilohs I got on this we never had information about the glycerin used The Substitute there are substitutes but they're not easy to get and then I found the substitute and then later realized that that substitute is meant for animals with pinworm not for human beings but they would allow for human beings if you really need it now I'm not going to tell a consumer when they get online to buy it that it says your pet will enjoy this right and even though it is fit for humans but like is that really my my alternative here right so again this is where the doctors recommending pen with medication there's one I'm not a doctor to recommend that doctor said is what you need and now there's a there's a bunch of over-the-counter versions of it and you're looking for a kosher version so I contacted Reese's you know by email and um or I asked you know in response they wrote me that it's it's it's not animal-based vegetable base and therefore now we have it on our list we have it now I'm talking year round it's now up on our list because this was a medicine so I would answer you if there's a medicine that you have to give your child first of all if you can't mix it then buy the name brands right don't don't buy the off Brands and mix if your child won't want to mix it B is if you can't get the the brand or it's the type of medicine we're not talking about then contact the company on your own get it get an answer from them if they tell you in writing that it's vegetable based you could rely on that for medicine okay so mikhail's asking it we're not letting you go around at 2 am when her children always seem to wake up with a high fever she should call the roof at two o'clock absolutely because I'll tell you a trick with my I'm not going to give you my phone numbers but I I usually work my cell phone but uh at night I charge it but my home phone is on uh it stays is is that's gonna ring the truth is that used to be a good eight sub but today some people only have you know you know the the congregation people don't even know home phone numbers you know they don't even know the home phone numbers anymore people don't so whatever but Lamay said it's 2 A.M it's hard to answer it depends I would say it depends on the issue well I I I don't know I would say if if somebody's child I mean has a high fever yeah right now absolutely yeah that that's that's important to get down that fever and I wouldn't even uh ask this question I didn't hear the whole question yeah the child yeah give it no problem no problem okay um let's take some of these other questions there but Heber um Adam's asking what's the issue with the glycerin what can be in there well it could come from animals that's the problem that's correct I'll give you a little history on that um Ivory soap bar soap right Cincinnati made in Cincinnati Ohio area they they make soap soap as you know it's from made from Taylor it's a bar of soap is a non-kosher substance that we don't eat it and it's also pugum but it's Tallow in making Taylor a byproduct is glycerin so the Procter Gamble Corporation probably all 150 years ago said this byproduct is sweet and is usable and they start selling it by the truckload and you know it's animal based it's not Kosher it's Trey forget I don't know you know which companies are making what but certainly animal glycerin is certainly still readily available on the market and it's it's not like a humra it is it is the real deal of typhus when it's animal trife right and uh Adam also asked how do we know that glycerin is one in five how do you know that so yeah I I um there was someone who worked in the pharmaceutical industry um a number of years ago and he you know he actually worked for some major major corporations and that was the number that he gave me I've recently seen another agency that wanted to claim that it might go as high as 25 percent um I was going to investigate if that even when I was told 20 I was told it's a guzma it's really 15 but to be on the safe side consider 20 and be without that rate I have seen other agents another agency wrote maybe 25 I don't know if that's just they patted the Guzman you know the exaggeration to protect just just in case maybe some company has a higher percent or or statistically that's the case but you know if that's the case we would up the percentage um so again the percentage was one teaspoon and two ounces right which is one to twelve which creates again the glycerin is one maximum one fifth five right of the item which is 20 and and we again I got it from experts in the industry and and um you know even seeing our own formulations I haven't I can't maybe over the years I poked around in some of our formulations well again we don't really give out a whole lot of liquid medication so I'd have to compare that with maybe a liquid vitamin maybe but there was another question there was another question for Michal if the kosher one is available but it costs significantly more do we need to get it okay that that would depend on several factors again I'm going to send you back to your rub on that one um it would depend on your financial status it would depend on how much more it costs overall um again if it's if it's more but it's not a big deal in your in your budget then then or you should try to get it if it is a big deal because you have you know someone has a number of children or you're buying it you know by the by the case load on a regular basis and it's talk a big amount and then that's a Shiloh I would ask you about a rather question you know where where the where where do you draw the line that gets into you know have some Aruba issues that you know speaks about right uh Sarah's asking what's considered a high fever in this case but I'm sure you're not gonna want to answer that question um yeah you know it depends on also what else is going on but I mean certainly 103 is high fever but even less than that yeah 100 do I buy baby even hundred two patches in the middle of the night would certainly be but someone miserable at 101 would you know maybe also qualify and that'd be reminds us exactly what might just said even you know a low fever maybe kind of a second you know it was the truth of speaking about a certain scenario and Circumstance uh or just a little kid that's you know waits in the middle of the night you know that every parent experiences with a child okay so Rachel's trying to get the numbers correct so uh again the the the the the the the the ratio is one teaspoon to two ounces which is basically one to twelve right you add you take one person of of medicine and you add 12 times that and then total you'll have 60 times the glycerin so you're not adding four-fifths of another liquid you're adding actually 12 times correct I mean if you really really really break it down right if someone really wants to pencil crunch this when we do Bittle we look at the you know the the the the numerator denominator we look at um you know how much if it technically if you had one teaspoon right to two fluid ounces okay two fluid ounces are now 12 teaspoons you really now have one teaspoon of Glycerin in 13 ounces of liquid which is 1 13. so correct technically you really only need to add it to 11 teaspoons which is a little bit less than two fluid ounces so then we're going to get everybody really confused that's correct that's correct that's what I would just say I see it added that much but maybe I'm taking care of the other agency that came up with 25 now that I'm thinking by the time we're done we have the 113th okay I'm not I'm not an expert in what the uh was 113th in percentage but we could we could do it here remember I wanted I want to take a minute to show uh what if people go to our website star Dash k.org they can see our list of approved medications let's take a look at that I have it here um so it was recently updated we spent a lot of time do you see this remember you see it I see it yes okay I hope uh everybody can see this this list um and let me make it a little bit bigger okay so output guidelines the top of it is just the guidelines how to use the list uh yes that's how to use a list so you go it doesn't appear on our website as this I I copied the whole thing it doesn't appear basically you search for medications for different by category and so on by name I made it into a PDF here um and uh we have more of the medicines you see five-hour energies at the top not exactly the medicine no although it keeps you awake so it's uh you know that's that's certified by star okay but just let's go down here to um let's see where is the Tylenol here [Music] um uh uh where is that one second a little bit lower you just had to go to Motrin also how come I can't get to the Tylenol here we go there's a Tylenol uh uh Children's Tylenol Cove runny nose grape and then up here on top right you have the tunnel PM so here you have the so how did you determine that those were kosher that's what you mentioned before it doesn't have a texture but you determine that the glycerin is kosher by speaking to people in the industry that's correct okay so this list did you ask a good question it requires a little bit of an explanation the way we do this list is follows there's some items on here with that sure that's that's right off the bat we could add to the list we we have guidelines to how we determine a product as kosher the easiest most efficient way to determine a product is Kosher for medicinal purposes is by reviewing the ingredients what I do is I sit with all these products right she said Unisom sleep tabs tablets and Unisom uh Etc Vanquish all that I actually look at the label of the product and I determine all the ingredients are Kosher now a couple questions that people might have there to within that framework there are a couple ingredients that we normally require a hexer but we allow in the medicines one of them is magnesium stearate which appears that every single almost every pill has magnesium steroid or calcium steroid or stearic acid the the good news is that there are two ways to make magnesium steer right one is vegetable one is animal the animals that kosher vegetable is kosher one can assume and number two is the amount of steer rate is is is typically bottle but magnesium steroid steering acid is not not a little bit more problematic but magnesium stearate goes in typically a less than shisham it's a it's a flowing agent it's not even you don't even need it in the product it helps the production it helps the powders flow along during the production once they're produced you don't need it anymore but it's it's in the pill right it's in the pill so one can assume magnesium stearate is either bottle shishim or vegetable based in other words the odds of it not being buckled and animal based are are small enough that again in a food we would never let it but in a medicine right one could rely on that right and I want to point out if you're machmere in this regard you basically cannot take any pills without action because everything has to make these obscure unless you know you know the percentages the other cool we had is flavors as we mentioned earlier right right as you mentioned before flavors you consume are bottled right other than that while I was looking I'm sorry while I was looking on the list I noticed here the uh the Mylanta is also with star k right that's correct that is correct that that's the reviewed review the formulations it actually has bear is a Sparky correct when it has to start counted it's good absolutely not that we're trying to push not that we're trying to push star k here well we have other agencies on there too that's absolutely right you have uh if you go to the kosher meds you know that's that's an OU product so we're anything with apps or a good answer we put up you know we want we want people to be able to know what's available Crusher you know regardless of the Hampshire um and the actor is good the other cool we have is our Caleb for for uh equipment um in medicines one could assume that even if the hot equipment was used it was and one could allow and I want to point out we sound like we're being these big McClellan here and we're throwing conscious out the window we're not we we don't give an answer that way the Mylanta for example anything with Starke we've reviewed the formula the flavors have actually the steer rates have actually the the Calum are going to be good anything with a Hatcher but again an absence of medications that are with a Hatcher as we see you know 90 of what's on there it doesn't have a hexer and if we would just put a list with action it would be you know a one-page list two-page list so we're making these these particular areas now if a company has told us that their glycerin is kosher or any other very Troublesome ingredient we have been the viral we have we have a clarified then one is allowed to be then we put it we put it on the list and that's how Tylenol got on there even though Tyler has glycerin but we we have put it on there you know for that for that sake I want to mention something or whatever so uh we used to certify a company that would add flavors to your prescription medication uh you go to the pharmacist you know the amoxicillin doesn't taste good so there were flavors that could be added that were actually Starkey kosher uh eventually the company stopped because there wasn't enough demand and we uh we sort of realized it's because when people call the Starkey like you know they call and they get the information we tell them that medicines flavors are not not a big deal so this company there wasn't a lot of demand for a kosher flavor because we uh we we you know we because of the need we would tell people they don't have to get it so we actually lost that company but okay let's take some of the of the uh of the questions here but let's go through uh Jonathan is asking a a question which uh you know you're a dad question what about Hanan the entire medicine should be also it should require 60 60 times the whole thing great question you're a day a question Tom o'clock I will briefly answer this question but I I gave a Shear on this uh um in in the Starkey cuddle in Spanish cover and BMG in Lakewood where they were learning this and and this was one of the things I by far in other words I I answered this exact question as an example uh the short answer with with without getting into the mechanics is there's um which means and I don't know if we want to spend the time to for all your listeners to understand what could happen is but basically we're lenient but perhaps itself we consider it I have synonyms it's a loss a person without it is going to feel sicker without it and therefore and it happens to say mix it at 60 would mean you can you kind of sort of buy like a you know I don't know a 12 ounce you know Big Gulp you know 32 on if you don't say if you do say Kanan here you're gonna need 60 times you're going to be giving the kid a a 12 ounce you know right so it's not traffic it has to remember we say it's permissible it's not a problem okay uh Mikhail asks if if on our list there are particular flavors listed right so what about the other flavors can you assume the company always uses the same question good question why why did you list only the cherry flavor and not the bubble gum questions so sometimes sometimes there's two reasons by most of them it was probably there because sometimes consumers if they just see let's say um um you know Motrin children's chewable tablets plain without without the flavor listed there they're going to call up and they're going to say what about grape right maybe maybe you only mean specific ones or maybe I have a great one you didn't say that so it's kind of like the rule of we want to be as clear as possible on this number two is that there are cases where when there's a different flavor there's a different formulation not only the flavor is different because we said flavors aren't going to matter but the flavor allows us to zero in on a specific item again there are cases or let's say Extra Strength I see this sometimes the formula is totally different or 24 hour are there cases you look on our list and you'll see um you know I'm looking at product goodies goodies is a is a powdered uh type of a pain reliever the cool orange powder is power of the extra strength powder is dairy so I'm calling it The Orange you can identify it you know that's the power version and the extra strength powder is Theory the orange flavor is not what makes it power of right it's just orange flavor happens to be happens to be powerful when they make the extra strength they're adding an ingredient that makes it Dairy so my way of identifying this so that the consumer knows which one's power which one's dairy or which one's kosher which one's not is because the flavor is the identifier the bottom line is if it's not on the list that with that flavor they should ask us that is correct unless it says there are certain cases where I write it without a flavor you could if there's no flavor mentioned technically you could assume that it includes all the flavors under that group but again I try to do flavors I don't always do I do see on our list we do have some store brands um again store brands are sometimes difficult to determine and sometimes they change they change um manufacturers that was one of the questions do we have store Brothers on the list you do have store brands not a lot I think I added it when I was desperate meaning there was a period where certain things weren't available there was a period where I think some of the meal products were were they I think it made itself recall or something like that and therefore it was off the shelf and people were desperate for uh ibuprofen so I I looked at these so like the the target um and the Walgreens ibuprofens I have the exact names on the list you know the last I checked with culture but those really need to be checked more often because store brands again this is the main problem with store brands is that they're made companies switch those Target gets a better deal they make it in company a in California and now they get a better deal from some company in Montana so they switch manufacturers and maybe even you know formulations and that means a different product do you have the Target brand uh Tylenol there only chewable up and up children's ibuprofit chewable tablets grape the last we checked they were fine ibuprofen Walgreens children's chewable tablets the last we checked they were fine also I see you don't have the liquid okay no liquids could be very hard to do because again I got to get the statement from them that it's kosher glycerin and that's not an easy statement to get because they don't make it themselves Walgreens doesn't make it they make it at a third party manufacturer that makes uh private labels private label products um Este is asking a very pertinent question what about prescription medications I think we actually you did discuss that right yeah typically prescriptions are for for an infection um and except maybe like acne medicine is not an infection right or sometimes you know but typically most you know most prescriptions are given for some sort of infection or problem and therefore in particular now if your regular medicine that you've been taking is not available and your doctor recommends you know medicine B take it right as you mentioned you could have uh gelatin capsules right that would be a problem okay the dog capsule the very very common in both prescriptions over the counters and that's I'm glad you brought that up um and if we could before we answer that question we spoke a lot about liquids chewables are tricky because um again you want to look at the ingredients again if it's antibiotic take it if it's over the counter then you want to look at the ingredients and determine um what what's in there if the ingredients are cautious based on our specifications is how we determine you know what's caution you can we can make on steer rates and so on then it's doable is fine if the chewable says good gelatin in it and it's just over the counter then then you have a big problem you really have to ask a rub before you take that because now you're eating something that's Trey for for a headache you know what's the answer for that for just a headache or runny nose or a little cough so those chewables you know could be an issue now your rough maybe answer sometimes it's so bitter and it's awful right it's not a normal way to eat people don't eat it's a bitter pill again that's up to my Raw on a particular product now let's get back to your question if you swallow swallowing um and actually had a question about the Jewish swallowable that was one of the questions that came in in advance so I guess I'll cover that also but let's talk about swallowing the swallowable let's let's um start with this aloha is mutter I think it's mutter um um in that area something is that means it's eaten in an abnormal manner it's not a normal way to eat it something that tastes terrible would be would be considered that if you have a let's say let's talk about a liquid gel all liquid gels are made of gelatin the outside gelatin is there is liquid inside in um uh it it is safer in the truth is safe for some true safer says what yep go ahead says that if something is made to swallow it's meant to swallow that's how you make it then and you're swallowing it by definition it's going to be a uh so all these swallow tablets on the market right all these all these items on the market that you swallow or it's like right um certainly could take it that's right foreign so now you need to take and all you have available there is this Tylenol liquid gel which is trafe and therefore it's permissible to swallow because you're sick now if you if you if you just have a medical center you want to ask your rob you don't feel well is that something that that uh that you want to you want to take uh you know that's something you need that's it's by the way um Zion and um your day is is equivalent hey um that's there and um the shock there is gimmel uh elaborates on that but that's you know they said I quoted the wrong the wrong thing before so anyway that's the answer if I swallow um you know if someone just has a mehush then under certain conditions also one might be able to swallow again that that's so I speak about this in my article you know that I have I have an article on glucosamine which is not culture and other remedies that are um people are in pain um they have other illnesses uh osteoporosis and so on you know we have a lot we have actually several articles one medication in general one medication that really that is from the OB GYN from nutrition gynecologist type of medications as well as an article relating to um you know osteoporosis and other types of pain management um medications that's a good point they can go to the Starke website and they can see the um the Articles you have on on medicines and and some of the information that we've been discussing is there as well right that's correct that's right okay um well I I also so you're talking about swallowing the pills and how uh the gel the gelatin capsules and so on how that may be okay but sometimes they come in in a a gel cap that can be pulled apart and the and the the medicine is inside and you don't need to take it in a gel cap sometimes you can mix it in applesauce you have to ask your pharmacist right if that's if that's correct yeah well okay so there you have be careful um so this if you can mix it that you have to check with pharmacists because some medications Time released right you're gonna you're gonna mess up the whole uh the whole structure of the medicine however you know hard capsules hard gel capsules are a big discussion reminders of the opinion that we consider it and therefore it fits into those guidelines if your highlights okay if you're not a pilot you know it's less push it um there are those that say that the gel en capsule in a hard shell which powder inside is it's difficile it's it's a piece it's a piece of wood right it's totally lost any you know it's it's it's my bottom it's totally inevitable I I can't trust it that's why I used the example before of a liquid gel there it's a soft pliable gelatin which is a much you know I'll use the word tastier for lack a better term versus the hard shell which is it's the rack so there are pricing that would allow many places to allow off the cuff Dad what you could do if you want to if you don't want to take the gel cap and I think I'll double check with your doctor but they do sell veggie caps on the market right and if you just have a powder in your gelatin capsule and you could open up the gel cap and put it into a a veggie cap you know that you could do that and they are cellulose capsules sell those capsules the pharmacy pharmacists sell the capsules as is and then most of them are Kosher you can look you can see the label so there you're getting the inside without putting a bitter powder in your mouth without messing up the time release again I'm going to say I'm not a doctor I'm not a pharmacist so before you do that double check with your pharmacist they're talking about transferring what's inside a hard gel cap into a kosher gel cap a kosher cellulose cap or veggie cat or a kosher cellulose cap correct and then screwing it closed and then taking it again I'm not going to write a blank check that you could do that every time oh see I know what you're doing because if if it's if it's a very constant medicine I would mess around with again if you're a Kyla and you have an infection and you have all the heart issues don't play games because you're going to miss some of it so it falls out you're a little bit uh you know like when you pour the wine or you know or when I'm pour the wine out of the Packer into the other kite some of it gets uh you know it falls on the table and so on don't play well but you're dealing with something that's you're not really it's some supplement let's say and it's it's kosher inside the contents are Kosher it's a it's a it's a gel cap this is a supplement that you're just taking for to maintain health and so on why take the gel cap transfer it to a cellulose cap double check with your doctor and pharmacist to make sure that you could do it and you're good to go Leo is asking are the medicines all the medicines sold in the Seven Mile Market are they all okay I know seven my seven mile marker of course is the is the store here um they they no we don't certainly vouch and they I think they try to get in or once while they'll ask me certain things they've had periods of time where they had I think pace of time with things on the list they put out our list but I I don't put you know I don't believe anyone vouches for everything that's there and they really can't because there's certain medications they're just hard to get kosher and um therefore I don't believe everything there is is they do have a good selection of of uh of kosher uh vitamins and I just bought this there yesterday zinc lozenges right definitely they have as well as Sydney Pharmacy also pharmacies or a full Pharmacy they all have a full line right of kosher vitamins that are you know that are available so remember let's just review for a second let's just that it would come to the end of our webinar let's review the uh the bottom line I can't get if the people should look at our list to see which are acceptable uh I put out I I posted the link uh before that they can get to straight to our site um if you can't find those like Tylenol and Motrin because of the uh the shortage then uh you're buying off brand um uh let's say uh a fever medication or a pain reliever medication uh you could you could dilute it one teaspoon in in uh two ounces of some other liquid right correct which is one to twelve ratio one to twelve ratio and then if you are uh if you're giving it to your children and they won't take it uh so you defer to the the rough and an absence of the rub you said that they should uh if it's very necessary then you know it's the middle of the night and it's a high fever then they could uh you know they could take it is that right again because we're determining that suffix icon at that point right okay um So Adam says that unrelated he has your safer the Intriguing intriguing world of Jewish time and he's giving you thank you for buying it tremendous work thank you so let's give that a a push their behavior is the uh distinguished author of A Couple Of Swarm on on zamanim on Jewish time and his latest work is is as we said the Intriguing world of Jewish time I guess you can get it on Amazon is it local bookstores Israel Israel Bookshop cases on their website they have it and Amazon has it as well or okay so on that no let's just to end off the uh the webinar do you have any any tidbits for us in with your your other one of one of your other you know Hobbies let's say of my name is there anything going on this year that's interesting that's um unique unusual for the coming Jewish year so we actually had um people who everyone noticed this past Shabbos was in possible because we said would say and and yeah the other way um right so if you had if you if you had the Chevy Broncos then even more it was even longer right so anyway four out of the last five hanukkahs we had this long expansion so people say oh yeah we do this all the time not so fast because we're not going to have that long expansion for another three years the next time will be Hanukkah stuff should pay Bob which is 20 25. so three years from now and after that we're gonna have the old time record for the longest time and that's going to be 14 years until 2039. wow so as I said the following if you have if you have a three-year-old so in three years he's gonna be six so six-year-olds typically don't bench full bench again if they do to say all these Shabbos is a lot so if you have a three-year-old who was born in 2019 they're going to be 20 years old and right 2039 before they experience this benching of it's pretty amazing the 20 years I say wow the longest benching that exists and and they will never have had it because again between 2025 and 2039 if you don't have it not going to happen it doesn't exist and then that not I'll end with what I said over on Shabbos from Chicago towels where I was able to learn by his father and the other you know he had last year he gave a schmooze they published his Muslim and and shirum and in the schmoozy noted that last year this past month says Shabbos we had the longest man esri foreign every so often last time was 1994 the next time will be 2089 it's a 95-year break in in Hutzel Arts we had the most rarest Monastery which was which was the same brother because it was before December 4th before the change of December or something December 5th it was early so that combination happened in 1899 1994 and 2089. so he mentioned that he was learning energy straw at the time and someone mentioned to him that hutzler they have this and he says even better and they said to himself no everything has to say yes but he said more than that everybody will tell you that but he said that brings down that every is different because everyone else you think of something a different situation a different need and my shortness is different than yours the entire average of every person in the world have no snowflake every snowflake's different but your Fila is going to barcelon every deal is different so it's not only the one that has this unique combination which I always fascinatingly enjoy talking about but really today's video that we're going to dive in is a whole different Stratosphere of itsfila today we don't have to wait we don't have to wait for 28 this past year but this is what he said in the schmooze last year I think it's a beautiful thoughts thank you very much Robert Heber and I want to uh thank you everyone for joining uh we had a nice turnout and again you can get also we had the people from America's thrall all over uh all over the world really um and you can get uh the uh Archive of this on our website star-k.org and uh and on our Vimeo Channel and on your podcast the kosher conversation if you have any questions that weren't answered here uh you can reach us at 410-484-4110 again 410-484-4110 or our email is info at Star Dash K dot o r g info at star-k.org our very busy front desk um we'll we'll we'll we'll be able to get back to you uh with with the answers and um you know if if your question warrants needs rubber heber's uh assistance then they'll put you through to teraby ever any any final view yeah go over for all the great work for all you listeners right Goldberg is in charge of our front desk and all the great information that comes out in a very clear concise manner with with of course the behind him and sock and and the input of all the rabbana minister K who each Rob has their own expertise and therefore front desk is answering shyla's in in an array of areas and really Goldberg puts it all together because it complicated knowing he's the expert of the expert thanking all the experts and becoming the expert of experts for the experts to be able to get that great information and again everyone should remain healthy gesund and those who are ill should have certainly ever fuslima um uh is there Aaron's asking is there a way to ask questions via text or WhatsApp so not yet because it's an interesting question I mean we could make it available but uh one more thing wait a second round my head but I forgot there's one more thing here that I I forgot to to show this I saw this uh this from uh from uh from London the London Rabb in it and basically what it says here is that there's a shortage of call visceral formula and they wanted to to make sure that people should should give the kids the formula that they need even if it is um they said parents should not be mahmir not be strict about it because I guess the other option is not to give them formula at all and they miss out on something what what do you think about this or whatever I mean certainly I mean you know the college formula is relatively new newly available it used to be if you wanted me to 12 formula you gave them power of the power of versions uh you know non-milk versions but obviously um you know the milk ones certainly have have their benefits now that coffee soil has become available so now again once you get used to something and now you want to scale back um it becomes it becomes a major issue um of of holy straw so there is also had been a very form of shortage and we're seeing that here also you know somewhat it has come up and again it gets an issue the regular baby formulas are pretty straightforward it gets an issue in some of the more uh sophisticated or specialty baby formulas a lot of babies can't properly Digest the the you know the enzymes that are being put into the into the formulas so they put artificial enzymes in there some of those artificial enzymes could be not Kosher nonetheless very often they're bottle and so on so we we don't have a list per se we have an internal list uh that we work off of so again certainly you know it's push it a baby that needs formula certainly could have the whole stop like I say till till recently baby formula that was obviously wasn't even available okay this is something that I thought I thought was interesting based on the shortage okay well thanks again Rabbi Heber and thank you all for for joining and have a have a great day take care bye-bye thank you