Off-label mishonga yemishonga: Zvaunoda kuziva

Zvinodhaka Info

Makore apfuura, pandakanga ndichinetseka nedambudziko rezvinyamusi, chiremba wangu akandinyorera mushonga unowanzoshandiswa kurapa pfari. Ndakanga ndavhiringika. Sei chiremba wangu achindipa mushonga wakaratidzirwa kune mamwe mamiriro akadaro? Yakanga iri tsika yakajairika yekutarisira kuyedza zvinodhaka zvekushandisa nyowani? Kushandiswa kwakadaro hakuna njodzi here?

Zvichida zvakaitika kwauri: Maitiro ako ekurapa anotumira mushonga kufesi yako, wobva wadzidza kuti mushonga unowanzo shandiswa kurapa mamiriro akasiyana zvachose kupfuura zviratidzo zvako. Izvi zvinodaidzwa kunzi--tabera kunyorera (inozivikanwawo sekuraira kushandiswa kusingatenderwe). Asi chii chinoita izvozvo chaizvo Zvinorevei?

Ndeapi ari-asiri mazita emishonga?

Kana Chikafu neDrug Administration (FDA) ichiongorora mushonga mutsva, kambani yemishonga iri kutsvaga mvumo inofanirwa kuendesa humbowo hwesainzi - senge mhedzisiro yemiedzo yekiriniki - kuti mushonga unoshanda mukushandisa kwawo. Kana mushonga wagamuchira FDA tendero (mushure menguva yakareba yekubvumidzwa maitiro), ndeyekurapa izvo kunyanya chirwere, uye izvo zvinongedzo chete. Chero kumwe kushandiswa kwemishonga kuri off-label.

Kune off-label chitambi kusimudzira zviri pamutemo?

Kana kambani yemishonga painotanga kutengesa mushonga, inogona kutaura chete mamiriro ezvinhu izvo chigadzirwa chinotenderwa kurapa. Kunze-chitaridzi kushambadzira , kana kushambadzira zvinodhaka zvekushandisa zvisina kutenderwa, zvinogona kusiya kambani yemishonga yakavhurika kumatare. Hazvisi pamutemo.

Vanachiremba vanobvumidzwa here kunyorera zvinodhaka?

Kana chiremba akaraira mushonga wekushandisa-kunze kwekushandisa zvinodhaka, zvinoreva kuti iye akanyorera mushonga kunze kwezviratidzo zvawo zvakatenderwa. Zviri pamutemo muUnited States, uye zvakajairika, kuti vanachiremba vape off-label. Muchokwadi, varwere vazhinji havatomboziva kana mushonga unowira kunze kwekushandisa kwawo kwakatenderwa.

Dzimwe nguva, FDA-zvinongedzo zvakanangana nemadosi kana hunhu hwevarwere (senge bonde), pane kungoita nyaya yekurapa pachayo. Muenzaniso wakanaka weiri izera reboka-mazhinji emakiriniki ekuyedza bvunzo mishonga kune vanhu vakuru pane vadiki, nekudaro kupa mishonga iyi kuvarwere vadiki zvinehunyanzvi inowira pasi pemuraira weasina-chitambi, kana kusatenderwa, shandisa.

Nei vanachiremba vachipa mushonga kure-chitaridzi?

Izvo zvakakosha kuti uzive kuti nekuda kwekuti kushandisa zvinodhaka kuri off-label, hazvireve kuti ichave isingabatsiri kurapwa. Icho chikonzero nei mishonga yemishonga ichinyanyo shandiswa off-label iri inoshanda, anodaro Amber Cann , Pharm.D, muridzi we Uturu hweVenus . Maitiro ekuwana mushonga kuburikidza nekiriniki yekuyedza uye kubvumidzwa neDFA inogona kutora makumi maviri emakore, uye inodhura zvisingaite, anotsanangura. Kazhinji hazvisi mukati mekufarira kwemugadziri wezvinodhaka kutsvaga zvimwe zvinoratidza kana mushonga wave pamusika.

Dzimwe nguva, mugadziri wezvinodhaka achaisa mari mune chimwe chiratidzo, kuitira kuti vagone kushambadzira mushonga wechinangwa icho, Dr Cann vanodaro. Semuenzaniso, iyo inodzvinyirira Paxil (paroxetine), yaiwanika kwenguva yakati musati agadzira, GlaxoSmithKline, akatsvaga mamwe maratidziro ezviratidzo pane inoisa pasuru yeakajairika kusagadzikana kusagadzikana uye obsessive-inomanikidza kusagadzikana.

Izvi zvinogadziriswa hazviwanzo — uye kana zvikaitika, zvinotora nguva. Zvinogona kutora makore kusati kunyorerwa kuchinge kwabatwa neazvino kiriniki data inoratidza kuti mushonga ungave unoshanda kune rimwe dambudziko, anodaro Amarish Dave , MD, chiremba wezveuropi uye mubatanidzi director wezvekurapa pa Mercyhealth muIllinois. Mumakore iwayo ekupindira, kushandisa zvinodhaka zvisiri-mabhaisikopo zvinogona kupa varwere kurapwa kwakanakisa.

Mibvunzo yekubvunza chiremba wako nezve off-label tsamba yekushandisa

Kana iwe uchida kuziva nezve-isiri-yekushandisa-kana kutya nezvayo-zviri mukati mekodzero dzako semurwere kubvunza mibvunzo. Ungangoda kuziva:

• Iko mishonga isiri-chitambi cheichi chiitiko?
• Ndeupi mushonga unobvumidzwa kurapa?
• Sei chiremba wako achinyorera?
• Mushonga unorapa sei mamiriro kana zviratidzo?
• Ndeipi mhedzisiro?
• Ndeapi mabhenefiti ekurapwa-kurebesa kurapwa?
• Ko yako inishuwarenzi yehutano ichavhara uyu mushonga weichi chiitiko?

Vazhinji varapi uye vemishonga vanofara kukurukura zvitsva zvinoratidza uye kuchengetedzwa kwezvinodhaka kana murwere achinetseka.

Kune off-label mishonga yakavharwa neinishuwarenzi uye Medicare?

Iwe ungangoda kuita imwe tsvagiridzo kuti uone kana yako inishuwarenzi, Medicare, kana Medicaid ichizovhara off-label tsamba. Kuvhara kunoenderana nemushonga-uye nemamiriro api anorayirwa nachiremba kuti arape. Kubhadharwa kwemishonga yakatemerwa kure-chitaridzi dzimwe nguva kungave kwakaoma, sezvo makambani einishuwarenzi anogona kunge achinetseka kubhadhara nekuda kwezvikonzero zvekunyepedzera. Kana izvi zvikaitika kwauri, taura nemupi wako wezvehutano kana wemishonga nezve mimwe mishonga. Iwe unogona zvakare kushandisa iyo ImweCare mutengo wekutarisa chishandiso kuti uone kana kwedu kuchengetedza kwakarova mutengo wemari.

Mabhenefiti ekushandisa-kurebesa kushandiswa

Kunyora off-label mishonga kunopa varapi dzimwe nzira dzekurapa kana mumwe mushonga ukasashandira iwe. Inonyanya kubatsira kune zvisingawanzo mamiriro izvo zvine mashoma marapirwo sarudzo. Semuenzaniso, chemotherapy inowanzo gamuchirwa chete kune imwe mhando yekurapa kenza. Vanachiremba vanogona kurishandisa kure-chitaridzi kunongedza akawanda akasiyana marudzi.

Dzimwe nguva kushandiswa-kwekushandisa kunogona kukuchengetedza mari. Kazhinji mushonga wegeneric unoshandiswa kure-chitambi chinogona kushandira chinangwa chimwe chete semushonga 'unobvumidzwa' unogona kunge wakachipa zvakanyanya, Dr. Dave anodaro. Zvimwe zvakanaka zvinosanganisira zvakasarudzika mhedzisiro.

Ngozi dzekushandisa-kurebesa kushandiswa

Sezvakaita chero mushonga, panogona kuve nenjodzi. Nekuti off-label kushandisa zvinodhaka kwave kusiri pasi peyakaomesesa maitiro emakiriniki miedzo uye kuyedzwa, sezvakaitwa mukubvumidzwa kushandiswa, panogona kuve neasina kutarisirwa mhedzisiro Asi Dr. Dave vanoti, Yakawanda isiri-yekushandisa mashandisirwo ndeyezvinodhaka izvo zvatove neanozivikanwa maitiro mhedzisiro.

Yakakurumbira off-label zvinodhaka

Kune akawanda akarairwa mamiriro anowira muchikamu chekurebera. Chiremba anogona kupa tricyclic antidepressants kurapa ADHD, kana kupa anticonvulsant, saTopiramate, yekuora mwoyo.

Mune zvimwe zviitiko, kushandiswa-kwemazita kushandiswa kwakajairika zvinova iyo iyo chikuru shandisa. Hazvina kusanzwika zvekunze-chitaridzi zvinoshandiswa pakupedzisira kuve FDA-inogamuchirwa. Minoxidil mushonga wekare wakamboshandiswa pakukwira kweropa, Dr. Cann vanodaro. Yakawanikwa iine [ipapo] isingafadzi mhedzisiro mhedzisiro yekusimudzira bvudzi kukura. Mushonga uya manje chaizvo isingawanzoshandiswa sehypertension mishonga, asi inowanzo shandiswa sevhudzi rinokura chigadzirwa. Tava kuzviziva se… Rogaine.

Mimwe mishonga iyo varairidzi vanowanzo shandisa off-label inosanganisira:

Zita reDrug	Kutenderwa Kushandisa	Kunyorerwa Kunze-Chiraira Kwe
Prazosin HCL	Kurapa kweBP	Manheru / PTSD
clomiphene-citrate	Kurapa kwekushaya mbereko muvakadzi	Kurapa kwekushaya mbereko muvarume
Namenda	Kurapa kweAlzheimer's Disease	ADHD uye OCD kurapwa kwevana
Catapres	Kurapa kwekudzvanywa kweropa	ADHD, Kupisa Kupisa, Tourette's Syndrome
Seroquel	Antipsychotic mishonga yekurapa schizophrenia, Bipolar Disorder uye Major Kushungurudzika Dambudziko	Kusarara, Kuzvidya Mwoyo, OCD, Psychosis kubva kuParkinson's Disease
topiramate	Anticonvulsant yekurapa kwekugumbuka, kudzivirira migraine	Matambudziko emafungiro, PTSD, kuonda
sildenafil citrate	Erectile kusagadzikana (mune varume	Mukadzi pabonde kumutsa kusagadzikana
gabapentin	Kurapa kwekugumburwa	Bipolar Dambudziko, Kupisa Kunopisa, Neuropathy
propranolol	Kurapa kweBP	Kuita kunetseka
Tegretol	Anticonvulsant yekurapa kwekugumburwa	Bipolar Dambudziko, ADHD