In a settlement with the U.S. Department of Justice, Pfizer pled guilty to a criminal charge and agreed to pay the fine for illegally promoting four drugs—Bextra, an anti-inflammatory drug; Geodon, an antipsychotic; Zyvox, an antibiotic; and Lyrica, an anti-seizure medication—for uses that had not been approved by the Food and Drug Administration.

While it’s illegal for pharmaceutical makers to promote their medications for uses that haven’t been FDA approved, it’s common and perfectly legal for doctors to do so. This practice is called off-label drug prescribing and in some cases, it can be beneficial because there may be evidence that the drug works well for treating a condition for which it has not received FDA approval. But in most cases, the evidence to support the off-label use is lacking.