“Prescribe” assessment: which drugs are on the blacklist?

in collaboration with

Dr. Yves Dour (Doctor in Pharmacy)

Three new drugs have been added to the magazine’s blacklist because, according to the independent review, they have an unfavorable benefit/risk balance.

2023 review: drugs to avoid

Among the drugs analyzed by the review Prescribe between 2010 and 2022, exactly 107 drugs were judged “more dangerous than useful in all the indications appearing in their MA, of which 88 are marketed in France“.

And this year, three newcomers are on the list. If these have been added, it is because their undesirable effects prove to be “disproportionate to the gain in efficiency they bring“, says the magazine.

• Peanut protein (Palforzia°). It is a powder containing peanut protein. “Used orally in the desensitization of peanut allergy, it reduces the frequency and intensity of allergic reactions to peanuts. But it also increases the frequency of allergic reactions in the daily life of patients, including those motivating the administration of adrenaline.“, notes the review.
• Roxadustat (Evrenzo°). It is a drug authorized in anemia linked to chronic renal failure, “which is no more effective overall than epoetins in correcting anemia, although it appears to increase mortality in some patients and has a higher adverse effect profile“, specifies Prescribe.
• Tincture of opium (Dropizal°). It is a “soup” of various constituents of poppy (Papaver somniferum L.) authorized in severe diarrhea, but which “does not provide any clinical advantage over loperamide (Imodium° or other), an opioid marketed alone in this situation”.

Nintedanib, again not recommended

While it had been removed from the list of drugs to be ruled out in 2020, nintedanib is making a comeback on the newspaper’s blacklist.

Indeed, this oral drug used for the treatment of idiopathic pulmonary fibrosis, authorized in certain non-small cell lung cancers (under the name Vargatef°) and in certain chronic lung conditions (under the name Ofev°), has subject to reassessment.

“Analysis of clinical evaluation data has shown that, in these situations too, the benefit-risk balance of nintedanib is unfavourable. It is therefore again among the drugs to be avoided“, notes Prescribe.

List of drugs pinned by Prescrire

Drugs used in Oncology, Transplants, Hematology

• 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 other)
• Vandetanib (Caprelsa)
• Vinflunine (Javlor)

Medicines prescribed in cardiology

Drugs used in dermatology and allergology

• Finasteride 1 mg (Propecia or other)
• Mequitazine (Primalan)
• Dermal pimecrolimus (Elidel, not marketed in France)
• Dermal tacrolimus (Protopic or other)
• Promethazine injection (Phenergan)
• A peanut seed powder containing peanut protein (Palforzia, not marketed in France)

Medications used in diabetes and nutrition

• Gliptins: alogliptin (Vipidia, Vipdomet), linagliptin (Trajenta, Jentadueto), saxagliptin (Onglyza, Komboglyze), sitagliptin (Januvia, Xelevia, Janumet, Velmetia) and vildagliptin (Galvus, Eucreas)
• Pioglitazone (Actos, not marketed in France)
• Bupropione and naltrexone combination (Mysimba, not marketed in France)
• Orlistat (Xenical or other)

Medications used for pain and rheumatology

• Aceclofenac (Cartrex or other)
• Oral diclofenac (Voltaren or other)
• Coxibs: celecoxib (Celebrex or other), etoricoxib (Arcoxia or other) and parecoxib (Dynastat)
• Ketoprofen gel (Ketum gel or other)
• Meloxicam (Mobic or other)
• Piroxicam (Feldene or other)
• Systemic tenoxicam (Tilcotil)
• Diacerein (Art 50 or other)
• Glucosamine (Flexea or other)
• Muscle relaxants
• Oral mephenesin (Decontractyl, not marketed in France)
• Methocarbamol (Lumirelax)
• Thiocolchicoside (Miorel or other)
• Denosumab 60 mg (Prolia)
• Romosozumab (Evenity, not marketed in France)
• Capsaicin patches (Qutenza)
• The combination colchicine, opium powder and tiemonium (Colchimax)
• Quinine (Hexaquine, Okimus)

Drugs used in gastroenterology

• Obeticholic acid (Ocaliva)
• Medicated clays: diosmectite (Smecta or other), hydrotalcite (Rennieliquo), beidellitic montmorillonite or monmectite (Beldelix, Gelox) and kaolin (Gastropax, Neutroses)
• Domperidone (Motilium or other)
• Droperidol (Droleptan or other)
• Metopimazine (Vogalene, Vogalib)
• Prucalopride (Resolor)
• Tincture of Opium (Dropizal)
• Glyceryl trinitrate, 0.4% ointment (Rectogesic)

Drugs used in gynecology and endocrinology

• Tibolone (Livial or other)
• Ulipistral 5 mg (Esmya, not marketed in France)

Medicines used in infectiology

Drugs used in neurology

Medications used in pneumology and ENT

• Ambroxol (Muxol or other)
• Bromhexine (Bisolvon)
• Oxomemazine (Toplexil or other)
• Pentoxyverine (Pentoxyverine Clarix 0.15%)
• Pholcodine (no longer marketed in France since September 2022)
• Alpha-amylase (Maxilase or other)
• Tixocortol Oral Spray (Rhinadvil Sore Throat)
• Oral and/or nasal decongestants: ephedrine, naphazoline, oxymetazoline, phenylephrine, pseudoephredine, tuaminoheptane and xylometazoline (not marketed in France)
• Inhaled mannitol (Bronchitol, not marketed in France)
• Nintedanib (Ofev)
• Roflumilast (Daxas, not marketed in France)

Drugs used in psychiatry and addictions

Medications used for smoking cessation

Drugs used in urology

• Oral pentosan polysulfate (Elmiron).