Table 1.
Incidence of off-label drug use
| Class of medication | Off-label medications | |||||
|---|---|---|---|---|---|---|
| Total | Evidence n (%) | Indications | Low/no evidence n (%) | Indications | ||
| Gastrointestinal | Pantoprazole | 273 | 273 (100) | Drug-induced gastrointestinal disturbances, prophylaxis | – | – |
| Ondansetron | 292 | 292 (100) | Drug-induced nausea and vomiting, prophylaxis | – | – | |
| Racecadotril | 11 | 11 (100) | Diarrhea, acute | – | – | |
| Antiasthmatic drug | Salbutamol | 52 | 43 (82.7) | Chronic obstructive pulmonary disease | 9 (17.3) | Bronchospasm–mechanical ventilation |
| Opioid | Fentanyl | 34 | 34 (100) | Analgesia for mechanically ventilated patients, procedural sedation–analgesia | – | – |
| Vasodilator | Nicorandil | 18 | 18 (100) | Congestive heart failure, ischemic heart disease, stable angina, unstable angina, variant angina | – | – |
| Steroid | Budesonide | 28 | 28 (100) | Chronic obstructive pulmonary disease, asthma–pregnancy | – | – |
| Antiarrhythmic | Digoxin | 12 | 12 (100) | Cor pulmonale–myocardial infection, supraventricular arrhythmia, supraventricular tachycardia, recurrent; prophylaxis | – | – |
| Cardiovascular | Calcium gluconate | 10 | – | – | 10 (100) | Hyperkalemia |
| Anti-infective | Oseltamivir | 10 | 10 (100) | Community-acquired pneumonia | – | – |
| Meropenem | 10 | 10 (100) | Hospital-acquired pneumonia, community-acquired pneumonia | – | – | |
| Azithromycin | 18 | 18 (100) | Community-acquired pneumonia, lower respiratory tract infection, prophylaxis | – | – | |
| Metronidazole | 16 | 11 (68.7) | Operative procedure on head—postoperative infection, prophylaxis | 5 (31.3) | Diarrhea, persistent | |
| Teicoplanin | 5 | – | – | 5 (100) | Community-acquired pneumonia, hosptal-acquired pneumonia | |
| Vancomycin | 2 | 2 (100) | Bacterial meningitis, nosocomial pneumonia | – | – | |
| Antiepileptic | Levetiracetam | 21 | 21 (100) | Partial seizure, monotherapy in newly diagnosed or untreated epilepsy, seizure. Neuroprotective, prophylaxis seizure | – | – |
| Antifibrinolytic | Tranexamic acid | 5 | 4 (80) | Postpartum hemorrhage; prophylaxis, gastrointestinal hemorrhage | 1 (20) | Epistaxis |
| Anticoagulant | Aspirin | 13 | 13 (100) | Angina pectoris, NSTEMI, venous thromboembolism, recurrent, prophylaxis, myocardial infection prophylaxis | – | – |
| Heparin | 41 | 41 (100) | Acute STEMI, angina pectoris, deep vein thrombosis, acute coronary syndrome, cerebrovascular accident | – | – | |
| Enoxaparin | 18 | 13 (72.2) | NSTEMI, cerebrovascular accident | 5 (27.8) | Arterial thrombosis | |
| Warfarin | 3 | – | – | 3 (100) | Portal vein thrombosis, cerebral venous sinus thrombosis | |
| Antihyper lipidemic | Atorvastatin | 11 | 11 (100) | Coronary arteriosclerosis, cerebrovascular accident, prophylaxis, chronic heart failure | – | – |
| Diuretic | Furosemide | 16 | 16 (100) | Acute renal failure | – | – |