The medical journal Prescrire awarded a vaccine against meningitis. But above all, she published a list of 68 drugs to avoid because of the risks they pose to patients who take them.
For the 6th consecutive year, the medical journal Prescribe did not attribute a Golden Pill to any drug in 2013, and for the 3rd year in a row, did not include any on its honor roll. “It’s another year without significant progress brought by new drugs (…). Real progress is elsewhere, particularly in adapting treatment to new evaluation or pharmacovigilance data. Knowing how to rule out drugs that are more dangerous than useful is also an area where significant progress is possible, in the interest of patients, ”comments the review. And as such, Prescrire also publishes in its latest issue an update of its list of “drugs to be avoided”.
From 2010 to 2013, the analysis of files by Prescrire identified 68 more dangerous than useful drugs marketed in France. They are either active drugs, but which, given the clinical situation, expose them to disproportionate risks; either old medicines whose use is outdated; either recent drugs, but whose benefit-risk balance is less favorable than that of older drugs; and finally drugs whose effectiveness is not proven, and which also expose to serious adverse effects.
Pain – Rheumatology
According to the editors of Prescrire (doctors, pharmacists, nurses, or dentists), several drugs authorized in osteoporosis should be ruled out because their effectiveness is modest at best, while they expose to serious adverse effects. Once again, strontium ranelate (Protelos °) is in the sights of the review. According to her, it has modest efficacy in preventing recurrence of vertebral fractures. And the latter to add that its undesirable effects are also “disproportionate”: neuropsychic disorders; cardiovascular disorders; and hypersensitivity.
So, for this bone disease which affects one in three women after menopause, when non-drug means and the intake of calcium and vitamin D are deemed insufficiently effective, Prescrire recommends choosing alendronic acid (Fosamax ° or other), which has a better risk-benefit balance, despite the significant limitations of these drugs.
In addition, other drugs used mainly in rheumatology should be ruled out. Prescribing cites for example quinine (Hexaquine °, Okimus °, Quinine vitamin C Grand °) in cramps, which exposes to serious side effects, sometimes fatal: anaphylactic reactions, haematological disorders, and heart rhythm disturbances, disproportionate with regard to low efficiency. The review admits, however, that it does not know of a drug with a favorable risk-benefit balance in cramps. “Stretching is sometimes useful,” she says.
Gastroenterology
For drugs supposed to treat diseases of the digestive system, Prescrire advises against domperidone (Motilium ° or other) and droperidol (Droleptan °), neuroleptics, which expose to ventricular rhythm disturbances and sudden deaths, disproportionate compared to symptoms treated, gastroesophageal reflux disease (only for domperidone) and nausea and vomiting.
In gastroesophageal reflux, for example, the review points out that other drugs have a much more favorable benefit-risk balance, such as antacids or omeprazole (Mopral ° or other).
Finally, in the smoking cessation, drugs authorized by health authorities should be ruled out, “because they are not more effective than nicotine and expose them to more undesirable effects”, believe these health professionals. As a drug for smoking cessation, nicotine is the more prudent choice, they say.
On the other hand, bupropione (Zyban °), an amphetamine, exposes, according to them, to neuropsychic disorders (including aggressiveness, depressions, suicidal ideation), sometimes serious allergic reactions (including angioedemas, Stevens- Johnson), addictions, and congenital heart defects if exposed in utero.
In addition, these practitioners issue a new recommendation with regard to varenicline (Champix °) which exposes people to depression, suicides, serious skin rashes (including Stevens-Johnson syndromes), and finally cardiac disorders (including angina and myocardial infarction, atrial fibrillations).
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