Worst Pills, Best Pills

An expert, independent second opinion on more than 1,800 prescription drugs, over-the-counter medications, and supplements

FREQUENTLY ASKED QUESTIONS

About WorstPills.org

  1. What is WorstPills.org?
  2. What are the sources for the information on WorstPills.org?
  3. How frequently is WorstPills.org updated?

Using WorstPills.org

  1. My drug is listed as Do Not Use, Limited Use or Do Not Use for Seven Years After FDA Approval. What does that mean?
  2. My drug is NOT listed as Do Not Use, Do Not Use for Seven Years After FDA Approval or Limited Use. What does that mean?
  3. If my drug is not listed on WorstPills.org, does that mean it is safe?
  4. I think I am suffering from an adverse drug reaction, but I do not see any information about this reaction on WorstPills.org. What should I do?
  5. Can I obtain a list of all the Do Not Use drugs?
  6. I have a website or blog. How can I share WorstPills.org content with my readers?

Subscription Information

  1. How do I subscribe to WorstPills.org?
  2. Can I purchase a subscription to WorstPills.org and pay for it over the phone or by mail?
  3. Is the information on this website available in a printed version?
  4. I’m a Worst Pills, Best Pills News print subscriber. Can I add an online subscription to WorstPills.org?
  5. How do I renew my online subscription?
  6. How can I cancel my online subscription and can I obtain a refund?
  7. Can I make copies of articles for distribution?
  8. I received information about the print newsletter Worst Pills, Best Pills News in the mail. How can I sign up for a subscription to the newsletter?

Technical Questions

  1. Why am I not receiving my monthly updates via email and/or other email messages from WorstPills.org?
  2. I have forgotten my password. Can I still log into WorstPills.org?
  3. How do I change the email address associated with my account?
  4. How can I view PDF documents?
  5. My question is not answered here — How can I contact you?

About WorstPills.org

  1. What is WorstPills.org?

WorstPills.org is an online database written by an expert staff of doctors, pharmacists and other experts at Public Citizen’s Health Research Group. It is searchable by drug name; by family of drugs; by disease or condition; by drug-induced disease or condition; and by health policy issue. In this central source of information, you can find recommendations on drugs and dietary supplements based on unbiased, expert evaluations of the most up-to-date medical literature and the Food and Drug Administration’s (FDA’s) own unpublished data.

WorstPills.org includes in-depth information about the safety and efficacy of several hundred top-selling drugs — including more than 200 that we recommend you not use under any circumstances. We also provide recommendations on safer alternatives to harmful drugs and up-to-the-minute email alerts about newly discovered drug dangers.

WorstPills.org is provided by Public Citizen, a national, nonprofit consumer advocacy organization. Public Citizen’s Health Research Group works to ban or relabel unsafe or ineffective drugs and to encourage greater transparency and accountability in the drug approval process. We also work toward improving the system for monitoring and responding to post-marketing safety concerns in the U.S., improving the information available to consumers regarding drugs and dietary supplements and helping doctors and patients make safe and economically wise decisions about drug treatment.

To maintain our independent status, we do not accept funding from corporations, government agencies or professional associations, and we do not accept outside advertising.

  1. What are the sources for the information on WorstPills.org?

Our reviews of drugs and supplements are based on several major sources, including:

  • FDA medical officer reviews of information submitted to that agency by drug manufacturers
  • FDA-approved labeling for pharmaceutical products
  • Reviews of the medical literature using the medical journal database PubMed
  1. How frequently is WorstPills.org updated?

The expert staff at Public Citizen’s Health Research Group review the drug profiles on WorstPills.org every six months based on a literature search, a review of FDA labeling changes and new relevant adverse-effect and effectiveness reports identified from the medical literature.

Using WorstPills.org

  1. My drug is listed as Do Not Use, Limited Use or Do Not Use for Seven Years After FDA Approval. What does that mean?

Do Not Use

After careful review, Public Citizen’s Health Research Group staff of experts have recommended that this drug not be used and have suggested an alternative treatment.

If you discover that you are taking a Do Not Use drug, do not stop taking the drug without first consulting your physician. Suddenly stopping any medication may have serious withdrawal symptoms or adverse effects.

Drugs are designated as Do Not Use based on one or more of the following criteria:

  • Published references that explicitly state not to use the drug in certain populations.
  • Public Citizen’s opinion that the drug is not as safe as an alternative drug or other treatment. The suggested alternative is always listed in the drug’s profile.
  • Public Citizen’s opinion that the drug lacks evidence of effectiveness.
  • Public Citizen’s opinion that the drug, a combination drug, does not meet scientific criteria justifying its use. Fixed combinations of drugs should be used only when their use is logical and well-studied. They should either aid compliance or improve the efficacy obtained with a single ingredient. Few fixed combinations meet this standard. Commonly, in the case of combination drugs, at least one ingredient has not been proven to be effective, or the second ingredient has not been proven to add significantly to the effectiveness of the first.
  • It is a “smoke and mirrors” drug, meaning the drug company has passed off as “new” a drug that is nearly chemically identical to an existing drug and received a new patent, thus allowing the company to rake in millions of dollars after the expiration of the patent on one of their top-selling drugs. “Smoke and mirrors” drugs are likely to function in an identical fashion as the original drug because they are chemically similar. These few drugs are Do Not Use for economic reasons. However, we understand that some insurance companies may reimburse for one drug and not the other. Unless otherwise noted, these drugs rarely pose a safety hazard not seen with the original drug.

Do Not Use for Seven Years After FDA Approval

This designation is made for the following reasons:

  • New drugs are the most dangerous because we know the least about their safety.
  • New drugs are tested in a relatively small number of people before they are approved, and much more is known about their effectiveness than their safety.
  • It is rarely known if the new drugs are more or less effective than older drugs.
  • Serious adverse effects or life-threatening drug interactions may not be detected until a new drug has been taken by hundreds of thousands of people.
  • A number of new drugs have been withdrawn from the market, or serious new adverse reaction warnings have been added to their labeling, usually within seven years after they have been approved by the FDA.

The exception to this rule is the unusual “breakthrough drug” that offers a documented therapeutic benefit over older, proven drugs. We recommend that the majority of new drugs we review on our site not be used for at least seven years after the date of FDA approval.

Do not assume that any drug is a Do Not Use for Seven Years After FDA Approval drug if no information is yet available about it on WorstPills.org. This designation is applied only after a thorough analysis of the drug in question.

Limited Use

Public Citizen’s Health Research Group designates drugs as Limited Use based on our experts’ belief that these drugs offer limited benefit or benefit only certain people or conditions.

Drugs are designated as Limited Use on the basis of one or more of the following criteria:

  • Published studies state that the drug should be used only if another drug does not work.
  • Published studies show that the drug is more dangerous than another preferable drug, but not to the extent that it merits being listed as Do Not Use.
  • Published evidence indicates that the drug, although effective and safe enough for treatment of certain conditions, is widely used for inappropriate and therefore unnecessarily unsafe purposes.
  • The drug is a combination drug that should be reserved for second-choice use (most such drugs are designated as Do Not Use). For example, many combination high blood pressure drugs are required to carry a warning label stating that because it is a fixed combination drug, the drug is not indicated for initial treatment of high blood pressure.
  1. My drug is NOT listed as Do Not Use, Do Not Use for Seven Years After FDA Approval or Limited Use. What does that mean?

For drugs not designated as Do Not Use, Limited Use, or Do Not Use for Seven Years After FDA Approval, we have assessed the drug’s safety and effectiveness with respect to the FDA-approved condition the drug treats (but not necessarily other uses) and have found the drug's use in that context acceptable in light of the risks of the drug for that condition only.

If a particular use for the drug is not discussed on WorstPills.org, you should not assume that the use is either appropriate or inappropriate. You should discuss any treatment decision that involves a drug's use in detail with your physician and weigh its risks and benefits in light of your personal medical history.

  1. If my drug is not listed on WorstPills.org, does that mean it is safe?

If a product is not listed on WorstPills.org, this does not mean that we endorse or reject it — it simply means that we have not researched or written about the product in question.

We select drugs to write in-depth profiles about based partly on data regarding how frequently they are prescribed. We focus on the most commonly prescribed drugs. As more drugs come on the market, they will be evaluated and added to the database if we feel they are likely to become part of the list of widely prescribed drugs.

The list of drugs discussed on WorstPills.org is not meant to be an exhaustive list of all prescription or over-the-counter drugs and dietary supplements. Not included are drugs used primarily to treat hospitalized patients, such as certain antibiotics and drugs for general anesthesia. In addition, drugs for cancer and other less-common diseases generally are not included.

Do not assume that any drug is a Do Not Use for Seven Years After FDA Approval drug if no information is yet available about it on WorstPills.org. This designation is applied only after a thorough analysis of the drug in question.

Reviews of new drugs will be posted on WorstPills.org as the information necessary to complete thorough analyses of the drugs becomes available. Such reviews appear as articles in our monthly newsletter, Worst Pills, Best Pills News, which are accessible on WorstPills.org dating back to 2004. You should discuss in detail any treatment decision that involves the use of a drug with your physician and weigh its risks and benefits in light of your personal medical history.

  1. I think I am suffering from an adverse drug reaction, but I do not see any information about this reaction on WorstPills.org. What should I do?

We seek to include all major drug-induced adverse effects, diseases and conditions for all drugs discussed in profiles on WorstPills.org. However, we do not include every possible drug-induced condition on WorstPills.org, even for the drugs that we review.

If you are experiencing a disease or condition that you believe may be caused by a drug you are taking and do not see it mentioned on WorstPills.org, you should discuss whether it could be drug-induced with your physician. Assume that any new symptom you develop after starting a new drug may be caused by the drug.

  1. Can I obtain a list of all the Do Not Use drugs?

Public Citizen does not offer a list of all Do Not Use drugs. We want consumers and their physicians to have all the information available on the reasons why a drug is designated Do Not Use when they make a decision whether or not to use a particular drug. We do not believe having a list would allow for this detailed analysis.

Researchers at Public Citizen’s Health Research Group apply the designation Do Not Use to a particular prescription or over-the-counter drug or dietary supplement only after a thorough consideration of the available data on the safety and efficacy of each product.

You can find information about the designation of a particular drug by searching for it in our online database.

  1. I have a website or blog. How can I share WorstPills.org content with my readers?

We would be delighted to see you link to WorstPills.org pages from your website or blog. However, our work is copyrighted, and, subject to fair use, you may not reproduce or republish our work on your website or blog or anywhere else without our written permission.

Subscription Information

  1. How do I subscribe to WorstPills.org?

To subscribe to WorstPills.org, click here. Complete all required fields (including entering any Promotion Code you have been provided to obtain a discount price) and then click on the “Subscribe” button. You will then be taken to the “Login” page. Enter your email and password and click on the “Login” button. You then will be taken to the “Set Up Payment” page. Please enter your credit card information and then click on the “Submit Payment” button. You then will have full access to WorstPills.org.

  1. Can I purchase a subscription to WorstPills.org and pay for it over the phone or by mail?

You may only pay for your WorstPills.org subscription online. We have gone to great lengths to ensure the security of financial transactions taking place on WorstPills.org.

  1. Is the information on this website available in a printed version?

You can print the content of individual webpages from WorstPills.org by clicking on the “Print Friendly” icon at the top of the webpage.

Worst Pills, Best Pills News, a monthly newsletter published by Public Citizen, provides monthly drug updates. The complete content from this newsletter is provided on WorstPills.org.

If you prefer to receive our monthly newsletter in printed form, a one-year subscription to Worst Pills, Best Pills News (12 issues) is available for $20 and a two-year subscription (24 issues) for $36. Individual copies of previously published newsletters from the past three years are available for $7 each.

To order individual copies of newsletters or subscribe to the print newsletter, send a check for the full amount of your order payable to “Worst Pills, Best Pills” to the following address:

Worst Pills, Best Pills News
PO Box 96978
Washington, DC 20090-6978

Please remember to indicate whether you are ordering a Worst Pills, Best Pills News subscription or individual newsletter copies, and include your name and the mailing address where you would like your subscription or copies to be sent.

If you would like to pay for a print subscription by credit card, please contact Member Services at 1-800-289-3787.

Public Citizen is no longer selling the 2005 drug safety information book, Worst Pills, Best Pills, due to concerns that its information has become outdated. However, all the reviews of individual drugs contained in the book are available on WorstPills.org and are updated twice annually.

If you have any questions, contact us here.

  1. I’m a Worst Pills, Best Pills News print subscriber. Can I add an online subscription to WorstPills.org?

Yes, as a print subscriber, you may add a one-year online subscription for only $10, which is 33% off the standard subscription price of $15. To take advantage of this special offer, please see the promotion code provided in the advertisement for WorstPills.org found at the bottom of the last page of any recent print issue of Worst Pills, Best Pills News. Enter this promotion code in the appropriate field when you subscribe to WorstPills.org by following the instructions in question 10 above.

  1. How do I renew my online subscription?

When your subscription is due to expire AT THE END OF 12 MONTHS, your credit card will be charged the standard annual subscription rate of $15.00 (or $10 if you are also a Worst Pills, Best Pills News print subscriber) automatically to renew your subscription FOR AN ADDITIONAL 12 MONTHS. Worstpills.org will send you email reminders 30 days and 15 days before this renewal charge is made. These emails will include instructions for cancelling your subscription and preventing the credit card renewal charge (see also the next question).

  1. How can I cancel my online subscription and can I obtain a refund?

WorstPills.org subscribers receive continuous access to WorstPills.org until their subscriptions expire. If you don’t want to renew your subscription, click on the “Cancel Subscription” button on the “Manage Your Subscription” webpage and then click “OK” in the pop-up message box. Your subscription will remain active until your current expiration date; after that date, your subscription will be inactivated, and your credit card will not be charged again.

Annual renewals, but not initial subscriptions, are only refundable within the first three months of the renewal. To request a refund, please go to the “Contact Us” webpage by clicking here within three months of renewal and fill in the requested information. In the “Subject” line, state “Request to cancel subscription and obtain a refund.” In the Feedback box, indicate that you wish to cancel your recently renewed subscription and obtain a refund. You will receive a confirmation email indicating that we have received your request. We also will notify you by email when the refund has been fully processed and the card used to establish the account has been properly credited. Please allow four weeks for this process to be completed. After the refund is provided, you will no longer have access to WorstPills.org content that is behind the paywall.

  1. Can I make copies of content for distribution?

Portions of WorstPills.org may be printed out for personal use or to share with your doctor, but not for distribution. To obtain permission to reprint content from WorstPills.org, please email hrg1@citizen.org with the subject line “WPBP reprint request.”

Alternatively, send a letter to the address below. Please include the title of the content you wish to reprint, the purpose for which you would like to reprint the content, the venue that will be used to distribute it, and the number of copies you would like to distribute:

Worst Pills, Best Pills News
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  1. I received information about the print newsletter Worst Pills, Best Pills News in the mail. How can I sign up for a subscription to the newsletter?

If you want to subscribe to the print newsletter, send a check for the full amount of your order payable to “Worst Pills, Best Pills” to the following address:

Worst Pills, Best Pills News
PO Box 96978
Washington, DC 20090-6978

Please include your name and the mailing address where you would like your subscription to be sent.

If you would like to pay by credit card, please contact Member Services at 1-800-289-3787.

You cannot sign up for a print subscription on WorstPills.org. In addition, any offer you received for a discount on a print subscription is not valid on WorstPills.org.

Technical Questions

  1. Why am I not receiving my monthly updates via email and/or other email messages from WorstPills.org?

When subscribers do not receive our monthly updates, the culprit is usually a SPAM filter. This may happen because of the large number of drug names in our emails — a tip-off for most filters that the message is spam. If you do find a message from us in your spam folder, please report to your email provider that the message is not spam.

In addition to reporting individual emails as legitimate, most email services allow you to designate specific email addresses or domains as not spam. To make sure that messages from WorstPills.org and Public Citizen arrive in your inbox, add the email address wpbpsupport@citizen.org to your contact list or address book.

If you have tried the above methods without success, email wpbpsupport@citizen.org to ensure that you receive your monthly updates. It is important that you receive all the emails that WorstPills.org sends so that you will be alerted when your subscription is due to automatically renew.

  1. I have forgotten my password or email address used to access my subscription to WorstPills.org. How do I regain access to WorstPills.org?

If you have forgotten your password, please click here. You will be asked to provide your email address, and we will send an email with a link that will allow you to reset your password.

If you have forgotten the email address you used to register your account, please send an email to wpbpsupport@citizen.org with the full name you used when you first subscribed.

  1. How do I change the email address associated with my account?

Follow these simple steps to change the email address for your account:

  1. Log into your account with your old email address and password.
  2. Click the "Manage Subscription" link at the top of any WorstPills.org webpage.
  3. On the “Manage Your Subscription” webpage, click on the "Update Email Address" button. On the next page, enter your new email address in both fields and click the “Save” button.
  1. How can I view PDF documents?

A PDF document is a type of electronic file that can be viewed with Adobe Acrobat Reader. To download a free version of this software program, please click here.

Most articles are available in print-friendly HTML format (viewable with any web browser such as Internet Explorer or Netscape).

  1. My question is not answered here — How can I contact you?

Click here for contact information.