Almost all medications carry some risk of side effects, but health care providers say that with proper communication and follow-up, off-label use can be everything from a chronic pain buster to a smoking-cessation aid.

“Off-label prescribing can be instrumental to delivering quality care to patients, as long as providers allow patients to make the ultimate decision about use of a drug,” said Reamer Bushardt, an assistant professor in the Medical University of South Carolina’s physician assistant program who also holds a doctorate in pharmacy. “If a patient consents and is closely monitored, there is strong rationale and potential benefit for patients.”

On the flip side, off-label prescribing often has plenty of unknowns, especially when it comes to drugs that act on the brain. The consequences can be dire, catching physicians and drugmakers in a legal crossfire. More than 2,000 families are taking legal action against Pfizer, for instance, alleging that off-label use of the epilepsy drug Neurontin led to severe depression and suicidal actions in their loved ones.

Since no law requires doctors to tell their patients that a prescribed therapy is off-label, the onus is on individual health care providers to educate patients, and patients to ask savvy questions about the drug’s history. They should understand their therapy early on, Bushardt said, not after they get spooked to see they’ve been prescribed something that says it’s for seizures when they actually have migraines.

http://www.charleston.net/stories/?newsID=67711&section=science