Skip to main content

Is My Medication FDA Approved for Off-label Use?

Yes, with an explanation.  Of course, if your doctor is prescribing a medicine, it must be approved by the Food and Drug Administration (FDA). But, it may not be approved for your specific condition.  Let me explain.

The FDA is charged with determining when a drug is considered safe and effective and can be brought to the marketplace.  Bringing a drug from the research bench to the pharmacy is a complex and arduous process that takes many years, even when it’s running smoothly and on schedule.  As you might expect, there are often unforeseen obstacles that will extend the timeline to approval when the FDA requires more studies to address their concerns.  Often, the drug must be abandoned at some point in the process, after millions of dollars of R & D investment.  We should consider this reality before we demonize PhRMA reflexively, which has become sport today. 

Guardians of Safety

When a drug is ultimately approved, this approval is only for a specific medical indication.  For example, a new antibiotic may be approved to treat a urinary tract infection (UTI). Physicians, however, are free to prescribe any medicine for any reason.  For example, a physician may prescribe the ‘UTI medicine’ to treat a pneumonia, if the physician believes this would be an effective option.

Does the FDA object to this ‘off-label’ use?  Not at all.  They recognize that off-label use is often appropriate and standard care that is supported by medical evidence.  Patients should recognize that most prescriptions that we physicians write are for off label use.  Moreover, if you ask your doctor the next time you are in the office what are the official FDA approved uses of your medications, I think that he will stumble in his response.  Why?  Because most of us don’t know the official FDA indications of many of your medicines.  I know this makes us sound sloppy and incompetent, but we’re more focused on choosing the right medicine than on whether it’s ‘approved’.   Similarly, patients should be more concerned if the choice of a drug is rationale than if the FDA has approved it for your particular condition.  Moreover, some illnesses have no FDA approved drugs for them, yet there are effective medicines available, which we physicians will prescribe.

Find out if your medicines are off-label or approved.  You might be surprised.  Remember, off-label may be on-the mark.  

Comments

Post a Comment

Popular posts from this blog

Becoming a Part-Time Physician

Next month my schedule will change.  I will henceforth be off on Fridays with my work week truncated to Monday through Thursday.   I am excited to be enjoying a long weekend every weekend.  And while the schedule change is relatively minor, this event does feel like an important career moment for me.  It is the first step on a journey that will ultimately lead beyond my professional career.  It is this recognition that makes this modest schedule modification more significant than one would think it deserves.  As some readers know,   my current employed position has been a dream job for me.   Prior to this, I was in a small private practice, which I loved, but was much more challenging professionally and personally.   My partner and I ran the business.   Working nights, weekends and holidays were routine for decades.   On an on-call night, if I slept  through until morning, I felt as if I had won the lottery.   And w...

When Should Doctors Retire?

I am asked with some regularity whether I am aiming to retire in the near term.  Years ago, I never received such inquiries.  Why now?   Might it be because my coiffure and goatee – although finely-manicured – has long entered the gray area?  Could it be because many other even younger physicians have given up their stethoscopes for lives of leisure? (Hopefully, my inquiring patients are not suspecting me of professional performance lapses!) Interestingly, a nurse in my office recently approached me and asked me sotto voce that she heard I was retiring.    “Interesting,” I remarked.   Since I was unaware of this retirement news, I asked her when would be my last day at work.   I have no idea where this erroneous rumor originated from.   I requested that my nurse-friend contact her flawed intel source and set him or her straight.   Retirement might seem tempting to me as I have so many other interests.   Indeed, reading and ...

A Patient's Loyalty to his Doctor

 A few days before preparing this post, I greeted a patient who was about to undergo her 5 th colonoscopy.  I was the pilot for the 4 prior excursions.   “You should’ve signed up for the rewards program,” I quipped.  “This one would’ve been free!”  Our patients, with rare exceptions, enjoy our light atmosphere seasoned with some humor.  This does not detract from our seriousness of purpose and commitment to their welfare, and they know it.  Our endoscopy team is comprised of outstanding medical professionals. I care for many patients for whom I have performed all of their colonoscopies, which may exceed 10 procedures.   I recently performed an examination on one of my colitis patients who has unique findings which have remained stable for years.   I know his colon as well as I know his face!   Indeed, if I were shown a photo of his colon, I would immediately be able to name the individual.   So, when we gastroenterologists c...