Can NPs prescribe meds for off label purposes?

[Cessna172]

Hi, I read my state's practice act, but can't tell if prescribing meds for off label use is permitted by NPs. Do any of you do it? This question has been bugging me for a while, so I'd like to hear from practicing NPs about this . I am in a FNP program, and graduate in December 2012. Thanks!

[sandnnw, BSN, MSN, EMT-B, APRN]

Don't sweat this too much. You will find all kinds of usages for drugs, "off label" doesn't mean unsafe.

A few examples from my daily experience:

Droperidol, Reglan, Benedryl, Magnesium for migraine

Gabapentin/Effexor for chronic pain syndromes already on opiates or known abusers

Steroids

Antibiotics, by class, e.g. COPD on max inhalers+steroids, low dose Zithro

HCTZ

The more your read and experience in your practice, the more you will learn about off label uses. As someone mentioned, the specialties often find numerous usages for new/old drugs. Read up on the history of Methotrexate, great example.

[Cessna172]

Thank you Juan and others, I appreciate your help and knowledge with this.

Bobby

[NPinWCH]

I'm in Ohio and as long as my collaborating agreement states that I can prescribe medications for off label uses, then I can. I do it all the time. I'll use gabapentin for pain syndromes (already mentioned) and restless leg syndrome and beta blockers for migraine and anxiety, also I've had good results with sertraline for men with premature ejaculation issues. All of these are off label uses, but are very common. If there is proof it works I see no reason not to prescribe it.

[smspicer]

Hi, I read my state's practice act, but can't tell if prescribing meds for off label use is permitted by NPs. Do any of you do it? This question has been bugging me for a while, so I'd like to hear from practicing NPs about this . I am in a FNP program, and graduate in December 2012. Thanks!

The law concerning this in many states is probably vague. In the state where I practice (Ohio), the Ohio Board of Nursing rules state that in order for a Nurse Practitioner to prescribe something off-label, it has to be specified in your Standard Care Arrangement (which is the term Ohio uses for a collaborative agreement between a Physician and an NP). We are required to have a SCA with every physician we work with. Within that SCA, there is a section where you name drugs you are able to prescribe off-label, with their approved FDA uses as well as what off-label use you may be prescribing them for.

Good luck starting your practice!