Non-Approved Uses of Celecoxib and Indomethacin: Pharmacy Students’ Knowledge and Opinions

Abstract

A survey was conducted among first-year pharmacy students at Howard University College of Pharmacy to measure their level of knowledge and gauge their opinion regarding the off-label uses of two non-steroidal anti-inflammatory drugs (NSAIDs), indomethacin and celecoxib. The average level of knowledge on indomethacin and celecoxib was 36.2% and 31.2%, respectively. Among the five knowledge-based questions on each of these drugs, the highest correct response rate was obtained on indomethacin dosing at 72.9%, and 64.7% on the class of drugs celecoxib belongs to. In the responses to questions on indomethacin, the highest correct response of 72.9% was significantly higher (p<0.05) than responses to other knowledge-based questions, except for the knowledge level on the class of drugs (59.5%; p=0.3257). In the same manner, the correct response rate of 64.7% for the class of drugs that celecoxib belongs to was significantly higher than the response rates for the other questions (p<0.05), except when compared to the response to the question whether hyperplastic polyps and serrated polyps can develop into cancer (41.2%, p=0.0883). The opinions of the students varied, with a majority (55.9%) agreeing that serious diseases should be treated with non-approved medications. In the case of indomethacin, 35.5% of the respondents believed that because of toxicity issues, it should not be used outside the approved indications, while 27.8% believed that the safety has been established and can be used outside the approved use. Most respondents (55.9%) on celecoxib thought colorectal cancer is a serious disease and can be treated with non-approved drugs.