2023-12-13 13:57:38
The journal Prescrire draws up its list of drugs “more dangerous than useful”, 88 of which are marketed in France. Among these drugs, we find in particular Maxilase or Toplexil. (Photo by SEBASTIEN BOZON / AFP)
Maxilase, Toplexil… These syrups are present in many medicine cabinets, and frequently prescribed and used to treat coughs or sore throats. However, warns the medical journal Prescribethey are part of the list of 105 drugs, including 88 marketed in France, whose benefit-risk balance remains “unfavorable in all clinical situations in which they are authorized”.
“First of all you need a diagnosis to know whether or not you need to take cough medicine. Someone who has a flu syndrome and is coughing can take nothing, or take honey or lozenges,” says straight away, Doctor Michaël Rochoy, general practitioner in Pas-de-Calais.
Toplexil: “Patients who take it not because they cough but because it makes them sleep”
In the case of Toplexil, the journal Prescrire writes that “oxomemazine”, present in the syrup, “is a sedative and atropinic H1 antihistamine from the phenothiazine group with neuroleptic properties, exposing it to disproportionate adverse effects”.
“Toplexil is an anti-cough syrup which has the undesirable effect of causing drowsiness and dependence. You have patients who take it not because they cough but because it makes them sleep. They take it not because they cough but because it makes them sleep. become dependent, as one becomes dependent on a drug. So it must be banned in all cases,” explains Doctor Matthieu Calafiore, general practitioner in the North.
Maxilase: “I prefer not to take anything and let nature do its work”
In the case of Maxilase, the journal Prescrire writes that alpha-amylase, an enzyme present in particular in Maxilase, “exposes people to sometimes serious skin or allergic disorders, including: urticaria, pruritus, angioedema, maculopapular rashes, erythema”. “In addition to measures (…) such as drinking water or sucking sweets, paracetamol, by controlling its dosage, is the best option,” writes the review.
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“Maxilase is a syrup that serves no purpose other than reassuring yourself by saying that you are taking something and that it will perhaps provide some relief. You have to think by putting the benefits on one side, nothing in this case, and the risks of the other, which here are a serious allergic reaction. So in this case I prefer not to take anything and let nature do its work”, continues the specialist, who deplores in France “a habit of prescribing a lot of drugs, some of which are useless.
According to’Organization for Economic Co-operation and Development (OECD), in 2021, France was the 8th country to buy the most medicines in 2021 behind in particular the United States, Germany, the leading consumer in Europe, Malta, Canada, Japan, South Korea and Switzerland. France has been in decline for decades.
Tussidane, with “a less unfavorable risk-benefit balance”
But if you have a cough, what should you do? “Cough has a natural cycle of regarding three weeks. So whether you take something ineffective or nothing, you have regarding three weeks. However, if it’s a dry cough, without fever, a syrup has with a less unfavorable risk-benefit balance is Tussidane”, advises the general practitioner, who in the majority of cases advocates measures that are easy to apply.
“Tussidane is certainly more effective, but also has greater side effects, so if it is a cough as part of a simple flu symptom, it is better not to take anything,” continues Doctor Rochoy.
A chronic cough requires consultation with a doctor
“In case of cough, you should try to humidify the room because cough can be caused by too dry air. And do what our grandmothers advised, take lozenges and salivate, this relieves the sore throat and limits the cough reflex. The lozenges are not necessarily the ones found in pharmacies, sweets in the form of lozenges are enough,” continues Doctor Calafiore.
“Someone who comes to see me because they have a cough, I don’t give anything or Helicidine, a syrup that will ‘grease’ the throat a little, like honey or lozenges,” explains the doctor. Rochoy, who calls for “changing our thinking” and saying “I don’t take medication for every symptom”.
“A chronic cough requires consultation with a doctor, because it can mask an illness other than a simple flu symptom. In the event of a chronic cough, it will be preferable to give a cough suppressant,” warns Doctor Rochoy.
This advice does not replace a medical consultation. If you have problems, consult a general practitioner.
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