PEBC: Theme of the Week: Using a Medication for a Different Route [Part 1]

When medications are approved by Health Canada, they are intended for certain approved indications called “on-label” use. However, prescribers may use medications for other purposes, which are called “off-label” uses. Although there are no large clinical trials investigating these off-label uses, or the manufacturer has not submitted data to support it, there may be a need and use for certain diseases. Here are the some unusual off-label routes for liquid preparations:

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1) Timolol eye drops: originally used to lower intraocular pressure in glaucoma, these drops can be applied topically to the skin for the treatment of infantile hemangiomas in babies. These benign lesions are bright red spots made of blood vessels, and shrink in response to timolol.

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2) Atropine eye drops: these eye drops are anticholinergic, which means it can be used to treat clozapine-induced sialorrhea. Atropine is used in the mouth to dry up excess saliva and drooling caused by clozapine.

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3) Budesonide nebules: a corticosteroid liquid originally used in a nebulizer machine to treat asthma, this can also be mixed with saline in a nasal irrigation bottle and used as a sinus flush to treat nasal inflammation.

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4) N-acetylcysteine: this injectable liquid is usually used as a reversal agent for acetaminophen overdoses. However, it can be swallowed orally as a form of kidney protection against intravenous contrast media during diagnostic procedures. Note: N-acetylcysteine has a very bad taste, so it is recommended to mix with cola beverage.

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Stay tuned for Part 2 where we explore more off-label routes!




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