Critically Ill children in hospitals frequently get drugs off-label exposing them to risk

A recent study at the Primary Children’s Medical Center in Salt Lake showed that a majority of drugs used in the pediatric intensive care unit (PICU), are used in an off-label manner, exposing the patients to meds that may not have been studied in children. Of 335 drugs used in a PICU over a 5-month period, 75% were used off label at least once and nearly all of the patients, 96%, received a drug off label at least once. In the study, a drug was considered used off label when it was prescribed for a patient whose age was not listed on the label, when no pharmacokinetic data were listed for the patient’s age, or when the drug was used for an indication not approved by the FDA.The medications most likely to be used off-label based on drug orders were morphine (268), ondansetron (144), metoclopramide (141), dopamine (130), and fentanyl (127).