My son has a light rash that’s been getting worse over the past few days. We made an appointment and took him in; short and long is, the doc’s not worried about it but doesn’t know if it’s allergies or an infection, so is treating it like an infection for now.
Er, okay, I suppose.
He expects it to get better within the next couple of days, which is reassuring. He gave us an oral antibiotic and a cream – betamethasone dipropionate, whatever the hell that means. While my boy was in brushing his teeth after I finished applying the goo to his back, I read the data sheet that came with it. The first line under the Pediatric Use heading is “Use of [drug name] in pediatric patients 12 years of age and younger is not recommended.” After that follows a long set of dire warnings about Bad Things that I really don’t understand but sound very ominous (“may interfere with the growth and development of children”).
Should I not be worried? I mean, the doctor AND the pharmacist both know how old my son is (almost 8); they’d catch it if it was totally unsuitable for kids, right?
And I know that drug companies need to do ten thousand types of butt-covering on these sheets, kinda like how hot sauce makers have to put warnings on their bottles about not putting it in your damn eyes. People are stoopid. I get it.
I’m just wondering if it’s something to worry about, or if I’m over-cautious.
I know, I know, call the doctor, and I will when his office is open again. But I’m kinda curious as to what people think about this, both specifically in my case and in general. Do the doctors and pharmacists actually pay attention to what they’re dishing out? Or is it a crapshoot – they’ll hand you the tried-and-true without thinking about possible consequences.
Edited to add: so, the data sheet says apply 1 or 2 times daily max, the prescription as written says apply 3 times daily. Now I’m even more confused. Is this sort of thing really common and I’ve just never noticed?
(In IMHO because opinions are what I’m after, not medical advice)
The reason for the concern would be over long-term use. As a steroid drug, it has potential side effects that aren’t pleasant. Use over a week or two for a rash shouldn’t be a problem. But I second the idea to go ahead and call a pharmacist- they’re trained better that most doctors on medications.
As I understand it, most drugs are not tested on people under the age of 18 in the US for legal reasons. The “not recommended for children under 12” (IOW, pre-pubescent people) warnings are for roughly the same reason that most drugs carry a “not recommended for women who are pregnant or may become pregnant” warning. They aren’t tested on children or pregnant women so as a CYA measure the warnings are included.
I think, without any cites to back me up, that whether this kind of thing is common depends on your definition of common. I think it is common enough (especially from the point of view of the medical professional) to be unalarming, but not so common as to be more likely than not.
That said, I agree with those above who point out that it may not be recommended for pediatric use primarily because it hasn’t been tested on children, due to issues with funding, liability, etc.
Off-label use is also common in adult medicine. DrugX is approved as a birth control pill, but users find it helps with acne symptoms? Prescribe it off-label as an acne treatment without clinical trials.
And sometimes the line between a dose which is strong enough to be effective and one which is strong enough to cause side-effects is small enough or fuzzy enough that warning labels like the one you read are put on the product, but the doctor’s directions are what you should follow, maybe not risk-free, but likely to be effective.
So, in my opinion, the treatment you have been given is likely to be effective and not harm your child. But, it is not impossible that your doctor forgot that the drug was not reccommended for children or was unaware of a change in labelling. So call your doctor and consult.
Doctors do make mistakes, and keeping up with changes in the phramaceutical world is hard for anyone. So the pharmacist is another good resource you can call–before or after you talk to the doctor.
Is this sort of thing really common and I’ve just never noticed?