TABLE 4.
Most common medicines dispensed off‐label by presence of age‐appropriate recommended doses in prescribing guide, Australian Medicines Handbook Children's Dosing Companion (AMH CDC). Some medicines may fall into both categories for a given age group depending on the cut‐offs for dose recommendations as listed in Table S6
| Age group | Off‐label with age‐appropriate recommended doses in prescribing guide (AMH CDC) | Off‐label without age‐appropriate recommended doses in prescribing guide (AMH CDC) | ||||
|---|---|---|---|---|---|---|
| Medicine name and route of administration | Dispensings per 1000 child‐years | Prescribed by specialist, % | Medicine name and route of administration | Dispensings per 1000 child‐years | Prescribed by specialist, % | |
| <1 year | TOTAL | 177.2 | 12.1 | TOTAL | 52.8 | 18.9 |
| hydrocortisone acetate (topical) | 76.1 | 5.7 | ranitidine (oral) | 17.4 | 21.2 | |
| omeprazole (oral) | 52.7 | 23.9 | methylprednisolone (topical) | 6.0 | 13.9 | |
| framycetin sulphate (eye drops) | 10.4 | 0.6 | salbutamol (oral liquid) | 5.8 | 0.3 | |
| salbutamol (inhaled) | 5.4 | 1.7 | fluticasone propionate (inhaled) | 4.9 | 25.4 | |
| azithromycin (oral) | 5.3 | 6.2 | lansoprazole (oral) | 4.5 | 30.3 | |
| ranitidine (oral) | 5.3 | 21.4 | roxithromycin (oral) | 3.9 | 2.8 | |
| timolol (eye drops) | 4.7 | 67.8 | pantoprazole (oral) | 1.7 | 47.2 | |
| ondansetron (oral) | 3.5 | 2.1 | topiramate (oral) | 1.1 | 32.7 | |
| epinephrine (auto‐injector) | 2.6 | 58.3 | dexamethasone (eye drops) | 0.7 | 43.4 | |
| ipratropium (inhaled) | 1.6 | 5.5 | ipratropium (inhaled) | 0.5 | 4.0 | |
| 1–5 years | TOTAL | 69.4 | 16.8 | TOTAL | 38.1 | 22.7 |
| hydrocortisone acetate (topical) | 29.4 | 3.6 | fluticasone +salmeterol (inhaled) | 13.3 | 8.6 | |
| framycetin sulphate (eye drops) | 6.0 | 2.3 | salbutamol (oral liquid) | 6.8 | 0.4 | |
| clonidine (oral) | 3.1 | 70.6 | methylphenidate (oral) | 3.6 | 88.6 | |
| ondansetron (oral) | 2.6 | 1.6 | dexamfetamine (oral) | 1.1 | 90.2 | |
| levetiracetam (oral) | 2.5 | 44.2 | pantoprazole (oral) | 1.1 | 57.8 | |
| oxycodone (oral) | 2.3 | 67.7 | fluoxetine (oral) | 0.8 | 15.1 | |
| ipratropium (inhaled) | 2.1 | 4.0 | risperidone (oral) | 0.8 | 81.3 | |
| ranitidine (oral) | 1.8 | 12.1 | beclomethasone (inhaled) | 0.8 | 77.5 | |
| hydrocortisone (oral) | 1.6 | 44.9 | budesonide +formoterol (inhaled) | 0.7 | 9.4 | |
| epinephrine (auto‐injector) | 1.5 | 53.2 | ciclesonide (inhaled) | 0.5 | 42.0 | |
| 6–11 years | TOTAL | 122.4 | 28.2 | TOTAL | 20.4 | 28.4 |
| clonidine (oral) | 22.9 | 69.1 | salbutamol (oral liquid) | 1.8 | 0.4 | |
| risperidone (oral) | 18.9 | 70.0 | escitalopram (oral) | 1.2 | 48.5 | |
| fluoxetine (oral) | 18.0 | 70.2 | oxybutynin (patch) | 1.0 | 11.3 | |
| hydrocortisone acetate (topical) | 11.4 | 4.3 | fluoxetine (oral) | 1.0 | 82.9 | |
| levetiracetam (oral) | 4.9 | 42.5 | paracetamol/codeine (oral) | 1.0 | 61.8 | |
| budesonide +formoterol (inhaled) | 4.4 | 9.3 | calcipotriol +betamethasone (topical) | 0.9 | 36.9 | |
| amitriptyline (oral) | 3.9 | 45.2 | imipramine (oral) | 0.8 | 30.8 | |
| fluorometholone (eye drops) | 2.8 | 25.1 | ramipril (oral) | 0.6 | 41.1 | |
| oxycodone (oral) | 2.5 | 49.0 | perindopril (oral) | 0.5 | 27.0 | |
| ranitidine (oral) | 2.5 | 8.3 | citalopram (oral) | 0.5 | 58.1 | |
| 12–17 years | TOTAL | 285.1 | 26.3 | TOTAL | 193.4 | 10.8 |
| fluoxetine (oral) | 90.4 | 33.4 | levonorgestrel +ethinylestradiol (oral) | 101.9 | 2.5 | |
| minocycline (oral) | 45.2 | 11.5 | desvenlafaxine (oral) | 8.7 | 23.1 | |
| escitalopram (oral) | 25.1 | 18.9 | medroxyprogesterone (injection) | 6.9 | 1.9 | |
| clonidine (oral) | 18.5 | 61.3 | venlafaxine (oral) | 6.6 | 24.5 | |
| risperidone (oral) | 12.8 | 58.8 | norethisterone +ethinylestradiol (oral) | 6.5 | 6.1 | |
| amitriptyline (oral) | 9.3 | 28.4 | mirtazapine (oral) | 6.5 | 26.6 | |
| hydrocortisone acetate (topical) | 8.0 | 6.5 | norethisterone (oral) | 4.1 | 8.8 | |
| citalopram (oral) | 6.9 | 19.5 | duloxetine (oral) | 3.7 | 24.0 | |
| diclofenac (oral) | 5.2 | 13.2 | meloxicam (oral) | 3.5 | 23.0 | |
| olanzapine (oral) | 4.0 | 36.3 | rabeprazole (oral) | 3.0 | 11.1 | |