Off label uses for some common meds

Over the past couple of weeks, I have learned about a lot of very strange and unusual uses for some common medications so I thought I’d share a few of them with you here because they are pretty interesting.

Premarin for recurrent epistaxis (nose bleeds)

The topical estrogen cream is applied to the nasal mucosa and improves the stability of the nasal blood vessels. This occurs by changing the weak epithelium into a thicker layer of stratified, squamous epithelium that is more resistant to trauma.

N-Acetylcysteine for altitude sickness

Dr. Regal may have told us about NAC’s use in acetaminophen toxicity but I think he forgot to mention its use in altitude sickness. This over the counter amino acid can easily cross cell membranes before being converted to cysteine and then to glutathione, a powerful antioxidant. NAC’s ability to regenerate glutathione levels is what’s thought to help with the symptoms of altitude sickness.

Everclear for antifreeze poisoning

Antifreeze (ethylene glycol) poisoning may not be a very common occurrence seen by us as pharmacists but it can happen. Fomepizole is the first line treatment; however, this is a very expensive medication that may not be readily accessible. In these cases, intravenous ethanol is used to treat ethylene glycol poisoning because the ethanol prevents ethylene glycol from being converted to toxic chemicals in the body.

These are a few new uses that I wasn't aware of before. It just goes to show that when asking the "What did your doctor tell you this was for?" question, you may be surprised by the answer but that doesn't mean it isn't true.