Here is the list of dangerous drugs to avoid in 2023

Here is the list of dangerous drugs to avoid in 2023

Maxilase, Rhinadvil, Smecta, Voltarene… As every year in December, the medical journal Prescrire updated its blacklist of drugs to avoid. 88 drugs marketed in France are listed. List 2023.

[Mise à jour le 12 décembre 2022 à 14h13] For the eleventh year, the medical journal Prescribe post your black list of drugs to avoid for treatment. In the 2023 edition, They point to 107 drugs “more dangerous than useful” whose finger 88 marketed in France because its the risk-benefit balance is unfavorable in all clinical situations in which they are authorized. “This report covers drugs whose detailed analysis was published in Prescrire from 2010 to 2022.analysis of new pharmaceutical specialtiesnew indications, follow-up evaluation, both in the undesirable effects that in the efficacy dataand, sometimes, updates of data related to certain undesirable effects of a drug”, says the review. “One of Prescrire’s main goals is to provide caregivers, and therefore patients, with clear, synthetic, reliable and up-to-date information, independent commercial or corporate conflicts of interest, which they need for their exercise”. After this evaluation, some drugs are addedothers are removed, either because its marketing has been stopped by decision of the company or a health authority, or due to a re-examination of its benefit-risk balance. The review states that it can be:

  • medicines activebut that, given the clinical situation, expose yourself to disproportionate risk in relation to the benefits they bring
  • medicines ancient whose use is outdated, because other newer drugs have a more favorable benefit-risk balance
  • medicines recentwhose risk-benefit balance is less favorable than that of older drugs
  • Medications includedefficacy is not proven beyond a placebo, and which lead to particularly serious adverse effects.

What drugs should be ruled out?

In the 2023 edition, these are 107 targeted drugs whose 88 marketed in France so Prescrire believes that the the benefit-risk ratio is unfavorable in all clinical situations in which they are authorized. The full 2023 list is available on the magazine’s website. Among these drugs we find for example;

  • in oncology : defibrotide (Defitelio®), mifamurtide (Mepact® not marketed in France), nintedanib (Vargatef® not marketed in France), panobinostat (Farydak®), roxadustat (Evrenzo® not marketed in France), trabectedin (Yondelis® or others) , vandetanib (Caprelsa®), vinflunine (Javlor®)
  • in cardiology : aliskiren (Rasilez® not marketed in France), bezafibrate (Befizal®), ciprofibrate (Lipanor® or other) and fenofibrate (Lipanthyl® or other), dronedarone (Multaq®), ivabradine (Procoralan ®), nicorandil (Ikorel® or other), olmesartan (Alteis®, Olmetec®), ranolazine (Ranexa® – not marketed in France), trimetazidine (Vastarel® or other).
  • In dermatology and allergology : finasteride 1 mg (Propecia® or other), mequitazine (Primalan®)
  • In diabetes and nutrition. : alogliptin (Vipidia®), vildagliptin (Galvus®), sitagliptin (Januvia®, Xelevia®; and associated with metformin in Janumet®, Velmetia®), orlistat (Xenical® or others).
  • In rheumatology / Pain relief : aceclofenac (Cartrex®), diclofenac (voltarene® or other) orally, coxibs: celecoxib (celebrex® or other), ketoprofen gel (cetum® gel or other), piroxicam (Feldene®), glucosamine (Flexea®), methocarbamol (Lumirelax®), capsaicin patches (Qutenza®), quinine (Hexaquine®)
  • in gastroenterology : obeticholic acid (Ocaliva®), diosmectite (smecta® or other), domperidone (motilium® or other), metopimazine (Vogalene®, Vogalib®), beidelitic montmorillonite also known as monmectite (bedelix®)
  • In gynecology-endocrinology: tibolone (Livial® or other), ulipristal 5 mg (Esmya® not marketed in France)
  • In neurology: in the treatment of multiple sclerosis natalizumab (Tysabri®), flunarizine (Sibelium®), and oxetorone (Nocertone®), neuroleptics used to prevent migraine attacks.
  • In case of sore throat or cough: alpha-amylase (maxylase® or others) exposed to sometimes serious skin or allergic disorders; oxomemazine (Toplexil® or others), exposes “disproportionate adverse effects”; tixocortol oral spray (a corticosteroid combined with chlorhexidine (rhinadvil sore throat®)) exposes you to allergic reactions such as angioedema of the face, glossitiseven Quincke’s angioedema.
  • In case of cold: to them oral or nasal decongestants (ephedrine, naphazoline, oxymetazoline, phenylephrine, pseudoephedrine, tuaminoheptane and xylometazoline (not marketed in France)).
  • Psychotropic depression: citalopram (Seropram® or other) and escitalopram (Seroplex® or other); duloxetine (saucer® or other); etifoxine (stream®).

What changes from the Prescrire 2022 list?

3 more drugs to avoid: Peanut protein (palforzia®) because “the frequency of allergic reactions increases in the daily life of patients”Roxadustat (evrenzo®) “a multi-component ‘soup’ of poppy (Papaver somniferum L.) licensed in severe diarrhea provides no clinical advantage compared to loperamide (Imodium° or others)” ,Y Opium tincture (dropizal®).

Return of nintedanib among the drugs to be ruled out: this medicine authorized in certain non-small cell lung cancers (under the name Vargatef®) and in certain chronic lung conditions (under the name of Ofev®), had been removed from the list of drugs to be discarded in 2020, in order to reassess its benefit-risk balance in new indications: certain pulmonary fibrosis, and diffuse interstitial pneumonitis linked to systemic sclerosis. Analysis of clinical evaluation data has shown that also in these situations, the benefit-risk balance of nintedanib is unfavorable. Therefore, it is again among the drugs to be avoided.

Two drugs withdrawn from the balance sheet for re-evaluation: idebenone and teriflunomide. Idebenone (Raxone®) has been removed from the rule-out list because Prescrire is reassessing its benefit-risk balance in Leber’s optic neuropathy. Teriflunomide (Aubagio®), a licensed immunosuppressant in multiple sclerosis, was also taken off the shelf because Prescrire assesses its benefit-risk balance in an extension of the indication in children since the age of 10.

Font : “For Better Treatment, Drugs to Avoid: 2023 Report” Revue Prescrire 2022 (pdf, free access)

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