HB 1374, to ban the common, or off-label, dosage of RU-486,
a pill used to induce a miscarriage in the first eight weeks of pregnancy, is on the agenda of a Senate committee today and likely headed to easy passage.
Some facts often missing in discussion of this legislation, which is meant to be an abortion deterrent.
Again, as Rep. Deborah Ferguso
n has noted, the bill attempts to enforce 20-year-old guidelines that are disputed by the American College of Obstetricians and Gynecologists. Smaller doses are less dangerous, the doctors say, though sponsor Charlene Fite
More troubling, really, is the Arkansas legislature's practice of medicine. Why focus on this off-label drug use?Other off-label drug use doesn't concern them. Rita Sklar of the ACLU
provides a few types of drugs and their off-label use:
Anti-seizure drugs: Migraines, depression, nerve pain
Antipsychotics (for Schizophrenia): Alzheimer’s Disease, autism, dementia, Attention Deficit Hyperactivity Disorder (ADHD)
Antidepressants: Chronic pain, ADHD, bipolar disorder
Antihistamines (for allergies): Colds, asthma, ear infection symptoms, as sleep aids
Antibiotics: Pediatric dosing
Anxiety drugs: as sleep aids
Proton Pump Inhibitors (for gastroesophageal reflux disease): Occasional heartburn, indigestion, irritable bowel
Beta-Blockers (for high blood pressure and heart disease: Migraines, heart rhythm disorders, anxiety
Drugs to treat Attention Deficit Hyperactivity Disorder: For people not diagnosed with ADHD, to enhance alertness and concentration
Insomnia medicines/“Sleeping Pills”: For people with infrequent insomnia, insomnia associated with depression, anxiety
Narcotic pain relievers: For people with only mild, infrequent pain
Aripiprazole (Abilify, antipsychotic): Dementia, Alzheimer’s Disease
Albuterol (for asthma): Bad coughs
Lamictal (antiepileptic, anti-seizure): Depression, bipolar disorder, mood stabilization
Tiagabine (Gabitril, anti-seizure): Depression, mood stabilization
Gabapentin (Neurontin, anti-seizure): Depression, nerve pain, migraines
Topiramate (Topamax, anti-seizure): Migraines, bipolar disorder, depression, nerve pain
Risperidone (Risperdal, antipsychotic): Alzheimer’s Disease, dementia, eating disorders
Lidoderm (skin patch for shingles): Lower back pain, sore muscles, tennis elbow,
Trazodone (Desyrel, antidepressant): As a sleep aid and for insomnia
Propranolol (Inderal, high blood pressure and heart disease): Performance anxiety
Modafinil (Provigil for excessive sleepiness): To enhance wakefulness and alertness
If this is really about safe medical practice and not merely another in the double-digit list of anti-abortion bills, the legislature has a lot of medical practice to do.
UPDATE: The bill came out of committee today, which leaves only Senate approval for final passage. In addition to mandating a dose of the drug that is more harmful to women, it shortens the period of time it may be used to the first seven weeks of pregnancy while increasing complications. It will make it much harder for women to obtain and use, particularly those who live great distances from available clinics. It is meant to discourage abortions, period. It has been challenged successfully in one U.S. judicial circuit, but upheld in another. Perhaps Arkansas will get another shot. Courts have said there is NO medical reason to follow the outdated FDA recommendation, which could be changed only if the drug manufacturer wished to go through an expensive process.