Fourteen commonly used medications that K often are prescribed "off-label"--that is, for uses for which the medications do not have FDA approval-merit immediate priority for additional study, according to researchers from Stanford University and the University of Illinois at Chicago. Questions remain regarding the safety and efficacy of these drugs when they are prescribed off-label.
The drugs in the chart are listed in the order in which researchers believe they should be studied (based, in part, on an analysis of volume of off-label drug use with inadequate evidence supporting that use).
According to researchers, this list is only a small sampling of drug uses that are not supported by sufficient scientific evidence.
Rank, Drug (brand name), Most common on-label use, Most common off-label use*
1, Quetiapine (Seroquel), Schizophrenia, Bipolar disorder maintenance
2 Warfarin (Coumadin), Atrial fibrillation, Hypertensive heart disease
3 Escitalopram (Lexapro), Depression, Bipolar disorder
4 Risperidone (Risperdal), Schizophrenia, Bipolar disorder maintenance
5 Montelukast (Singulair), Asthma, Chronic obstructive pulmonary disease
6 Bupropion (Wellbutrin), Depression, Bipolar disorder
7 Sertraline (Zoloft), Depression, Bipolar disorder
8 Venlafaxine (Effexor), Depression, Bipolar disorder
9 Celecoxib (Celebrex), Joint sprain/strain, Muscle aches
10 Lisinopril (Prinivil, Zestril), Hypertension, Coronary artery disease
11 Duloxetine (Cymbalta), Depression, Anxiety
12 Trazodone (Desyrel), Depression, Sleep disturbance
13 Olanzapine (Zyprexa), Schizophrenia, Depression
14 Epoetin alfa (Procrit, Epogen), Chronic kidney failure, Anemia associated with chronic disease
Better Medication Instructions
When researchers studied 2.346 older adults who took the blood thinner warfarin (Coumadin), those who received written instructions or written plus verbal instructions were 60% less likely to suffer a serious bleeding problem-a possible side effect-over the next two years than those who received only the instructions printed on the prescription bottle.
Self-defense: Ask for both written and verbal information on the proper use of medication.
Outrageous! Generic Drugs Don't Always Work Like Brand Names
The Food and Drug Administration (FDA) requires that generic drugs carry labels identical to the labels of their corresponding brand-name drugs--but this can lead to errors.
Example: There is evidence that the generic version of the antidepressant Wellbutrin XL is more quickly absorbed than the original.
Self-defense: If you switch to any generic from any brand-name drug and you notice a difference, let your doctor know immediately.