Any time a doc prescribes any med for anything, the doc is supposed to give the patient informed consent, which would include discussion of potential side effects, alternative treatments, no treatment, etc. If the drug is being used off-label, that fact is also supposed to be included in this discussion. The doc documents he/she had this discussion with the patient in the patient's chart.
I don't do patient care anymore, but when I did and I prescribed something off-label, I can't recall a time where a patient balked at a med for that reason. I truly just don't think off-label use is a big deal, especially for a drug with minimal safety concerns.
If you were a patient getting treatment for cancer and were told about the horrible side effect of OM, and then were told that there was a proven, FDA-approved treatment for it that had a decent chance of even preventing it in the first place, was easy to take, but had only been formally approved by the FDA for a different cancer, would you really care?
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