Medicines to reconsider: When Risks Outweigh Benefits
For the 13th year running, the independent scientific journal prescribe, run by a non-profit group of doctors, pharmacists, and other healthcare professionals, has published its updated list of drugs to approach with caution. This year’s list flags 106 active ingredients, 88 of which are still available in France despite some European countries having already banned them.
These pharmaceuticals often fall into a category known as “blacklist” because their risk-benefit ratio is unfavorable. This means the risks associated with their use may outweigh any potential benefits they offer. Some drugs are considered too risky compared to safer alternatives, while others are simply not effective enough, with results comparable to a placebo, making their use questionable.
Potential Pitfalls: Medications to Discuss with Your Doctor
One example is Floroglucinolo, sold under the brand name Spasfon, a drug available over-the-counter in France. While used for intestinal issues, gynecological pain, and menstrual cramps, its potential side effects are serious, including allergic reactions and, in rare cases, lyell’s syndrome, a severe skin condition. Despite this, it remains available in France and Italy, but was withdrawn from the market in Belgium back in 2010. While it’s marketed as a solution for these ailments, “its effectiveness is not supported by solid clinical tests and may not exceed that of a placebo,” says Prescribe.
Another concern highlighted by Prescribe involves some common cold and flu treatments. Drugs like Dosmectitis (Smecta) and Hydrotalcite (Rennieliqui), despite being readily available, carry risks due to potential contamination with lead, which can pose neurological dangers. The journal advises opting for safer alternatives like sodium bicarbonate and sodium alginate-based antacids, which offer similar effectiveness without the lead-related risks.
Cough syrups are another area where risks may outweigh benefits. Oxomemazine (Toplexil), for instance, is associated with numerous side effects, and Ambroxolo (Muxol) can trigger serious allergic and skin reactions. Despite this, its effectiveness doesn’t exceed that of a placebo. while dextromethorphan is suggested as an option, Prescribe acknowledges its limitations as well.
Even seemingly harmless medications like Alfa-Damilase (Maxilasis), used for sore throats, lack any proven clinical efficacy and can cause serious allergic and skin reactions. In these cases, natural remedies like honey, sucking candies, or paracetamol for intense pain are recommended as safer options.
Joint pain treatments aren’t immune to these concerns either. Aceclofenac (Cartrex) and diclofenac (Voltarene) can increase the risk of heart attacks or heart failure. Certain muscle relaxants, like Metocarbamolo (Lumirelax), have effectiveness on par with a placebo and come with their own set of potential side effects.
The message from Prescribe is clear: when it comes to your health, don’t assume all medications are created equal. It’s crucial to have a proactive conversation with your doctor to weigh the potential benefits against the risks and explore all available options.
the Rising Tide of Drug Exclusions: A Look at 2025’s Blacklist
The year 2025 is poised to see a critically importent shift in the pharmaceutical landscape. A new set of guidelines and recommendations will introduce a growing “blacklist” of drugs, with clinicians urged to reconsider their use. This raises critical questions about patient safety, efficacy, and the future of pharmacological treatment.
The spotlight shines on several drugs with controversial histories and concerning side effect profiles. Fenfluramine, despite a recent review exploring its potential in treating Lennox syndrome, remains on the list due to a persisting unfavorable risk-benefit ratio.
“Clinical data confirm that its risk-benefit relationship remains unfavorable,” according to recent findings.
Reboxetine,a noradrenaline and serotonin reuptake inhibitor,faces exclusion due to its documented lower effectiveness compared to other antidepressants and its association with sexual dysfunction and appetite loss.Ulipristal, previously under scrutiny for its potential for serious liver damage, has been removed from the list following its marketing authorization withdrawal in the European Union.
Though, some medications remain controversial. Floroglucinolo, with its uncertain efficacy and potential for severe side effects, including allergic reactions and Lyell syndrome, is strongly discouraged, particularly for pregnant women or those attempting to conceive.
The exclusion list extends beyond individual drugs, encompassing various therapeutic categories.Oncology, transplants, and hematology see a number of medications flagged, including Defibrotide, Mifamurtide, Ninten, Panobinostat, Roxadustat, Trabectedina, Water anb, and The friendship.
Cardiology presents another area of concern, with Aliskiren, Bezafibrato, Ciprofibrato, Dronedarone, Fenofibrato, Ivabradina, Nicorandil, Olmesartan, Liquid, Trimetazidine, and Vernakalaant facing exclusion.
Dermatoligists and allergists also grapple with a number of drug exclusions, specifically Finasteride 1mg, Mequitazine, Pimecrolimus, Injectable Prometazine, Peanut protein (palforzia), and Tacrolimus topical.
Diabetology and nutrition also face scrutiny, with Alogliptina, Bupropione/Naltrexone, Linagliptina, Orlistat, Pioglitazone, Saxagliptina, Sitagliptina, and Vildagliptina facing potential exclusion.
in the realm of pain and rheumatology, Coxib (Celecoxib, Etoricoxib, Parecoxib) and Aceclofenac are facing increasing scrutiny.
This impending shift in prescribing practices underscores the ongoing need for vigilance and critical evaluation of pharmaceuticals.
A Deep Dive into Medications Across Specialities
Navigating the world of medications can be complex. This guide aims to shed light on a diverse range of drugs used across various medical specialties, providing a valuable resource for understanding treatment options.
Pain management and Musculoskeletal Health
For conditions like osteoarthritis and arthrosis, several medications provide relief from pain and inflammation. nonsteroidal anti-inflammatory drugs (NSAIDs) like oral diclofenac, gel ketoprofen, meloxicam, piroxicam, and systemic tenoxicam are commonly prescribed. Muscle relaxants like mefenesin (available orally and topically),metocarbamolo,and tiocolchicoside are also used to ease muscle spasms associated with musculoskeletal disorders.
Osteoporosis and Related Conditions
Managing osteoporosis and other bone-related conditions frequently enough involves medications that increase bone density. Denosumab 60mg and romosozumab are examples of medications used for this purpose. Capsaicin patches provide topical pain relief,while colchicine combined with opioids and temazepam offers a multi-pronged approach to managing various conditions.Quinine, known for its antimalarial properties, has also been used in certain contexts.
Gastrointestinal Health
A variety of medications are used to address gastrointestinal issues. Obeticholic acid targets cholesterol and bile acid disorders, while diosmectite, domperidone, droperidol, idrotalcite, and kaolin offer relief from diarrhea and gastrointestinal discomfort. Menophoject, beidellite montmorillonite, and prucaloprida are also used in the management of gastrointestinal symptoms. Opium tincture,a traditional remedy with analgesic and anti-diarrheal properties,is another option. Glycerin trinitrate 0.4% can help relieve pain associated with Irritable Bowel Syndrome (IBS).
Neurological Conditions
Neurological disorders frequently enough require specific medications to manage symptoms and slow disease progression. Alemtuzumab, donepezil, galantamine, ginkgo biloba, load, naftidrophs, natalizumab, oxetorone, piracetam, rivastigmine, and tolcapone are examples of drugs used in neurology.In the specific case of triflunoma, treatment approaches may vary based on individual factors.
Respiratory and Ear, Nose, and Throat (ENT) Disorders
Respiratory ailments and ENT problems often respond well to targeted medications. Alpha-melasi, ambroxolo, bromelain, and nasal and oral decongestants like ephedrine, nafazoline, ossimetazoline, phenylephrine, pseudoephedrine, tuaminoheptan, and xilometazolina are commonly used to relieve congestion and breathing difficulties. Inhaled mannitol and other medications like ninten, oxomemazina, pentossiverina, and roflumista also play a role in managing respiratory conditions.
Mental Health
Psychiatry utilizes a range of medications to address various mental health conditions. Agomelatine, citalopram, dapoxetine, duloxetine, escitalopram, etifoxine, milnacipran, reboxetine, tianeptine, and venlafaxine are examples of antidepressants, anxiolytics, and mood stabilizers used in psychiatric practice. Sprayary Sprayary is another medication employed in this field.
Smoking Cessation
medications aiding in smoking cessation are available to help individuals quit tobacco use. These medications can assist in reducing cravings and withdrawal symptoms, making quitting easier.
Urological Conditions
Oral pentosan polysulfate is a medication used to address certain urological conditions.
This guide provides a starting point for understanding the diverse world of medications. It is essential to consult a healthcare professional for personalized medical advice and treatment.
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