Health Affairs April 29, 2024
Vikhyat S. Bebarta, Robert L. Mabry, Arthur L. Kellermann

Repurposing a Food and Drug Administration (FDA)-approved drug for a new use has been informally practiced for years. In fact, “off-label” medication administration is so common that the Congressional Research Service estimates that nearly 40 percent of prescriptions in the US are written for this purpose. A prime example is using ketamine to treat acute pain in emergency care settings. In this commentary, we explain how this practice came about, the advantages of using ketamine to treat acute pain, and the benefits that could be derived if the FDA approved this indication.

Background

Morphine has been the mainstay of treating pain since the Civil War. Early on, physicians recognized that morphine could cause serious adverse effects, including addiction if administered...

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