Observations Drug Monitoring

Investigating beneficial drug reactions

BMJ 2012; 344 doi: https://doi.org/10.1136/bmj.d8337 (Published 04 January 2012) Cite this as: BMJ 2012;344:d8337
  1. Jim Parle, professor in primary care1,
  2. Nick Ross, professor in medical education2,
  3. June Jones, senior lecturer in biomedical ethics1
  1. 1School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2SP, UK
  2. 2Education Unit, College of Medical and Dental Sciences, University of Birmingham
  1. Correspondence to: J Parle j.v.parle{at}bham.ac.uk

It is time to move from serendipity to systematic searching

All clinicians are familiar with drugs that have multiple uses. Codeine, for example, may be given to reduce cough (when it may have the adverse effect of constipation) or to treat diarrhoea (when suppressing the cough reflex becomes the unintended adverse effect). Shaughnessy has recently named these additional uses that are identified and introduced after a drug has been established in its initial role as “repurposing.”1 There are many other examples, such as sildenafil (Viagra), which was initially developed to treat ischaemic heart disease. Once its effects on erectile dysfunction were serendipitously noted from pharmacodynamic studies,2 the entire rationale for its development and prescribing changed. Other examples abound, in the professional and lay literature, such as recent discussion, including on the BBC, concerning clomipramine’s potential to have a beneficial effect on brain tumours.

In general such potential repurposings have been identified serendipitously by …

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