Versatile meds
Medications can have multiple purposes, as President Donald Trump likely knows. Trump takes finasteride — which can be used to treat an enlarged prostate and can be used to maintain hair growth in men — his longtime physician, Dr. Harold Bornstein, told The New York Times. The drug is sold as Propecia to treat male pattern baldness, and it’s one example of a medication that’s been approved by the Food and Drug Administration for two purposes, says Dr. Ken Williams, a hair transplant surgeon and founder of Orange County Hair Restoration in Irvine, California. Other drugs are approved by the FDA for one condition but used for others. This is known as off-label use and is ethical, legal and a common practice in medicine, Williams says.
Talk to your physician.
In the U.S., 21 percent of all prescriptions are off-label, says Dr. Archelle Georgiou, author of the 2017 book “Healthcare Choices: 5 Steps to Getting the Medical Care You Want and Need.” A study published in November 2015 in JAMA Internal Medicine compared prescription drugs used for off-label indications with and without strong scientific evidence to back the alternative use. When that evidence is lacking, there’s a 54 percent increase in adverse drug events, which can include such things as hallucinations or weight gain. “If you’re considering using an off-label drug, check with your physician about possible side effects and how it may interact with other medications,” says Dr. Sarah Yamaguchi, an obstetrician-gynecologist at Good Samaritan Hospital in Los Angeles. Here are eight medications that have multiple uses:
Amitriptyline
The antidepressant amitriptyline is also used to prevent and help reduce the frequency of migraines, says Dr. Vernon Williams, director of the Kerlan-Jobe Center for Sports Neurology and Pain Medicine at Kerlan-Jobe Orthopaedic Clinic in Los Angeles. Some physicians prescribe it off-label for people who have difficulty sleeping, too, he says. It can cause such side effects as confusion, numbness, skin rash, nausea, blurred vision, tingling in your arms and legs, headache, constipation and diarrhea. Research suggests it can also cause weight gain and increased blood pressure, which are risk factors for cardiovascular disease. It should be safe in low doses.
Aspirin
An over-the-counter medication, aspirin is used to treat pain, inflammation and fever, but some doctors also recommend it on an off-label basis to prevent heart attack and stroke. Aspirin helps prevent platelets from clumping, which can lead to blood clots. When someone suffers a heart attack, blood clots form in narrowed arteries and block the flow of blood to the heart. Such clots can contribute to heart attacks and strokes. The FDA supports the general use of aspirin by people who’ve already had a heart attack or stroke or have evidence of coronary heart disease. Aspirin could cause bleeding in some people. Consult your doctor whether aspirin is right for you and at what dosage.
Atenolol
Many doctors prescribe atenolol to treat angina (a condition marked by severe chest pain) and to lower high blood pressure, which can lead to a heart attack or stroke. This medication acts on beta receptors and blocks the affects of adrenalin, Georgiou says. Some physicians prescribe it on an off-label basis to those with stage fright; taking it immediately before a public performance decreases heart rate and, in turn, feelings of anxiety. The medication can cause side effects such as dizziness, lightheadedness or nausea.
Birth control
The primary function of birth control pills is, of course, to prevent pregnancy, but they can also be used to fight acne, Georgiou says. Oral contraceptives “turn off” hormones in the body, which means oil glands that can cause acne breakouts are not stimulated, Georgiou says. Birth control pills are also used to treat the pain associated with endometriosis, a painful, chronic disease in which tissue typically found inside the uterus grows in other parts of the body, potentially causing painful lesions. Possible side effects of taking birth control off-label include nausea, breast tenderness, headache, weight gain, depression, decreased libido and blood clots.
Gabapentin
Gabapentin is an anti-epileptic medication, or an anticonvulsant. It’s also approved by the FDA to treat neuropathic pain; for example, it can be taken to treat the pain caused by herpes zoster lesions, or shingles, Vernon Williams says. The medication is also used off-label to help stabilize some people with mood disorders. Possible side effects include rashes and, in rare cases, thoughts of suicide, research has shown.
Remeron
Some doctors prescribe the antidepressant Remeron on an off-label basis to people who need to gain weight, Vernon Williams says. It prompts a voracious appetite for carbohydrates in 20 to 30 percent of those who take it. Whether it’s used for its FDA-approved purpose or as an off-label treatment, the medication can cause dizziness and dry mouth.
Minoxidil
The FDA originally approved minoxidil as a medication to treat high blood pressure, Ken Williams says. Then physicians noticed it caused new hair growth on some areas of the scalp that had been balding, prompting researchers to explore this side effect. In 1988, the FDA approved minoxidil to treat male pattern baldness; it’s the active ingredient in Rogaine, which became a widely-known product. Four years later, the FDA approved minoxidil to treat female pattern baldness.
Sildenafil
Sildenafil is an active ingredient in Viagra, a product approved by the FDA to treat erectile dysfunction. It’s also used in Revatio, an FDA-approved drug to treat pulmonary arterial hypertension, in which there’s a narrowing of the arteries leading into the lungs. When used for erectile dyfunction, Viagra could cause a long-lasting erection, sudden vision loss in one or both eyes or sudden hearing loss. Revatio shouldn’t be used by children. When used to treat pulmonary arterial hypertension, it could cause headache, flushing and other effects, which are typically transient and mild to moderate. While pulmonary arterial hypertension is technically a cardiovascular disease, the most common underlying causes are lung disease, congenital and heart valve disease; in many cases the cause is unknown, Georgiou says.
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8 Medications That Treat Multiple Conditions originally appeared on usnews.com
