Off Label Use Part II

We began the topic of off label drug use in the previous post. So here are a few more prescription drugs that have multiple uses.  Let’s start with Actiq (fentanyl citrate), a controlled substance, is used off-label to treat moderate to severe chronic, non-malignant pain. In the United States it is approved for management of breakthrough pain in cancer patients 16 years of age and older who are tolerant to around-the-clock opioid therapy. Next on the list of off label use is Bevacizumab (Avastin) is an angiogenesis inhibitor that slows the growth of new blood vessels which is effective against cancer. Avastin has also been used against wet age-related macular degeneration (eye disease that causes vision loss), as well as macular edema which occurs when fluid and protein deposits collect on or under the macula of the eye (a yellow central area of the retina) and causes it to thicken and swell (edema).

More Off Label Drugs

Buprenorphine is a synthetic opioid used in combination with naloxone to treat addiction. It has been shown experimentally to be effective against severe, refractory depression. Carbamazepine, or Tegretol is an anticonvulsant. It works by decreasing nerve impulses that cause seizures and pain. In terms of off label use, it has been used as a mood stabilizer and is accepted treatment for bipolar disorder.

Gabapentin, approved for treatment of seizures and nerve pain caused by shingles. It is used off label for a variety of conditions including bipolar disorder, essential tremor, hot flashes, migraine prophylaxis, neuropathic pain syndromes, phantom limb syndrome, and restless leg syndrome.

ADD/ADHD

Stimulants such as Amphetamine (Adderall) and Methylphenidate (Ritalin) are used to treat childhood attention deficit disorder.   Atomoxetine (Strattera), a non-stimulant norepinephrine reuptake inhibitor, is indicated (in the United States) for adult ADD. Strattera has been used off label to treat binge eating disorders, bed wetting and even weight loss. In Australia dextroamphetamine is indicated for adult ADHD treatment. This one is one of those banned sports chemicals because dextroamphetamine has been shown to improve stamina, endurance, and reaction time. These prescription medications are used off label to treat various forms of depression, usually in conjunction with a standard antidepressant drug.

Now lets talk about low-dose naltrexone which is cheap without side effects for the treatment of alcohol dependence. In some situations, it has been used to treat cancer and autoimmune diseases like focal segmental glomerulosclerosis (kidney disease). Doxepin has is classified to treat depression, anxiety, and sleep disorders. Due to its strong antihistamine properties, add the treatment of  treat Angiodema and severe allergic reactions to the list.

Have you been prescribed any medications for off label use?