Off-Label Prescriptions: Risks and Benefits

In Greek mythology, the goddess Panacea was said to have a potion which could cure all diseases, and her name is even mentioned in the first line of the Hippocratic oath: "I swear by Apollo the Healer, by Asclepius, by Hygeiea, by Panacea, and by all the gods and goddesses, making them my witnesses, that I will carry out, according to my ability and judgment, this oath and this indenture."

So far, no one has invented a pill that can cure everything, but for years doctors have been prescribing drugs for "off-label" uses, meaning the Food and Drug Administration (FDA) permits physicians to prescribe approved medications for conditions other than those they were designed to address. 

Although the practice is very common (up to one-fifth of all drugs and nearly 31% of psychiatric drug prescriptions are for off-label uses), many patients don't realize their medicine was intended and approved for an entirely different condition. It's perfectly legal, though, and the practice can be beneficial or even life-saving, especially when patients have exhausted all other approved options. (The drug companies also find it quite beneficial as well—sometimes sales for off-label use exceed sales for the drug's stated purpose.) But there is some debate about off-label usage, particularly when there is no scientific evidence to support it.  

One example would be Fen-Phen. The FDA approved both fenfluramine hydrochloride and phentermine hydrocholoride as separate, individual, short-term treatments for obesity, but doctors starting prescribing them together, based on a few medical articles that described dramatic weight loss using the drug cocktail. Unfortunately, it also caused potentially fatal heart problems, which eventually led to Fen-Phen being taken off the market and legal damages of more than $13 billion.  

The library has a great selection of trustworthy medical databases and resources, such as the Gale Encyclopedia of Prescription Drugs (available in Gale Virtual Reference with your DPL card), which mentions any off-label uses in its drug overviews and also includes side effects, interactions, dosages and other resources such as websites, articles and organizations.

The Merck Manual Consumer Version is available to everyone and has complete, easy-to-understand information about prescription drugs, including a pill identifier, drug interactions and off-label uses. There's also a news and commentary section featuring articles such as "A Bone Drug that Treats Baldness?"

Got questions? Ask Us or call Reference Services at 720-865-1363! 

Written by Lisa on May 9, 2018

Comments

SuzanneK on May 10, 2018

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Great information to know!

SuzanneK on May 10, 2018

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Great information to know!

Janeen on May 14, 2018

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Where are the risks and benefits mentioned in the headline?

FrankW on May 14, 2018

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Hey, I'll try some of that WAY-316606!

LF on May 14, 2018

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Yes, that should be very beneficial for your bones.

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