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Let's talk about unlicensed / licensed / Off label medications

September 2, 2022

Let’s talk about unlicensed / licensed / Off-label medications

As doctors are we legally allowed to prescribe all of them? Absolutely! So, what are unlicensed, off-label and licensed medications? There is a good explanation from Oxford University NHS trust.

The bottom line is unlicensed medications don’t have a license in the UK, but sometimes their use is justified, for example, in oncology or for rare diseases.

Off-label medications do have a license, but to treat a different health condition.

For example, you go through your menopause and have very low testosterone. You have no sex drive or will to live. In this case, your GP will prescribe you testosterone, which is licensed for men, but your dose will be much lower. This will be your off-label medication.

Now let’s talk about weight loss injectable medications.

There are currently 2 types of “skinny jabs” available on the UK market – one is called Saxenda (licensed) and another one Ozempic/ Semaglitide), off-label for obesity, but licensed for diabetes.

Why would we choose off-label for obesity Semaglutide over licensed Saxenda?

  1. Under the name of Wegovy, Semaglutide has already been approved by MHRA and recommended by NICE for weight loss in Feb 2022. It will be available in the UK (including the NHS) for the treatment of obesity in the next few months.
  2. It is a weekly injection compared to daily injections with Saxenda. To make it worse, those daily injections have to be done at the same time of the day, which doesn’t sound convenient.
  3. A recent 68 week Saxenda vs Semaglutide effectiveness was compared in over 300 adults. The results show that people taking Semaglutide (Wegovy) had lost significantly more weight compared to those taking Saxenda.

So, we choose off-label Semaglitide because it is more effective, comfortable to administer and safe.

Lastly, let’s talk about when we should use only licensed medication.

Correct, Botulinum toxins for cosmetic use. There are currently only 4 licenced medications available on the market- Azzalure, Botox, Bocouture and very recently launched Alluzience. Nothing else should be used.

However, did you know that botulinum toxin is not licensed to be used in the lower face for cosmetic purposes? Are we still legally allowed to lift corners of your mouth or treat the smoker’s lines above the lip? Don’t worry, we can, as an off-label treatment.

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