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in collaboration with
Dr Yves Dour (Doctor of Pharmacy)
As every year for the past twelve years, the journal Prescrire establishes the list of drugs “authorized but more dangerous than useful”. Doctissimo takes stock of the subject with Dr Yves Dour, pharmacist on the Doctissimo expert committee.
The 2024 report on “drugs that are more dangerous than useful”, established by the journal Prescrire, has just been published in the last issue of the year. It includes a total of 105 drugs, including 88 marketed in France. Which “translates” to Prescribe, “the inadequacies of health authorities to protect patients“.
Medications “to be discarded for better treatment”
The drugs listed and singled out by the editors of the independent review are “more dangerous than useful in all the indications appearing in their AMM (marketing authorization)”. Sometimes it is a particular form or dosage.
But, supports Prescrire, “most often, when a drug treatment seems desirable, other options have a better benefit-risk balance than these drugs to be ruled out. And in some situations, the most prudent option is not to resort to medication.”.
Changes compared to 2023
The list of these drugs therefore evolves each year and here are those that have been added and those, on the contrary, that have been removed.
- Teriflunomide (Aubagio or other), is an immunosuppressant authorized in multiple sclerosis. After being withdrawn in 2023, in order to evaluate its benefit-risk balance in a new indication (children from the age of 10), it is back on the black list. Indeed, the analysis has shown that, among children too, this balance is unfavorable.
- Fenfluramine (Fintepla), which is an amphetamine, was removed from the 2024 review. In fact, the review evaluates its benefit-risk balance in a new authorized indication: Lennox-Gastaut syndrome in children. According to Prescrire, it should be ruled out as an addition to antiepileptic treatment in Dravet syndrome, a rare and serious form of childhood epilepsy.
- Idebenone (Raxone), which is an analogue of Coenzyme Q10, was re-evaluated this year after a withdrawal in 2023. The objective being to “re-evaluate its benefit-risk balance following new data in Leber optic neuropathy”. After reassessment, Prescrire concluded that its “risk-benefit balance was uncertain, not more unfavorable“. The withdrawal of idebenone is however maintained.
“All medicines are likely to be poisons”
Questioned on the subject, Dr Yves Dour, pharmacist member of the Doctissimo expert committee, recalls that the pharmacist is originally “the master of poisons”. “The original role of the pharmacist is to be the master of poisons, which means that any medicine is likely to be one.
This is why each molecule is analyzed according to a benefit-risk balance. “It makes it possible to measure a patient’s tolerance for a treatment. Sometimes it is less positive and the patient will respond less well to treatment. At that point, the diverse therapeutic arsenal to which we have access often allows us to opt for a more appropriate treatment.” estimates the specialist.
List of medications pinned by Prescrire
Discover the list of drugs singled out by the review Prescribe.
Medicines used in Oncology, Transplants, Hematology
Antitumor drugs
- 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)
Medications prescribed in cardiology
Medications 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 proteins (Palforzia, not marketed in France)
Medicines used in diabetes and nutrition
Diabetes
- 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)
Weightloss
- The combination of bupropione and naltrexone (Mysimba, not marketed in France)
- Orlistat (Xenical or other)
Medications used for pain and rheumatology
The following non-steroidal anti-inflammatory drugs (NSAIDs):
- Aceclofenac (Cartrex or other)
- Oral diclofenac (Voltarene 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)
- General tenoxicam (Tilcotil)
- Diacerein (Art 50 or other)
- Glucosamine (Flexea or other)
Muscle relaxants
Osteoporosis
- Denosumab dosed at 60 mg (Prolia)
- Romosozumab (Evenity, not marketed in France)
Others
- Capsaicin in patches (Qutenza)
- The combination of colchicine, opium powder and tiemonium (Colchimax)
- Quinine (Hexaquine, Okimus)
Medications 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)
- Opium tincture (Dropizal)
- Glyceryl trinitrate, 0.4% ointment (Rectogésic)
Medicines used in gynecology and endocrinology
- Tibolone (Livial or other)
- Ulipistral 5 mg (Esmya, not marketed in France)
Drugs used in infectious diseases
Drugs used in neurology
Multiple sclerosis
Others
Medications used in pulmonology and ENT
Cough
- Ambroxol (Muxol or other)
- Bromhexine (Bisolvon)
- Oxomemazine (Toplexil or other)
- Pentoxyverine (Pentoxyverine Clarix 0.15%)
- Pholcodine (no longer marketed in France since September 2022)
Sore throat
Others
- 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)
Medications used in psychiatry and addictions
Depression medications
Other psychotropic drugs
Medications used for smoking cessation
Medications used in urology
- Oral pentosan polysulfate (Elmiron).