INSERT INTO off_label_uses (
   medication_base_id,
   condition_id,
   primary_treatment,
   mechanism_of_action
) VALUES
(1, 14, 'Pain management in arthritis', 'Pain and inflammation reduction'),
(2, 18, 'COPD symptom management', 'Bronchodilation'),
(4, 1, 'Heart failure management', 'Reduces cardiac workload'),
(7, 24, 'H. pylori eradication', 'Bacterial protein synthesis inhibition'),
(8, 39, 'Hives treatment', 'Histamine blockade'),
(10, 20, 'Nasal polyps', 'Anti-inflammatory effect'),
(12, 46, 'Hypertension management', 'Sodium/water excretion'),
(15, 27, 'PCOS management', 'Hormone regulation'),
(16, 1, 'Heart failure management', 'Reduces cardiac workload'),
(18, 22, 'IBS symptom management', 'Improves insulin sensitivity'),
(19, 2, 'Atrial fibrillation rate control', 'Heart rate reduction'),
(21, 23, 'Gastroparesis symptom relief', 'Reduces acid production'),
(22, 3, 'Anxiety management', 'Serotonin modulation'),
(25, 13, 'Neuropathic pain', 'Pain signal modulation'),
(28, 13, 'Neuropathic pain management', 'GABA modulation'),
(31, 35, 'Severe eczema', 'Anti-inflammatory effect'),
(32, 15, 'Fibromyalgia pain', 'Muscle relaxation'),
(36, 15, 'Fibromyalgia management', 'Pain signal modulation'),
(37, 4, 'PTSD treatment', 'Anxiety reduction'),
(49, 46, 'Hypertension resistant', 'Aldosterone blocking'),
(56, 13, 'Neuropathic pain', 'Pain signal modulation'),
(57, 13, 'Neuropathic pain', 'Pain signal modulation'),
(58, 10, 'Sleep disorders', 'Sedation through H1 blockade'),
(61, 5, 'OCD treatment', 'Serotonin modulation'),
(64, 4, 'PTSD treatment', 'Anxiety reduction'),
(69, 10, 'Sleep disorders', 'Sedation'),
(70, 13, 'Neuropathic pain', 'Pain signal modulation'),
(6, 1, 'Heart failure prevention', 'Anti-inflammatory effects'),
(20, 14, 'Rheumatoid arthritis pain', 'Leukotriene pathway modulation'),
(29, 6, 'Panic disorder treatment', '5-HT1A modulation'),
(34, 2, 'Atrial fibrillation control', 'Heart rate control'),
(35, 14, 'Rheumatoid arthritis', 'Anti-inflammatory effect'),
(38, 15, 'Fibromyalgia symptoms', 'Hormone modulation'),
(42, 14, 'Arthritis pain', 'Muscle relaxation'),
(44, 34, 'Rosacea treatment', 'Anti-inflammatory effect'),
(47, 23, 'Gastroparesis treatment', 'Gut microbiota modulation'),
(50, 13, 'Neuropathic pain management', 'Central nervous system depression'),
(52, 41, 'Surgical prophylaxis', 'Bacterial elimination'),
(59, 16, 'Chronic pain syndromes', 'Pain pathway modulation'),
(60, 13, 'Neuropathic pain', 'Sodium channel modulation'),
(62, 13, 'Trigeminal neuralgia', 'Nerve pain reduction'),
(68, 15, 'Fibromyalgia pain', 'Pain signal modulation'),
(71, 13, 'Complex regional pain syndrome', 'GABA modulation'),
(72, 16, 'Chronic pain conditions', 'Pain signal modulation'),

-- Additional neurological/psychiatric medications
(37, 6, 'Panic disorder', 'Serotonin modulation'),
(58, 6, 'Panic attacks', 'Anxiety reduction through sedation'),
(64, 10, 'Insomnia treatment', 'Sedation through H1 blockade'),
(69, 4, 'PTSD-related insomnia', 'Sleep promotion'),
(25, 15, 'Fibromyalgia pain', 'Pain signal modulation'),
(36, 16, 'Chronic pain syndromes', 'Pain pathway modulation'),

-- Additional cardiovascular medications
(13, 1, 'Heart failure', 'Fluid reduction'),
(17, 1, 'Heart failure', 'Cardiac remodeling prevention'),
(19, 3, 'Anxiety with tachycardia', 'Heart rate reduction'),
(27, 1, 'Heart failure prevention', 'Thrombosis prevention'),

-- Additional respiratory medications
(14, 17, 'Asthma', 'Bronchodilation'),
(48, 18, 'COPD maintenance', 'Long-term bronchodilation'),
(10, 18, 'COPD inflammation', 'Anti-inflammatory effect'),

-- Additional gastrointestinal medications
(21, 22, 'IBS symptoms', 'Acid reduction'),
(40, 23, 'Gastroparesis', 'Motility improvement'),
(47, 21, 'Refractory GERD', 'Gut flora modification'),

-- Additional dermatological uses
(31, 33, 'Severe acne', 'Anti-inflammatory effect'),
(44, 35, 'Eczema infection prevention', 'Antibacterial effect'),
(39, 36, 'Psoriasis with fungal component', 'Antifungal effect'),

-- Additional pain/musculoskeletal
(28, 14, 'Arthritis pain', 'Muscle relaxation'),
(30, 15, 'Fibromyalgia', 'Muscle relaxation'),
(32, 13, 'Neuropathic pain', 'Muscle relaxation'),
(33, 14, 'Arthritis spasticity', 'Muscle relaxation'),
(42, 15, 'Fibromyalgia', 'Muscle relaxation'),
(43, 13, 'Neuropathic pain', 'Muscle relaxation'),
(46, 14, 'Arthritis pain', 'Muscle relaxation'),

-- Additional antimicrobial uses
(35, 41, 'Surgical prophylaxis', 'Bacterial prevention'),
(39, 33, 'Acne treatment', 'Antifungal effect'),
(41, 42, 'Post-surgical infections', 'Bacterial elimination'),
(52, 50, 'Endocarditis treatment', 'Bacterial elimination'),

-- Additional endocrine/hormonal uses
(15, 25, 'Diabetes management support', 'Metabolic regulation'),
(38, 27, 'PCOS symptoms', 'Hormone regulation'),
(49, 27, 'PCOS symptoms', 'Androgen blocking'),
(3, 49, 'Vitamin D deficiency', 'Calcium absorption enhancement'),
(5, 24, 'H. pylori infection', 'Bacterial elimination'),
(9, 41, 'Surgical prophylaxis', 'Bacterial prevention'),
(11, 39, 'Chronic urticaria', 'Histamine blockade'),
(16, 2, 'Atrial fibrillation', 'Cardiac remodeling prevention'),
(23, 2, 'Atrial fibrillation prevention', 'Anti-inflammatory effect'),
(24, 17, 'Asthma maintenance', 'Bronchodilation'),
(26, 55, 'Cryptococcal meningitis', 'Fungal membrane disruption'),
(45, 42, 'Post-surgical infections', 'Bacterial elimination'),
(51, 56, 'HIV prophylaxis', 'Viral replication inhibition'),
(53, 55, 'Cryptococcal infection', 'Fungal elimination'),
(55, 13, 'Neuropathic pain', 'Pain signal modulation'),
(61, 6, 'Panic disorder', 'Anxiety reduction'),
(65, 13, 'Neuropathic pain', 'Pain signal modulation'),
(66, 13, 'Refractory pain', 'Pain signal modulation'),
(67, 13, 'Neuropathic pain', 'Pain signal modulation');