Worst Pills, Best Pills

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

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DISEASE AND DRUG FAMILY INFORMATION
Misprescribing and Overprescribing of Drugs
The numbers are staggering: in 2003, an estimated 3.4 billion prescriptions were filled in retail drugstores and by mail order in the United States. That averages out to 11.7 prescriptions filled for each of the 290 million people in this country. But many people do not get any prescriptions filled in a given year, so it is also important to find out how many prescriptions are filled by those who fill one or more prescriptions. In a study based on data from 2000, more than twice as many prescriptions were filled for those 65 and older (23.5 prescriptions per year) than for those younger than 65 (10.1 prescriptions per year).
Adverse Drug Reactions
Although some adverse drug reactions (ADR) are not very serious, others cause the death, hospitalization, or serious injury of more than 2 million people in the United States each year, including more than 100,000 fatalities. In fact, adverse drug reactions are one of the leading causes of death in the United States. Most of the time, these dangerous events could and should have been avoided. Even the less drastic reactions, such as change in mood, loss of appetite, and nausea, may seriously diminish the quality of life.
Drug-Induced Diseases
Each year, more than 9.6 million adverse drug reactions occur in older Americans. The referenced study found that 37% of these adverse reactions were not reported to the doctor, presumably because patients did not realize the reactions were due to the drug. This is not too surprising considering that most doctors admitted they did not explain possible adverse effects to their patients.
Diet Drugs
The FDA has set the bar too low for the approval of diet drugs. Instead of requiring that diet drugs be proved to prevent the long term consequences of obesity (none ever has), diet drugs can be approved if they show a modest weight loss over a relatively short period.
Oral Contraceptives
The pill can cause many adverse effects. Some of them are merely a nuisance, while others can be life-threatening. The pill can cause headaches, bloating, nausea, irregular bleeding and spotting, breast tenderness, weight gain, or vision changes. Other more serious adverse effects that can occur from a few months to a few years after starting oral contraceptives include high blood pressure, gallbladder disease, liver tumors, depression, and metabolic disorders, such as diabetes. Temporary infertility has been associated with the period of time right after pill use is stopped. But the two most dangerous risks associated with taking birth control pills are blood clots and cancer.
Migraine Headaches
For reasons of both safety and cost, the newer migraine drugs known as triptans should be used only after determining that the NSAIDs and acetaminophen fail to work. The triptans can dangerously, even fatally, narrow arteries in the heart.
Thyroid Hormone
Variations in the amount of active levothyroxine available in a tablet can affect both the safety and effectiveness of the drug. Levothyroxine is unstable in the presence of light, temperature, air, and humidity. Patients who receive superpotent tablets (too much levothyroxine) experience chest pain, rapid heart rate, or heart rhythm disturbances. There is also evidence that overtreatment can cause the bone-weakening disease osteoporosis. Subpotent (too little levothyroxine) tablets will not be effective in controlling the symptoms of low thyroid hormone production (hypothyroid).
Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder
To correctly establish the diagnosis of ADHD requires the use not only of medical but also of special psychological, educational, and social resources. Many children diagnosed with ADHD actually have problems that are primarily caused or worsened by inadequate teachers, unsuitable educational settings, or by problems with their parents. Similarly, many adults diagnosed with ADHD may have interpersonal problems that need to be dealt with by psychotherapy.
Diabetes Prevention and Treatment
Diets that are very complicated or very different from what you are used to are hard to follow. The American Diabetes Association (ADA) diet is a highly structured plan based on exchange lists. Although it serves its purpose of regulating calorie and sugar intake quite well, the ADA diet may be difficult for older people to use. Successful use of this diet requires considerable time spent planning meal patterns and food portions. Older people often have trouble with this diet because the food lists are long and complicated and require considerable memorization.
Muscle Relaxants
Some of the widely prescribed muscle relaxants covered on this web site have been on the market for more than 40 years. Yet five of these drugs were among the top 200 most frequently prescribed medications in the United States in 2002, with more than 30 million prescriptions dispensed. Since their original marketing, there has been very little reliable evidence that these drugs actually relax muscles.
Benign Prostatic Hypertrophy (BPH)
If your BPH symptoms are minimal, no treatment is necessary, no matter what the size of your prostate gland. If you have BPH symptoms and do not have a very enlarged gland, then an alpha-blocker such as terazosin would be the best choice. If your prostate is very enlarged, treatment with an alpha-blocker would again be the best choice. Finasteride should be used only if an alpha-blocker failed to relieve your symptoms.
Osteoporosis
Osteoporosis is a reduction in bone mass and weakening of bone architecture that increases the susceptibility of bone to fracture. Bone is a living tissue that is constantly being broken down and resynthesized at 1 to 2 million microscopic sites in the adult skeleton. Osteoporosis occurs when the rate of breakdown is faster than the rate of resynthesis. The history of the treatment or prevention of osteoporosis is strewn with drugs such as estrogens—discussed below—and others in this chapter with marginal effectiveness or with risks clearly outweighing the benefits.
Hormone Replacement Therapy
In 1991, the Health Research Group published the Women’s Health Alert. The largest chapter in the book was on hormone replacement therapy (HRT). By then, the evidence was clear that these drugs caused breast cancer, and very serious doubts had been raised about their ability to protect against heart disease. The first sentence in this chapter began: Female replacement hormones may someday be remembered as the most recklessly prescribed and dangerous drugs of this century.
Smoking Cessation
There is no question that smoking involves a physical addiction to nicotine as well as psychological addiction to the patterns of smoking in certain circumstances or situations. Unless attention is paid to both of these kinds of addiction, the chance of success in stopping smoking will not be as good as it could be.
Erectile Dysfunction
A number of drugs can cause sexual dysfunction in both women and men. Determining the potential benefits of vardenafil, tadalafil, or sildenafil is much more complex than for drugs that are used to treat cancer, heart disease, or high blood pressure, for example, where one of the potential benefits may be increased survival or avoidance of a heart attack or stroke. It is unlikely that untreated ED contributes to decreased survival, even though it may contribute to emotional distress and strained relationships.
Adrenal Steroids
There are three types of adrenal steroids: mineralocorticoids, which maintain sodium and potassium balance in the body, glucocorticoids, and male sex steroids (although most male sex hormones are produced in the testicles). Our Web site only considers glucocorticoids.
Urinary System
It is important to distinguish between urge incontinence, overflow incontinence, stress incontinence, and a fourth form of incontinence called functional incontinence (incontinence due to ambulatory difficulties or inadequate access to a toilet), as each has different treatments.
Sleeping Pills and Tranquilizers
Older adults have a much more difficult time eliminating benzodiazepines and similar drugs from their bloodstreams and these drugs can thus accumulate in their bodies. Also, older adults are more sensitive to the effects of many of these drugs than are younger adults. For older adults the risk of serious adverse drug effects is significantly increased. Serious adverse effects may include: unsteady gait, dizziness, falling (causing an increased risk of hip fractures), increased risk of an auto accident, drug-induced or drug-worsened impairment of thinking, memory loss, and addiction.
Antipsychotic Drugs: Dangerously Overused
Antipsychotic drugs, also called neuroleptic drugs or major tranquilizers, are properly and successfully used to treat serious psychotic mental disorders, the most common of which is schizophrenia. In younger adults, an alarming number of those with schizophrenia who could and often have previously benefited from antipsychotic drugs are not receiving them. They are seen, among other places, on the streets and in homeless shelters. In older adults, the problem is not underuse but, rather, gross overuse by people who are not psychotic.
Depression: When are Drugs Called For And Which Ones Should You Use?
Ironically, one of the kinds of depression that should not be treated with drugs is depression caused by other kinds of drugs. If someone is depressed and the depression started after beginning a new drug, it may well be drug-caused. Commonly used drugs known to cause depression include the following:
Application of Eye Drops and Ointments; Glaucoma
The normal eye can hold about 10 microliters (10 millionths of a quart) of liquid. A single drop formed by an eye dropper, however, ranges from 25 to 50 microliters. What happens to the excess 15 to 40 microliters when you apply eye drops? Two things occur:
Alzheimer's Disease
The strategy to sell Alzheimer’s disease drugs is based on hope, fear, and guilt: hope that one of these drugs might work, fear that if one of these drugs is not started quickly, all will be lost; and guilt if family members have not made the decision to fight the disease with expensive, sometimes dangerous, drugs. Recent reviews by the U.S. Preventive Services Task Force and the American Academy of Neurology are appropriately skeptical of the use of these drugs.
Salicylates and Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
The salicylates are used to relieve pain and to reduce fever and inflammation. Aspirin, a nonsteroidal anti-inflammatory drug (NSAID), is the most well-known and frequently used salicylate. Other salicylates discussed on this web site are salsalate and choline and magnesium salicylates.
Opioids
Most of the time when someone is able to swallow, they should first try a non-opioid drug such as aspirin taken by mouth. If aspirin alone is not effective, it can be combined with an opioid, such as codeine. These two drugs work in different ways, and when they are used together, they generally relieve pain that would otherwise require a higher dose of an opioid, while causing fewer adverse effects.
Arthritis and Inflammation
At least 31.6 million Americans suffer from some form of arthritis. The three most common types are rheumatoid arthritis, osteoarthritis, and gout. Each has a different cause, treatment, and probable outcome.
Ulcers and Gastroesophageal Reflux Disease (GERD)
There are nondrug treatments, with no safety concerns, and less expensive drugs that may be effective for GERD; these should be tried before you use any drugs for heartburn. First, try to avoid foods that trigger your condition (e.g., fatty foods, onions, caffeine, peppermint, and chocolate), and avoid alcohol, smoking, and tight clothing. Second, avoid food, and particularly alcohol, within two or three hours of bedtime. Third, elevate the head of the bed about six inches or sleep with extra pillows.
Irritable Bowel Syndrome
The FDA has approved drugs for both diarrhea-predominant and constipation-predominant IBS. The former, alosetron (LOTRONEX) , had to be removed from the market after it caused serious constipation and a condition of decreased blood flow to the intestine called ischemic colitis. The latter, tegaserod (ZELNORM), has also been associated with ischemic colitis and severe, disabling diarrhea, and it is barely effective.
Constipation
When do you really need to take a laxative? You should not take a laxative to “clean out your system” or to make your body act more normally. It is untrue that everyone must have a bowel movement daily. Perfectly healthy people may have from three bowel movements per week to three bowel movements per day.
Diarrhea
How to Treat Acute Simple Diarrhea Do not eat or drink milk and dairy products, fresh fruits and vegetables, coffee, spicy foods, or other food you do not tolerate well. Do not consume drinks with a high sugar content, such as grape juice, apple juice, and soft drinks, including cola, ginger ale, and sports drinks. Do not eat highly sweetened foods such as candy, ice cream, or Jell-O because they have too much sugar, which can make the diarrhea worse.Drink plenty of ORS (see formula in box).
Gas
One of the miracles of modern Madison Avenue marketing is that the public is still spending money for simethicone, alone or in combination with other drugs, for gas or infant colic. Despite the millions spent on advertising to convince us otherwise, the feeling of bloating and pain after eating is not caused by gas. There is no relation between these symptoms and the amount of gas in the intestinal tract. The use of antigas products to relieve this discomfort is inappropriate, as there is no medical need to expel gas from the body.
Vitamins and Minerals
One promotional strategy of supplement suppliers is to make people worry about whether they are getting enough nutrients. But do most people really need to take vitamins and minerals to supplement their diets? Or are they a waste of money? Are there better alternatives to taking supplements to ensure adequate nutrition? This section will attempt to answer these questions and help you sort through the fact and fiction surrounding nutritional supplements.
Cough and Cold
Many prescription or over-the-counter drug combinations of two or more ingredients should not be used because they are irrational combinations of single ingredients, some of which are safe and effective and sensible to use alone if treating the symptom for which they are intended. The combinations, however, present extra risks for extra ingredients that will usually not add any benefit (possibly a risk) to the first ingredient and will invariably cost much more than the single ingredient alone.
Asthma, Chronic Bronchitis and Emphysema
Do not try to diagnose or treat yourself. Asthma, chronic bronchitis, and emphysema must be diagnosed and treated by a doctor or other health professional. Two other common conditions that cause breathing difficulties, congestive heart failure and pneumonia, have similar symptoms, and many of the drugs used to treat asthma or COPD may worsen these conditions. Therefore, it is extremely important that you have your condition properly diagnosed before starting any medication.
Allergy and Hayfever
If you suffer from an itchy and runny nose, watery eyes, sneezing, and a tickle in the back of your throat, then you probably have an allergy. An allergy means a hypersensitivity to a particular substance called an allergen. Hypersensitivity means that the body’s immune system, which defends against infection, disease, and foreign bodies, reacts inappropriately to the allergen. Examples of common allergens are pollen, mold, ragweed, dust, feathers, cat hair, makeup, walnuts, aspirin, shellfish, poison ivy, and chocolate.
Antibiotics
Antibiotics (drugs used to treat bacterial infections) are overwhelmingly misprescribed in the United States. Despite congressional hearings and numerous academic studies on this issue, it has become the general consensus that 40 to 60% of all antibiotics in this country are misprescribed. New studies continue to confirm the fact that a large proportion of antibiotic prescribing for both children and adults continues to be inappropriate.
Penicillins and Cephalosporins
Penicillins are a group of antibiotics used to kill bacteria or prevent infections. They are probably the least toxic of all the antibiotics. The penicillins are some of the most commonly prescribed antibiotics and are often the drugs of choice for people who are not allergic to them. Cephalosporins are relatives of the penicillins and have a similar, if slightly expanded, range of action. They have a good safety record but certain problems can occur with their use. Diarrhea is the most common adverse effect, and it may become so bad that treatment must be stopped.
Fluoroquinolones
One of the biggest-selling and most overprescribed classes of drugs in the United States is the family called fluoroquinolones. One clue that a drug your doctor wants to give you is in this class is the fact that the generic names of all such drugs approved in the United States include the sequence floxacin. These drugs have been alternatives for individuals allergic to, or with infections resistant to, other antibiotics. Some fluoroquinolones are commonly misprescribed for colds, sore throats, bladder infections, or community-acquired (as opposed to hospital-acquired) pneumonia.
Tetracyclines
Tetracyclines are rarely the antibiotics of choice to treat bacterial infections that are common in older adults. In general, tetracyclines are used to treat such infections as urethritis (inflammation of the urinary tract), prostate infections, pelvic inflammatory disease, acne, Rocky Mountain spotted fever, recurrent bronchitis in people with chronic lung disease, walking pneumonia, and other miscellaneous infections.
High Blood Pressure
A study of nutritional therapy showed that over one-third of people who previously needed drug treatment for high blood pressure were able to adequately control their blood pressure with nutritional therapy alone.Several factors should be taken into account when considering whether your high blood pressure should be treated. One is the benefits of the treatment for your blood pressure, which vary significantly depending on how high it is, your age, and whether you have other risk factors such as high cholesterol or are a smoker or a diabetic, and whether you have had a heart attack, heart failure, a stroke, or have kidney damage. The other consideration is the risks or the adverse effects of the treatment, which will vary depending on what is being considered.
Elevated Cholesterol Levels
The evidence for treatment, especially with cholesterol-lowering drugs, is much weaker for people who have not yet had the cardiovascular disease described above, known as primary prevention. This is especially so for those people who do not have more than one of the following risk factors: hypertension, diabetes, smoking, obesity, or a close family history of premature heart attacks or strokes.
Potassium Supplementation
Very few people actually need to take a potassium supplement or a potassium-sparing diuretic (amiloride, spironolactone, triamterene). If, however, you take digoxin, have severe liver disease, or take large doses of diuretics (water pills) for heart disease, eating a potassium-rich diet may not be sufficient to replace the potassium that you are losing. If you fall into one of these categories, it is very important for your doctor to precisely monitor and regulate the amount of potassium in your bloodstream.
Dietary and Herbal Supplements
In the other chapters of this book, we have had access to published articles describing randomized, controlled trials in medical journals, medical textbooks, the FDA-approved label, and, importantly, the detailed review of the drug (based on a review of the raw data from the sponsor’s clinical trials) conducted by the FDA medical officer, at least for more recent drugs. This evidence base is far from complete for any dietary supplement. By definition, no supplement has passed an FDA safety and efficacy review (otherwise it would be a drug).
Protecting Yourself and Your Family from Preventable Drug-induced Injury
Doctors and pharmacists often blame the adverse effects of prescription drugs on patients, accusing them of improperly taking their medications. The standard solution offered by some health professionals is to get patients to better “comply” with doctors’instructions by using what are called compliance programs or strategies. (Another word for compliance is, of course, obedience.) Occasionally, the blame is also put on doctors for misprescribing and overprescribing, on pharmacists for failing to detect serious drug interactions, and only rarely on the drug industry for overselling drugs to doctors and now directly to patients through direct-to-consumer advertising.
Saving Money When Buying Prescription Drugs
For many people in the United States, the price of prescription drugs is unaffordable. Many drugs cost $500, $1,000, $2,000, or more per drug and many people are taking more than one of them. Although the majority of these drugs have not yet come off patent and generic equivalents are therefore not available, the lack of the kind of price controls that exist in all other developed countries (and in the Department of Defense and the Veteran’s Administration in the United States) presents an insufferable financial burden for too many people. This section of our web site discusses five ways to save on prescription drugs.
Myths and Facts About Generic Drugs
Unless you want to waste a large amount of money—often hundreds of dollars a year—by using brand-name instead of generic drugs, you should ask for the generic version, especially if you are starting on a drug for the first time. One of the few bits of comparative information about prescription drugs readily accessible to consumers is the retail price of brand-name versus generic drugs. You can get this information easily by asking your pharmacist.
Ten Rules for Safer Drug Use
Ten straightforward ways to reduce you and your family's chances of being injured by drugs. The rules include communicating more effectively with your health care providers, using the lowest effective dose of your medication, adjusting the dose for your age and deciding whether you are experiencing an adverse effect from your drugs.
For Prescriptions, Eye Doctors Recommend Using One Drop per Eye, Not Two
Ophthalmologists consulting for the Medical Letter generally agree that all eye drops should only be used in a dose of one drop because there is a smaller chance of an overdose with one drop. Also, using one drop instead of two makes more efficient use of the medicine.
Used as a Glaucoma Treatment, Beta-Blocker Eye Drops May Cause Serious Adverse Reactions in Some
You should not use beta blocker eye drops to treat glaucoma if you have pre-existing breathing or certain heart conditions.
Combination Treatments for Helicobacter Pylori Infection
The bacterium Helicobacter pylori (H. pylori) has been implicated in causing ulcer disease. The combination treatments described have high success rates and low recurrence rates, but the treatment is arduous.
Public Citizen Sues FDA for Failing to Act on Petition to Remove Darvon from the Market
Public Citizen sues the Food and Drug Administration after the agency failed to act on the organization's two-year-old petition to remove all drugs containing propoxyphene, including Darvon and Darvocet.
Dangers of Mixing Alcohol with Certain Medications or Diseases
The article discusses 273 drugs that can have harmful interactions with alcohol. Also reviewed are several ways in which these harmful interactions can occur: 1/ Medications Can Increase Alcohol Blood Levels 2/ Additive effects of medications and alcohol. One of the best- known drug-alcohol interactions is when alcohol, a depressant, is taken with other sedative medications, and excessive sedation or depression of respiration can occur 3/Alcohol can increase the blood levels of some medications leading to toxicity of these drugs. 4/ Alcohol also can reduce blood levels of some medications causing them to be less effective. Although some of the interactions between alcohol and medications mainly occur in people who drink heavily (three or more drinks on one occasion), many of these interactions may occur with much lower amounts of alcohol use, such as one to two drinks on an occasion. We strongly urge you to tell your physicians and other health care providers how much alcohol you are drinking so they can effectively assess the risks and advise you about the safe use of alcohol and medications.
29 Medications That May Cause Adverse Interactions with Thyroid Drugs
Thyroid medications are among the most widely-prescribed drugs in the U.S. In this article, we review 29 different medications that can have harmful interactions with thyroid medicines such as levothyroxine (Synthroid). There are four major kinds of interaction problems that can occur: • Certain medications can decrease the absorption of levothyroxine resulting in lower levels in the blood. • Other medications can increase the rate at which the body gets rid of levothyroxine, also resulting in lower thyroid levels in the blood. • Other medications can cause changes of levothyroxine binding in blood, decreasing the body's ability to use levothyroxine. • Levothyroxine can affect the safety or effectiveness of other medications by raising or lowering the levels of these other drugs in the blood, causing them to be either infective (lower levels) or dangerous (higher levels).
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DRUG AND DIETARY SUPPLEMENT PROFILES

A comprehensive review of the safety and effectiveness of this drug. If the drug is not a Do Not Use product, information on adverse effects, drug interactions and how to use the medication are included.

orlistat (ALLI, XENICAL)
  • We list this drug as a Do Not Use drug because it has not been shown to cause long-term health benefits.
sibutramine (MERIDIA)
  • We list this drug as a Do Not Use drug because it causes very limited weight loss and also causes high blood pressure and increased heart rate.
thyroid tablets USP (ARMOUR THYROID, NATURE-THROID, NP THYROID, WESTHROID, WP THYROID)
  • We list this drug as a Do Not Use drug because it is not adequately guaranteed to provide appropriate blood levels of thyroid hormone and reliable alternatives are available.
desogestrel and ethinyl estradiol (APRI, CAZIANT, CESIA, CYCLESSA, DESOGEN, MIRCETTE, ORTHO-CEPT, RECLIPSEN, SOLIA, VELIVET)
  • We list these drugs as Do Not Use drugs because they cause blood clots and are no more effective than other oral contraceptives in preventing pregnancy.
drospirenone and ethinyl estradiol (GIANVI, YASMIN, YAZ, ZARAH)
  • We list this drug as a Do Not Use drug because it can cause increased blood levels of potassium and is no more effective than other oral contraceptives in preventing pregnancy.
dexmethylphenidate (FOCALIN, FOCALIN XR)
  • We list this drug as a Do Not Use drug because it has no advantage over similar drugs with longer safety records.
pemoline (CYLERT)
  • We list this drug as a Do Not Use drug because the evidence for its effectiveness is limited and it causes liver damage.
esterified estrogens with methyltestosterone (ESTRATEST, ESTRATEST HS)
  • We list these drugs as Do Not Use drugs because the male hormone portion of this combination drug does not add to its effectiveness.
acetohexamide (DYMELOR); chlorpropamide (DIABINESE, GLUCAMIDE)
  • We list these drugs as Do Not Use drugs because they are more likely than similar drugs for diabetes to cause low blood sugar.
pioglitazone (ACTOS); rosiglitazone (AVANDIA)
  • We list these drugs as Do Not Use drugs because they may be less effective than other drugs for diabetes and cause liver damage, weight gain, anemia and heart failure.
nateglinide (STARLIX); repaglinide (PRANDIN)
  • We list these related drugs as Do Not Use drugs because one of them is less effective than other drugs available for diabetes.
isometheptene, dichloralphenazone and acetaminophen (MIDRIN)
  • We list this drug as a Do Not Use drug because each of the active ingredients included in this drug do not contribute to the drug's effectiveness, as required by law.
carisoprodol (SOMA); carisoprodol with aspirin (SOMA COMPOUND); carisoprodol, aspirin and codeine (SOMA COMPOUND WITH CODEINE)
  • We list these drugs as Do Not Use drugs because it is no more effective than aspirin and related drugs, is sedating and breaks down into a chemical with a potential for abuse.
chlorzoxazone (PARAFON FORTE DSC)
  • We list this drug as a Do Not Use drug because it is no more effective than aspirin and related drugs, is sedating and can cause liver damage.
cyclobenzaprine (FLEXERIL)
  • We list this drug as a Do Not Use drug because it is no more effective than aspirin and related drugs and is sedating.
methocarbamol (ROBAXIN)
  • We list this drug as a Do Not Use drug because it is no more effective than aspirin and related drugs and is sedating.
orphenadrine (INVAGESIC, NORFLEX); orphenadrine and aspirin and caffeine (NORGESIC, NORGESIC FORTE, ORPHENGESIC, ORPHENGESIC FORTE)
  • We list these drugs as Do Not Use drugs because the main ingredient is no more effective than aspirin and related drugs and has the same adverse effects as antihistamines.
amitriptyline
  • We list this drug as a Do Not Use drug because it has more adverse effects than related drugs.
amitriptyline and chlordiazepoxide (LIMBITROL)
  • We list this drug as a Do Not Use drug because it is an irrational combination of two other Do Not Use drugs.
amitriptyline and perphenazine (TRIAVIL)
  • We list this drug as a Do Not Use drug because it is an irrational combination of one drug with another Do Not Use drug.
calcitonin [calcitonin-salmon] (FORTICAL, MIACALCIN)
  • We list this drug as a Do Not Use drug because, unlike other drugs for osteoporosis, there is no clear evidence that it can reduce the rate of new fractures.
teriparatide (FORTEO)
  • We list this drug as a Do Not Use drug because it has not been shown to reduce fractures in men and caused bone cancer in animal studies.
thioridazine (MELLARIL)
  • We list this drug as a Do Not Use drug because it is more likely to cause irregular heartbeat than related drugs.
nefazodone (SERZONE)
  • We list this drug as a Do Not Use drug because it causes liver failure.
ziprasidone (GEODON, ZELDOX)
  • We list this drug as a Do Not Use drug because it is no more effective than older drugs for schizophrenia and causes irregular heartbeat.
zaleplon (SONATA)
  • We list this drug as a Do Not Use drug because it is less effective than related drugs and can cause addiction.
mesoridazine (SERENTIL (DISCONTINUED))
  • We list this drug as a Do Not Use drug because, unlike some other drugs available for schizophrenia, it causes an irregular heartbeat.
meprobamate (EQUANIL, MILTOWN)
  • Do Not Use: This drug is sedating and addictive and can cause hip fractures. There are safer drugs available.
sulfacetamide and prednisolone (BLEPHAMIDE, VASOCIDIN)
  • We list this drug as a Do Not Use drug because it is an irrational combination of ingredients and there is no persuasive evidence that it is effective.
neomycin and dexamethasone (NEODECADRON); neomycin p, polymyxin b, and dexamethasone (MAXITROL)
  • We list these drugs as Do Not Use drugs because they are an irrational combination of ingredients and there is no persuasive evidence that they are effective.
phenazopyridine (PYRIDIUM)
  • We list this drug as a Do Not Use drug because it has questionable effectiveness and causes anemia and liver damage, as well as cancer in animals.
indomethacin (INDOCIN, TIVORBEX)
  • We list this drug as a Do Not Use drug because it is no more effective than related drugs and causes a higher rate of ulcers.
ketorolac (SPRIX)
  • We list this drug as a Do Not Use drug because it is no more effective than related drugs and causes a higher rate of ulcers.
piroxicam (FELDENE)
  • We list this drug as a Do Not Use drug because it is no more effective than related drugs and causes a higher rate of ulcers and skin reactions.
celecoxib (CELEBREX); meloxicam (MOBIC); rofecoxib (VIOXX); valdecoxib (BEXTRA)
  • We list these drugs as Do Not Use drugs because they are no more effective than related drugs, most have not been shown to have a lower rate of ulcers than related drugs and some have been shown to cause heart disease.
buffered aspirin (ASCRIPTIN, BUFFERIN); diflunisal (DOLOBID); salsalate (DISALCID)
  • We list these drugs as Do Not Use drugs because they have no advantage over ordinary generic aspirin in safety or effectiveness.
donepezil (ARICEPT, ARICEPT 23); tacrine (COGNEX)
  • We list these drugs as Do Not Use drugs primarily because they are minimally effective.
galantamine (RAZADYNE, RAZADYNE ER); rivastigmine (EXELON)
  • We list these drugs as Do Not Use drugs primarily because they are minimally effective.
memantine (NAMENDA)
  • We list this drug as a Do Not Use drug primarily because there is no persuasive evidence that it is effective.
ergoloid mesylates (HYDERGINE, HYDERGINE LC)
  • We list these drugs as Do Not Use drugs because there is no evidence that they are effective.
butorphanol
  • We list this drug as a Do Not Use drug because it is no more effective than related drugs, is more expensive and is addictive.
pentazocine and naloxone (TALWIN-NX)
  • We list this drug as a Do Not Use drug because it causes more confusion and hallucinations than related drugs.
tramadol (CONZIP, ULTRAM); tramadol and acetaminophen (ULTRACET)
  • We list these drugs as Do Not Use drugs because they are no more effective than similar drugs, are addictive and cause seizures.
butalbital, acetaminophen and caffeine (ESGIC PLUS, FIORICET); butalbital, caffeine and aspirin (FIORINAL); butalbital, caffeine, aspirin and codeine (FIORINAL WITH CODEINE)
  • We list these drugs as Do Not Use drugs because they are irrational combinations that include drugs that are unsafe or ineffective.
benztropine (COGENTIN); trihexyphenidyl
  • We list this drug as a Do Not Use drug because it causes memory impairment, confusion, hallucinations, and retention of urine.
tolcapone (TASMAR)
  • We list this drug as a Do Not Use drug because it causes liver failure.
leflunomide (ARAVA)
  • We list this drug as a Do Not Use drug because it may be less effective than other drugs and causes liver damage and high blood pressure.
niacin [extended release] [vitamin B3] (NICOBID, SLO-NIACIN)
  • We list this drug as a Do Not Use drug because it causes liver damage, unlike other forms of this drug.
vitamin E [alpha tocopherol]
  • We list this drug as a Do Not Use drug because Vitamin E deficiency is rare and Vitamin E has not been proved to prevent heart attacks or for any other medical purpose.
indapamide (LOZOL)
  • We list this drug as a Do Not Use drug because it is no more effective than similar drugs and causes low blood sodium levels.
amiloride and hydrochlorothiazide (MODURETIC)
  • We list this drug as a Do Not Use drug because it is an irrational combination of ingredients and can lead to high blood potassium levels.
spironolactone and hydrochlorothiazide (ALDACTAZIDE)
  • We list this drug as a Do Not Use drug because it is an irrational combination of ingredients and can lead to high blood potassium levels, kidney failure, confusion and paralysis.
triamterene (DYRENIUM)
  • We list this drug as a Do Not Use drug because it can lead to high blood potassium levels, kidney stones, kidney failure, and bone marrow toxicity.
nifedipine [short acting] (ADALAT, PROCARDIA)
  • We list this drug as a Do Not Use drug because it can cause low blood pressure, heart attack and stroke.
amlodipine and benazepril (LOTREL); felodipine and enalapril (LEXXEL); verapamil and trandolapril (TARKA)
  • We list this drug as a Do Not Use drug because it does not contain any of the first-line treatments for high blood pressure.
doxazosin [heart] (CARDURA [HEART]); prazosin (MINIPRESS); terazosin [heart] (HYTRIN [HEART])
  • We list these drugs as Do Not Use drugs because they are less effective than first-line treatments for high blood pressure.
clonidine (CATAPRES, KAPVAY); clonidine and chlorthalidone (CLORPRES, COMBIPRES); clonidine transdermal therapeutic system (CATAPRES-TTS)
  • We list these drugs as Do Not Use drugs because clonidine causes depression and missing one or two doses can lead to sweating, tremors, flushing, and severe high blood pressure.
gemfibrozil (LOPID)
  • We list this drug as a Do Not Use drug because, unlike for other drugs for high cholesterol, there is no evidence that it decreases the risk of heart disease. It also causes cancer in animals.
fenofibrate (ANTARA, FENOGLIDE, LIPOFEN, TRICOR, TRIGLIDE, TRILIPIX)
  • We list this drug as a Do Not Use drug because studies of other drugs in its class show them to lead to pancreatitis, gallstones, cancer and an increased risk of death.
azelastine (ASTELIN, ASTEPRO, OPTIVAR)
  • We list this drug as a Do Not Use drug because it is no safer or more effective than oral antihistamines, but is more expensive.
rosuvastatin (CRESTOR, EZALLOR)
  • We list this drug as a Do Not Use drug because it causes kidney, muscle and liver damage.
desloratadine (CLARINEX)
  • We list this drug as a Do Not Use drug because it is merely a breakdown product, and no more safe and effective, than another drug that was losing patent protection.
pseudoephedrine (SUDAFED)
  • We list this drug as a Do Not Use drug because it raises heart rate and blood pressure and causes heart attacks and strokes.
dextromethorphan (BROMFED DM, DELSYM)
  • We list this drug as Do Not Use a drug because it is not effective.
cilostazol (PLETAL)
  • We list this drug as a Do Not Use drug because it has limited effectiveness and may lead to an increased risk of death.
pentoxifylline (TRENTAL)
  • We list this drug as a Do Not Use drug because it has limited effectiveness and may cause bone marrow toxicity.
ticlopidine (TICLID)
  • We list this drug as a Do Not Use drug because it is only somewhat more effective than aspirin, but causes bone marrow toxicity and high blood cholesterol levels.
guaifenesin (MUCINEX, ROBITUSSIN)
  • We list this drug as a Do Not Use drug because there is not adequate evidence for its effectiveness.
fexofenadine and pseudoephedrine (ALLEGRA D); loratadine and pseudoephedrine (CLARITIN D, CLARITIN D 24); promethazine and phenylephrine (PROMETHAZINE VC); triprolidine and pseudoephedrine (ACTIFED)
  • We list this drug as a Do Not Use drug because it is an irrational combination of ingredients and the individual ingredients either have safer alternatives or are ineffective.
hydrocodone and chlorpheniramine (TUSSICAPS); promethazine and codeine (); promethazine and dextromethorphan ()
  • We list these drugs as Do Not Use drugs because they contain an irrational combination of ingredients.
pseudoephedrine, triprolidine, and codeine (TRIACIN-C)
  • We list this drug as a Do Not Use drug because it is an irrational combination of ingredients and for one ingredient a safer alternative is available.
guaifenesin and dextromethorphan (MUCINEX DM, ROBITUSSIN COUGH+CHEST CONGESTION DM, ROBITUSSIN-DM)
  • We list this drug as a Do Not Use drug because it is an irrational combination of two Do Not Use drugs.
guaifenesin and pseudoephedrine (GUIFENEX PSE, MUCINEX D, ROBITUSSIN PE SYRUP)
  • We list this drug as a Do Not Use drug because it is an irrational combination of ingredients and one of the ingredients is ineffective.
hydrocodone and homatropine
  • We list this drug as a Do Not Use drug because it is an irrational combination of ingredients and one ingredient causes memory impairment, confusion, hallucinations, and retention of urine, without clear evidence that it is effective.
fluticasone propionate and salmeterol inhalation powders (ADVAIR DISKUS, ADVAIR HFA)
  • We list this drug as a Do Not Use drug because it has been associated with an increased death rate and safer alternatives are available.
salmeterol (SEREVENT)
  • We list this drug as a Do Not Use drug because it has been associated with an increased death rate and safer alternatives are available.
isoetharine (BETA-2, BRONKOMETER, BRONKOSOL)
  • We list this drug as a Do Not Use drug because it is more likely to increase blood pressure and heart rate than other drugs for this condition.
magnesium hydroxide, aluminum hydroxide and simethicone (MYLANTA, MYLANTA-II)
  • We list this drug as a Do Not Use drug because it contains an ineffective ingredient.
oxtriphylline (CHOLEDYL SA)
  • We list this drug as a Do Not Use drug because it is no more effective but is more expensive than similar drugs.
montelukast (SINGULAIR); zafirlukast (ACCOLATE)
  • We list these drugs as Do Not Use drugs because they are less effective than other drugs and can cause blood vessel inflammation, liver disease, lupus and recurrences of ulcerative colitis.
erythromycin estolate
  • We list this drug as a Do Not Use drug because, unlike other forms of this drug, this form causes liver damage.
telithromycin (KETEK)
  • We list this drug as a Do Not Use drug because it is no more effective than other antibiotics and causes irregular heartbeat.
moxifloxacin (AVELOX)
  • We list theses drugs as Do Not Use drugs because they are no more effective than similar drugs and cause irregular heartbeat.
alosetron (LOTRONEX)
  • We list this drug as a Do Not Use drug because irritable bowel syndrome is not life-threatening, the drug is minimally effective and it causes lack of blood flow to the intestines and severe constipation.
tegaserod (ZELMAC, ZELNORM)
  • We list this drug as a Do Not Use drug because irritable bowel syndrome is not life-threatening, the drug is minimally effective, and it causes diarrhea, ovarian cysts and lack of blood flow to the intestines.
trovafloxacin (TROVAN)
  • We list this drug as a Do Not Use drug because it causes liver failure.
gemifloxacin (FACTIVE)
  • We list this drug as a Do Not Use drug because it causes severe rashes and may cause irregular heartbeat and liver damage.
trimethobenzamide (TIGAN)
  • We list this drug as a Do Not Use drug because there is no convincing proof that it is effective.
atropine, hyoscyamine, methenamine, methylene blue, phenyl salicylate and benzoic acid (URISED)
  • We list this drug as a Do Not Use drug because it is an irrational combination of six ingredients.
neomycin, polymyxin b, and bacitracin (MYCITRACIN, NEOSPORIN MAXIMUM STRENGTH OINTMENT); neomycin, polymyxin b, and hydrocortisone (CORTISPORIN)
  • We list this drug as a Do Not Use drug because there is no convincing evidence that it is effective.
betamethasone and clotrimazole (LOTRISONE CREAM)
  • We list this drug as a Do Not Use drug because it is an irrational combination of ingredients.
terbinafine (LAMISIL); itraconazole (ONMEL, SPORANOX, TOLSURA)
  • We list these drugs as Do Not Use drugs because toenail fungus is a cosmetic condition and these drugs have been associated with liver and/or heart failure.
nystatin and triamcinolone (MYCO-BIOTIC II, MYCOLOG II)
  • We list this drug as a Do Not Use drug because it is an irrational combination of ingredients.
lindane (KWELL)
  • We list this drug as a Do Not Use drug because it is less effective than other products for this condition and causes central nervous system toxicity, including seizures, particularly in small children.
zanamivir (RELENZA)
  • We list this drug as Do Not Use because it is only minimally effective and can cause asthma.
black cohosh (AWARENESS FEMALE BALANCE, ESTROVEN, REMIFEMIN)
  • We list this drug as a Do Not Use drug because there is no evidence that it is effective.
coenzyme q10 [co q 10, q10, vitamin q10, ubiquinone, ubidecarenone] (ANTI-AGING DAILY PREMIUM PAK, Q-GEL, VITAMIST INTRA-ORAL SPRAY)
  • We list this drug as a Do Not Use drug because there is no evidence that it is effective.
echinacea [purple coneflower, red sunflower, thimbleweed, rudbeckia] (HALLS DEFENSE MULTI-BLEND SUPPLEMENT DROPS)
  • We list this drug as a Do Not Use drug because there is no evidence that it is effective.
ephedra [ma huang, chinese ephedra, epitonin]
  • We list this drug as a Do Not Use drug because there is no evidence that it is effective and it causes heart attacks, strokes and seizures.
garlic (KWAI, PHYTO-VITE)
  • We list this drug as a Do Not Use drug because there is no evidence that it is effective.
glucosamine and chondroitin (DONA, FLEXIJOINT, FLEXIPURE, MAJESTIC EARTH, MOVE FREE, OSTEO BI-FLEX, TRIPLE FLEX)
  • We list this drug as a Do Not Use drug because there is no evidence that it is effective.
green tea
  • We list this drug as a Do Not Use drug because there is no evidence that it is effective.
milk thistle (MILK THISTLE HEALTH LIVER, RELIVE, THISILYN)
  • We list this drug as a Do Not Use drug because there is no evidence that it is effective.
morinda citrifolia [noni, nono, nonu, ba ji tian, nhau] (PREMIUM HAWAIIAN NONI JUICE, TAHITIAN NONI LIQUID)
  • We list this drug as a Do Not Use drug because there is no evidence that it is effective.
saw palmetto [serenoa repens; serenoa serrulata; sabal serrulata] (ONE-A-DAY PROSTATE HEALTH, PERMIXON, POWER LASTING)
  • We list this drug as a Do Not Use drug because there is no evidence that it is effective.
St. John's wort [hypericum, goatweed, the lord god's wonder plant, witch's herb] (SUN BEAUTY)
  • We list this drug as a Do Not Use drug because there is no evidence that it is effective and it interacts with many other drugs.
bisacodyl (DULCOLAX); docusate (COLACE, SURFAK); docusate and casanthranol (DIALOSE PLUS, PERI-COLACE)
  • We list these drugs as Do Not Use drugs because they can lead to dependence and safer alternatives are available.
diphenoxylate and atropine (LOMOTIL, LONOX)
  • We list this drug as a Do Not Use drug because it can cause breathing difficulty.
atropine; atropine, hyoscyamine, scopolamine, and phenobarbital (DONNATAL); dicyclomine (BENTYL); hyoscyamine (LEVBID, LEVSIN)
  • We list these drugs as Do Not Use drugs because all contain an ingredient that can cause sedation and one is an irrational combination of ingredients.
chlordiazepoxide and clidinium (LIBRAX)
  • We list this drug as a Do Not Use drug because it is an irrational combination of dangerous drugs and there is no evidence that it is effective.
simethicone (MYLICON, PHAZYME)
  • We list this drug as a Do Not Use drug because there is no evidence that it is effective.

WORST PILLS, BEST PILLS NEWSLETTER ARTICLES
Oral Bisphosphonates for Osteoporosis: Important Warnings
October 2021
Patients taking bisphosphonates need to know that these drugs are associated with a wide range of potentially serious adverse effects.
Inspector General to Probe FDA Approval of Alzheimer’s Disease Drug
October 2021
Finally, after months of foot-dragging, the Department of Health and Human Services’ Office of Inspector General has heeded our call for an investigation into the unprecedented and inappropriately close collaboration between Biogen and the FDA during the analysis of data from the key clinical trials of aducanumab (ADUHELM) for treatment of Alzheimer’s disease, which dangerously compromised the integrity of the FDA’s review of the drug.
Drug-Induced Hair Loss
October 2021
Learn about some of the commonly used medications that may lead to hair loss, also known as alopecia.
Study Shows Fasting and Heavy Drinking Associated With Liver Injury After Standard Acetaminophen Doses
October 2021
In this article, we discuss new research showing that prolonged use of acetaminophen at recommended dosages in conjunction with excessive drinking or fasting may lead to catastrophic liver failure.
Important Drug Interactions for the Stomach-Acid–Suppressing Drugs Lansoprazole and Dexlansoprazole
October 2021
Patients taking the commonly used stomach-acid–suppressing drugs lansoprazole (PREVACID, PREVACID 24 HR) and dexlansoprazole (DEXILANT) should be aware that these drugs have clinically important interactions with many other prescription medications.
Drug for Treating Nighttime Urination Too Dangerous
September 2021
Learn why Public Citizen’s Health Research Group has designated desmopressin sublingual tablets (NOCDURNA) as Do Not Use.
Direct-to-Consumer Advertising May Be Driving Up Medicare Drug Spending
September 2021
A recent Government Account¬ability Office report found that direct-to-consumer prescription-drug advertising may be a major factor contributing to rising spending on medications by the Medicare program and its beneficiaries.
Levothyroxine Ineffective for Depressive Symptoms in Elderly Patients With Subclinical Underactive Thyroid
September 2021
In this article, we discuss the results of a recent rigorously conducted study showing that therapy with the thyroid-hormone drug levothyroxine in older adults with subclinical hypo-thyroidism (a mild form of underactive thyroid) who had depressive symptoms provided no significant benefit.
Medications That Cause Gastrointestinal Bleeding
September 2021
Gastrointestinal bleeding is a common cause of hospitalization and in severe cases can result in death. Find out which commonly used medications can cause gastrointestinal bleeding.
Despite Big Risks, Dementia Patients Often Prescribed Multiple Psychoactive Drugs
September 2021
New research reveals marked overuse of central nervous system-active medications in dementia patients despite the substantial risks, including an increased risk of premature death.
High-Dose Vitamin C and Zinc Supplements Ineffective for COVID-19 Treatment, Trial Shows
August 2021
Unfounded claims about the supportive roles of vitamin C and zinc for treating COVID-19 infection have led to increased demand and expenditures for these supplements, among others. Evidence from a recent study that was conducted by Cleveland Clinic researchers refutes these claims.
FDA’s Reckless Decision to Approve Aducanumab for Alzheimer’s Disease
August 2021
In his editor’s column, Dr. Michael Carome discusses why the FDA’s June approval of Biogen’s monoclonal-antibody drug aducanumab (ADUHELM) for the treatment of Alzheimer’s disease was one of the worst decisions in the agency’s history.
Quitting Smoking: Behavioral Therapy and Medications Can Help
August 2021
In this article, we discuss the most recent smoking-cessation recommendations from the U.S. Preventive Services Task Force and the underlying research supporting these recommendations.
Important Drug Interactions for the Hypertension and Angina Drug Nifedipine
August 2021
Patients taking the widely prescribed calcium channel blocker nifedipine (PROCARDIA, PROCARDIA XL) should be aware that it has clinically important interactions with many other prescription medications.
Critiquing Evidence About the Risky Arthritis and Pain Drug Celecoxib (CELEBREX, CONSENSI)
August 2021
Learn why we have designated celecoxib, a widely used selective COX-2 inhibitor that belongs to a drug class called nonsteroidal anti-inflammatory drugs, as Do Not Use.
New FDA Warning About Heart, Cancer Risks for Tofacitinib (XELJANZ)
July 2021
In this article, we discuss an important new warning issued by the FDA about preliminary results from a safety clinical trial that showed increased risks of serious heart-related adverse effects and cancer in rheumatoid arthritis patients taking the oral drug tofacitinib.
Numerous Companies Cited for Promoting Bogus COVID-19 Cures
July 2021
In his editor’s column, Dr. Michael Carome advises readers to remain vigilant for businesses peddling COVID-19 products that are fraudulent, a waste of money and potentially harmful.
Important Drug Interactions for the Abnormal Heart Rhythm Drug Amiodarone
July 2021
Patients taking the commonly prescribed abnormal heart rhythm drug amiodarone should be aware that it has clinically important interactions with many other prescription medications.
FDA Needs to Quickly Ban the Illegal Opioid-Like Substance Tianeptine
July 2021
Learn why tianeptine — an addictive synthetic chemical compound that has led to abuse, physical dependence and withdrawal adverse reactions similar to those of opioids — has emerged as a growing public health threat in the U.S. and internationally.
Important Information in Prescription Drug Labels
July 2021
Knowledge about key information found in a prescription drug’s professional label can be an important tool for consumers seeking to improve their health while avoiding drug-induced injuries.
Question & Answer
July 2021
In this month’s Question & Answer, we respond to a reader’s question about what steps can be taken to prevent or manage common adverse reactions due to COVID-19 vaccines.
Important Drug Interactions for the Antibiotic Erythromycin
June 2021
Patients taking the commonly prescribed antibiotic erythromycin should be aware that it has clinically important interactions with many other prescription medications.
Some Hand Sanitizers Tainted With Benzene, a Known Human Carcinogen
June 2021
In his editor’s column, Dr. Michael Carome lambasts the FDA for its policy that allowed some hand sanitizers to be marketed in the U.S. during the COVID-19 pandemic that were tainted with carcinogenic benzene.
Omega-3 Fatty Acid Supplements Not Beneficial for Reducing Cardiovascular Events, Trials Show
June 2021
Learn why taking daily oral omega-3 fatty oral supplements containing a combination of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) may not be good for your heart.
Serious Adverse Effects Associated With Short-Term Use of Oral Corticosteroids
June 2021
In this article, we review data from new research showing that even short-term (14 or fewer days) use of oral corticosteroids can increase your risk of serious adverse effects.
Proton Pump Inhibitors Associated With Increased Risks of Fractures and Asthma in Children
June 2021
Results of recently published studies suggest that use of the potent stomach-acid–suppressing proton inhibitor medications in children may lead to small increases in the risks of fractures and asthma.
News Brief: Easy-to-Swallow Acetaminophen Tablets Pose Danger to Young Children
June 2021
In this month’s News Brief, we discuss a recent safety advisory issued by drug regulators in Canada warning of multiple reports of children experiencing acetaminophen poisoning after ingesting adult acetaminophen easy-to-swallow tablets that look like candy.
Overview of the Blood Thinner Rivaroxaban (XARELTO): An Update
May 2021
Learn why we have designated rivaroxaban, one of the so-called “novel” oral anticoagulants (blood thinners), as Do Not Use.
Merck, FDA Failed to Disclose Hair-Loss Drug’s Potential Suicide Risk
May 2021
In his editor’s column, Dr. Michael Carome discusses a troubling report that detailed how drugmaker Merck & Co. and the FDA failed to add a warning about the potential risk of suicidal thoughts in men taking the company’s anti-baldness drug PROPECIA to the drug’s U.S. product labeling.
FDA Belatedly Requires Abuse-Related Black-Box Warnings for Benzodiazepines
May 2021
In September 2020, the FDA announced that it would require the manufacturers of all benzodiazepines to update the black-box warning (the strongest warning that the agency can require) for these drugs to describe risks of abuse, addiction and other related adverse reactions. Such action was long overdue.
A Look at Cognitive Behavioral Therapy for Insomnia in Patients With Other Medical Conditions
May 2021
In this article, we review results of new research that examined a specific form of nondrug psychological therapy, referred to as cognitive behavioral therapy for insomnia, for management of chronic insomnia in patients with other major physical or mental disorders.
Drugs That Cause Neuroleptic Malignant Syndrome
May 2021
Neuroleptic malignant syndrome is a life-threatening neurological disorder most often caused by neuroleptic (antipsychotic) medications, which are used to treat schizophrenia and certain other psychiatric disorders, among other things. The syndrome also can be caused by certain other drugs used to treat nausea and depression, as well as by the sudden discontinuation of a dopamine agonist (drugs that are used most commonly to treat Parkinson’s disease).
Question & Answer
May 2021
In this month’s Question & Answer feature, we respond to a reader’s question about whether the potassium-sparing diuretic spironolactone (ALDACTONE, CAROSPIR) can cause magnesium deficiency.
New Research Shows Bisphosphonates Prevent Osteoporosis-Related Hip Fractures
April 2021
Recently published research demonstrated that bisphosphonate drugs are useful for preventing osteoporosis-related hip fractures, but that continuous bisphosphonate therapy beyond five years appears to offer no additional benefit for preventing such fractures.
COVID-19 Pandemic Cripples FDA’s Drug-Manufacturing Inspections
April 2021
According to a troubling report issued in January by the Government Accountability Office — an independent, nonpartisan federal watchdog agency that works for Congress — the COVID-19 pandemic has caused severe reductions in the FDA’s entire inspection program, with inspections of foreign drugmakers brought to a virtual standstill.
Important Drug Interactions for Cholesterol-Lowering Drug Atorvastatin (LIPITOR)
April 2021
Patients taking the commonly prescribed drug atorvastatin, which is a member of the statin family of cholesterol-lowering drugs, should be aware that it has clinically important interactions with many other prescription medications.
New Research: Safe to Continue Commonly Used Hypertension Drugs in COVID-19 Patients
April 2021
Soon after the coronavirus pandemic began, theoretical concerns were raised about the possibility that the widely prescribed angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) may increase the risk of contracting the coronavirus and predispose COVID-19 patients to more severe illness. Results of a randomized controlled trial provide new evidence that ACE inhibitors and ARBs can be safely continued in patients hospitalized with COVID-19.
Overview of the Unproven Blood-Thinner–Reversal Drug Idarucizumab (PRAXBIND)
April 2021
Idarucizumab (PRAXBIND) received accelerated approval from the FDA in 2015 for reversal of the effect of the new oral anticoagulant (blood thinner) dabigatran (PRADAXA) when needed before emergency surgery or urgent procedures or in life-threating or uncontrolled bleeding. Learn why we have designated idarucizumab and dabigatran as Do Not Use.
Question & Answer
April 2021
In this month’s Question & Answer feature, we respond to a reader’s question about whether we had any new information regarding the risks of allergic reactions in recipients for the two-dose Pfizer-BioNTech and Moderna messenger RNA COVID-19 vaccines.
Research Not Supportive of Taking Low-Dose Aspirin Solely for Cancer Prevention
March 2021
In this article, we discuss key evidence supporting the conclusion that low-dose aspirin should not be used for the sole purpose of preventing any type of cancer, an indication for which the drug is not approved by the FDA.
Federal Watchdog Targets Pharma’s Paid Physician Speaker Programs
March 2021
In his editor’s column, Dr. Michael Carome applauds the U.S. Department of Health and Human Services Office of Inspector General (OIG) for issuing a “Special Fraud Alert” highlighting the “inherent risks” of illegal fraud associated with pharmaceutical and medical device com¬panies paying physicians and other health care professionals to speak at company-sponsored events.
Important Drug Interactions for the Seizure Drug Carbamazepine
March 2021
Patients taking the commonly prescribed epilepsy drug carbamazepine (CARBATROL, EPITOL, EQUETRO, TEGRETOL, TERIL) should be aware that it has clinically important interactions with numerous other prescription and over-the-counter medications.
New Research Shows Gabapentin Not Effective for Pelvic Pain in Women
March 2021
Gabapentin (NEURONTIN, HORIZANT, GRALISE) is frequently prescribed for uses not approved by the FDA (so-called off-label uses), especially for chronic pain. A recently published clinical trial of the drug for treatment of chronic pelvic pain in women underscores why such off-label use, which we oppose, should be avoided.
FDA Warns Against Using NSAIDs in Pregnancy at 20 Weeks or Later
March 2021
Learn why the FDA in October 2020 warned that pregnant women in general should avoid using nonsteroidal anti-inflammatory drugs (NSAIDs) at about 20 weeks or later in pregnancy because of the rare risks of pregnancy complications and serious harm to an unborn baby.
Question & Answer
March 2021
In this month’s Question & Answer feature, we respond to a reader’s question about whether the stomach-acid–suppressing drug esomeprazole (NEXIUM, NEXIUM 24HR, VIMOVO) has the same drug interactions as the closely related drug omeprazole (PRILOSEC, PRILOSEC OTC, ZEGERID).
Overview of the Questionable Drug Andexanet (ANDEXXA)
February 2021
Andexanet (ANDEXXA) received accelerated approval from the FDA for emergency reversal of life-threatening or uncontrolled bleeding caused by the use of two new oral anticoagulants: apixaban (ELIQUIS) and rivaroxaban (XARELTO). Learn why we have designated andexanet and these two anticoagulants as Do Not Use.
Our Current Views on the First Two FDA-Authorized COVID-19 Vaccines
February 2021
In his editor’s column, Dr. Michael Carome explains why we encourage readers eligible to receive either of the first two COVID-19 vaccines granted Emergency Use Authorizations by the FDA to get vaccinated when the vaccines become available.
Reformulated OxyContin Fails to Show Less Abuse 10 Years After FDA Approval
February 2021
In this article, we review four postmarketing studies Purdue Pharma submitted to the FDA that evaluated the alleged abuse-deterrent properties of the company’s reformulated OxyContin and the agency’s independent assessment of the studies’ results. The data failed to show any meaningful reductions in overall opioid abuse or overdoses since the reformulated Oxycontin was approved in 2010.
Drugs That Cause Magnesium Deficiency
February 2021
Magnesium deficiency, due to either inadequate dietary intake, impaired intestinal absorption or excessive urinary loss of the mineral, results in low blood magnesium levels — a condition known as hypomagnesemia — and a wide range of adverse health effects. Importantly, many commonly used drugs also can cause magnesium depletion.
High-Dose Biotin Supplements Can Cause Inaccurate Laboratory Test Results
February 2021
Dietary supplements that contain more than the recommended daily intake of biotin, also known as vitamin B7, can significantly interfere with many important clinical laboratory blood tests (including those for heart disease and thyroid problems), falsely altering their results. Incorrect test results can lead to misdiagnosis and inappropriate treatment of health conditions, which may have serious or even deadly consequences.
News Brief: Non-melanoma Skin Cancer Warning Added to Hydrochlorothiazide Drug Label
February 2021
In this month’s news brief, we report on FDA-required changes to the product labeling for hydrochlorothiazide (MICROZIDE), a thiazide diuretic drug (“water pill”), warning about a small increased risk of non-melanoma skin cancer associated with use of the drug.
Postmenopausal Women Should Not Use the Conjugated Estrogens and Bazedoxifene Combination (DUAVEE)
January 2021
We previously designated Duavee as “Do Not Use for Seven Years” because, at the time of its approval by the FDA in 2013, it did not represent a clear clinical breakthrough over standard hormone replacement therapy for postmenopausal women. Learn why we have now updated our designation of the drug to Do Not Use.
Tainted Hand Sanitizers Reinforce Need for FDA Drug-Recall Authority
January 2021
In his editor’s column, Dr. Michael Carome discusses how unscrupulous companies exploited pandemic-related shortages of hand sanitizers and consumer panic by marketing hand sanitizers that contained dangerous ingredients and thus violated regulatory standards established by the FDA.
Important Drug Interactions for Angiotensin-Converting Enzyme Inhibitors
January 2021
Patients taking the widely prescribed angiotensin-converting enzyme (ACE) inhibitors, such as benazepril (LOTENSIN) and lisinopril (PRINIVIL, QBRELIS, ZESTRIL), should be aware that these medications have clinically important interactions with many other prescription and over-the-counter medications.
Common Antidepressants Carry Very Small Risk of Birth Defects
January 2021
In this article, we review results of a new study that sheds further light on the association between the use of specific antidepressants during early pregnancy and the small risk of birth defects.
New Research Finds Commonly Used Gout Drug Not Useful for Slowing the Progression of Chronic Kidney Disease
January 2021
Results of two recently published large, well-designed, randomized clinical trials provide important new evidence against using allopurinol (LOPURIN, ZYLOPRIM) to slow the rate of kidney function decline in patients with chronic kidney disease, a use of the drug that is not approved by the FDA.
Alcohol and Benzodiazepines Commonly Co-Involved in U.S. Opioid Overdose Deaths, Study Finds
December 2020
Combining opioids with other central nervous system depressants — mainly alcoholic beverages or benzodiazepines — greatly increases the risk of opioid overdose and death. These dangers are highlighted by new research showing that alcohol and benzodiazepines were commonly co-involved in U.S. opioid overdose deaths in recent years.
Maker of “Female Viagra” Deceives Women With Misleading Radio Ad
December 2020
In his editor’s column, Dr. Michael Carome discusses a recent FDA warning letter to Sprout Pharmaceuticals accusing the company of airing of an illegal radio ad that made “false or misleading claims about the risks” associated with flibanserin (ADDYI) — a drug intended to increase sexual desire in premenopausal women with hypoactive (low) sexual desire disorder that is often erroneously dubbed the “female VIAGRA” and that we have designated as Do Not Use.
Dexamethasone: A Marginally Beneficial Treatment for Severe COVID-19
December 2020
In this article, we review the results of randomized clinical trials showing that the anti-inflammatory corticosteroid dexamethasone reduces the risk of death in patients hospitalized with COVID-19 who require supplemental oxygen or mechanical ventilation.
Important Drug Interactions for the Calcium Channel Blocker Diltiazem
December 2020
Patients taking the widely prescribed calcium channel blocker diltiazem (CARDIZEM, CARTIA XT, TAZTIA XT, TIAZAC) should be aware that it has clinically important interactions with many other prescription medications.
Liraglutide (SAXENDA): The Wrong Choice for Weight Loss
December 2020
Find out why the FDA-approved high-dose form of liraglutide, which was originally marketed at a lower dose for treatment of type 2 diabetes, is not a safe option for managing weight loss.
Question & Answer
December 2020
In this month’s Question & Answer feature, we respond to a reader’s question about whether the risks of montelukast (SINGULAIR) outweigh its benefits when it is used for chronic obstructive pulmonary disease (COPD).
Hydroxychloroquine and Chloroquine: Failed Remedies for COVID-19
November 2020
Early during the coronavirus pandemic, hydroxychloroquine and chloroquine were considered potentially useful treatments for COVID-19. In this article, we discuss results of randomized clinical trials showing that hydroxychloroquine is not effective for treating or preventing COVID-19.
Leading Generic Drug Manufacturer Indicted by Feds for Price Fixing
November 2020
In his editor’s column, Dr. Michael Carome discusses U.S. Department of Justice charges brought against generic drug maker Teva for engaging in illegal price-gouging schemes for multiple prescription drugs.
Nitrosamine Impurities in Medications
November 2020
Since 2018, the FDA has found that certain commonly used medications contained unacceptable levels of nitrosamine impurities (contaminants) that are considered probable human carcinogens. Learn about the risks of nitrosamines and specific drugs that have been found to be contaminated with these compounds.
New Research Finds Folic Acid and Zinc Supplementation in Men Not Effective for Treating Infertility
November 2020
Supplements for male fertility often contain folic acid and zinc, likely because both substances have been shown to play key roles in the formation and maintenance of normal healthy sperm. However, data from a recently published clinical trial funded by the National Institutes of Health showed supplementation with folic acid and zinc in men among couples undergoing infertility treatment does not increase the chances of achieving a successful pregnancy.
Highlights of the New Guidelines for Severe Allergic Reaction
November 2020
We review new guidelines for treating life-threatening allergic reactions (known as anaphylaxis) recently issued by the American Academy of Allergy, Asthma & Immunology and the American College of Allergy, Asthma and Immunology.
Question & Answer
November 2020
In this month’s Question & Answer feature, we respond to a reader’s question asking about our recommended alternatives to the opioid analgesic tramadol (CONZIP, ULTRACET, ULTRAM), which we have designated as Do Not Use.
Public Citizen Calls on FDA to Require Black-Box Warning for Newest Diabetes Drugs
October 2020
Learn why patients with type 1 diabetes should never use any of the type 2 diabetes drugs known as sodium-glucose cotransporter-2 (SGLT2) inhibitors, which are often referred to as “flozins” or “gliflozins.”
“Male-Enhancing” Dietary Supplements Were Tainted With Dangerous Drugs
October 2020
In his editor’s column, Dr. Michael Carome discusses a recent report published in Morbidity and Mortality Weekly Reports that hammers home the potentially life-threatening dangers of using these illegal dietary supplements.
Gabapentinoid Drug Use Is Exploding Despite Poor Safety and Efficacy Profiles
October 2020
Marked increases in the prescribing of the gabapentinoids gabapentin and pregabalin, particularly for uses not approved by the FDA (so-called off-label uses), indicate that these drugs are widely overprescribed and misused in the U.S. In this article, we review three recent studies that characterized the growth and extent of gabapentinoid overuse during the past two decades.
Adults Often Inadvertently Put Children at Risk of Oral Medication Poisoning, Study Finds
October 2020
Ingestion of prescription medications or over-the-counter products is a common cause of poisoning among children. A recently published study found that adults frequently are to blame for this avoidable problem.
Important Drug Interactions for the Stomach-Acid–Suppressing Drug Omeprazole
October 2020
Patients taking the commonly used stomach-acid–suppressing drug omeprazole should be aware that it has clinically important interactions with many other prescription medications.
News Brief: Shortages in Albuterol Asthma Inhalers During the COVID-19 Pandemic
October 2020
In this month’s news brief, we report on shortages of the inhaled asthma drug albuterol that have occurred because of the coronavirus pandemic.
Key Takeaways From the Updated CDC Report on Antibiotic Resistance
September 2020
An updated report from the Centers for Disease Control and Prevention underscores the continued threat of antibiotic resistance in the U.S. and highlights the emerging areas of concern and actions needed to combat this major public health problem.
Evidence Lacking to Support Use of Compounded Topical Pain Creams
September 2020
In recent years, there has been a surge in the use of compounded topical pain creams as an alternative to oral pain medications, such as non-steroidal anti-inflammatory drugs and opioids. However, a committee of experts convened by the National Academies of Sciences, Engineering, and Medicine recently concluded that there is a lack of evidence to support the safety and effectiveness of these compounded products.
Testosterone Therapy for Men: More Evidence of Blood Clot Risk
September 2020
In this article, we discuss the results of a recent large observational study that provide added support for the concern that testosterone therapy heightens the risk of dangerous blood clot formation.
Review of Phenytoin, a Best Pill for Seizures
September 2020
Medications are the mainstay of treatment for most patients with seizure disorders, and more than two dozen such drugs have been approved by the FDA. We review one of the oldest seizure drugs, phe¬nytoin (DILANTIN, PHENYTEK). Patients using the drug need to be aware of its many potentially serious adverse effects.
Driving Under the Influence Caused by Medications
September 2020
Although impaired driving usu¬ally is caused by alcohol or marijuana, many commonly used prescription and over-the-counter medications also can impair one’s ability to drive safely. Learn about several classes of medications that can cause this serious problem to protect yourself, your passengers and others who share the road with you.
Recent FDA Safety Warnings About Schizophrenia Drug Clozapine, Asthma/Allergy Drug Montelukast
August 2020
Learn about important new safety warnings issued by the FDA regarding the schizophrenia medica¬tion clozapine (CLOZARIL, VERSA¬CLOZ) and the asthma/allergy drug montelukast (SINGULAIR).
Beware of Companies Promoting Bogus COVID-19 Cures
August 2020
Soon after the novel coronavirus began infecting people in the U.S., unscrupulous companies rushed to sell products not approved by the FDA with fake claims that they could prevent, treat or cure coronavirus disease 2019 (COVID-19). Consumers need to be aware that such products are fraudulent, a waste of money and potentially harmful.
Important Drug Interactions for the Anticoagulant Warfarin
August 2020
Patients taking the commonly used blood thinner warfarin (COUMADIN, JANTOVEN) should be aware that it has clinically important interactions with numerous other prescription and over-the-counter medications, as well as some dietary supplements.
Vitamin D and Calcium Dietary Supplements: Do They Prevent Bone Fractures?
August 2020
In this article, we discuss whether vitamin D and calcium dietary supplements are useful for promoting bone health and preventing bone fractures.
Allergists’ Group Recommends Newer Antihistamines Over Older Antihistamines for Nasal Allergies and Hives
August 2020
Because of the better safety profile of newer second- and third-generation antihistamines, Public Citizen’s Health Research Group has previously recommended their use over older first-generation antihistamines for both allergic rhinitis and urticaria. A recent position statement by the Canadian Society of Allergy and Clinical Immunology that summarized the research evidence about these drugs reinforces our recommendation.
Important Drug Interactions for the Antibiotic Azithromycin
July 2020
Patients taking the commonly prescribed antibiotic azithromycin (ZITHROMAX) should be aware that it has clinically important dangerous interactions with many other prescription medications.
Chloroquine and Hydroxychloroquine: Dangerous Options for COVID-19
July 2020
In his editor’s column, Dr. Michael Carome explains why President Trump’s reckless promotion of chloroquine and hydroxychloroquine as “game-changing” treatments for COVID-19 was so dangerous.
Melatonin Dietary Supplements: Useful for Jet Lag, Not for Other Conditions
July 2020
We summarize the available evidence from well-designed clinical trials that support the use of the dietary supplement melatonin for treating jet lag, but not other conditions.
Strong Topical Steroids Often Sold Over the Counter Illegally in the U.S., Study Finds
July 2020
New research reveals that potent, prescription-strength topical steroids can be purchased over the counter readily in many U.S. cities. Learn how to protect yourself and your loved ones from these illegal and potentially harmful products.
Daily Low-Dose Aspirin Should Not Be Used to Prevent a First Heart Attack or Stroke
July 2020
If you do not have cardiovascular disease, you should not take aspirin to prevent a first heart attack, stroke or other cardiovascular event, particularly if you are over the age of 60, because the benefits of such treatment generally do not exceed its bleeding risk.
Question & Answer
July 2020
In this month’s Question & Answer, we provide a list of websites that describe the appearance of prescription pills, resources that can help consumers protect themselves from life-threatening pharmacist errors.
Overview of the Insomnia Drug Zolpidem (AMBIEN, AMBIEN CR, EDLUAR, ZOLPIMIST)
June 2020
The insomnia drug zolpidem belongs to a family of drugs known as the non-benzodiazepines or “Z drugs.” Learn why we for years have designated this drug as Do Not Use.
Gilead Exploited FDA Loophole, Sought Windfall Profits From Pandemic
June 2020
Learn about Gilead Sciences’ greedy attempt to profiteer off of the catastrophic coronavirus (COVID-19) pandemic by seek¬ing and receiving a lucrative orphan drug designation from the FDA for an experimental drug being tested as a treatment for COVID-19.
Important Drug Interactions for Cholesterol-Lowering Drug Simvastatin
June 2020
Patients taking the commonly prescribed cholesterol-lowering drug simvastatin (FLOLIPID, VYTORIN, ZOCOR) should be aware that it has clinically important interactions with many other prescription medications.
Restless Legs Syndrome: Overdiagnosed and Overtreated
June 2020
In this review of restless legs syndrome (RLS), we discuss the limitations of the available drug treatments for the disorder and the nondrug approaches that are the safest options for people with mild to moderate RLS symptoms.
FDA Warns 15 Companies Selling “Snake Oil” Cannabidiol Products
June 2020
Except for one purified cannabidiol product approved by the FDA for treatment of two rare forms of childhood epilepsy, cannabidiol products marketed in the U.S. are illegal. Find out why the FDA is cracking down on companies selling these illegal drugs.
Drug-Induced Liver Injury
May 2020
There are more than 1,000 prescription and over-the-counter medications, as well as certain herbal and dietary supplements, that are implicated in liver injury, and the list continues to grow.
FDA Must Be Fully Transparent During the Novel Coronavirus Pandemic
May 2020
In his editor’s column, Dr. Michael Carome calls for greater FDA transparency regarding which drugs are in short supply because of the coronavirus pandemic and the resulting manufacturing disruptions in China and elsewhere.
For COPD Patients Without Heart Disease, Risks of Beta Blockers Outweigh Benefits
May 2020
Learn why you should avoid taking metoprolol or any other beta blocker if you have COPD and have not previously suffered a heart attack and do not have heart failure.
Norelgestromin-Ethinyl Estradiol Patch (XULANE): An Unsafe Choice for Birth Control
May 2020
We explain why the norelgestromin-ethinyl estradiol patch is too dangerous to use and describe safer birth control medication options.
Thiazides (Water Pills): Best Initial Treatment for High Blood Pressure, Study Finds
May 2020
We summarize results of new research showing that thiazides or thiazide-like diuretics, such as hydrochlorothiazide (MICROZIDE), appear to be the most effective and safest medications for initial treatment of hypertension.
News Brief: FDA Requests Withdrawal of Lorcaserin (BELVIQ), a Diet Drug That It Never Should Have Approved!
May 2020
In this month’s news brief, we discuss why the FDA decided to ask the manufacturer of the weight-loss drug lorcaserin to voluntarily withdraw the medication from the U.S. market.
Beware of Piracetam-Containing Dietary Supplements Touting Unproven Brain Benefits
April 2020
In this article, we explain why consumers need to beware of dietary supplements containing the illegal drug piracetam that are promoted to enhance cognitive performance, mood, sleep and longevity.
Protecting Yourself from Life-Threatening Pharmacist Errors
April 2020
In his editor’s column, Dr. Michael Carome discusses findings of a recent exposé published in The New York Times that highlighted how overworked pharmacists at major national pharmacy chains — such as CVS, Rite Aid and Walgreens — have endangered patients by making potentially fatal errors when filling and dispensing prescriptions.
Important Drug Interactions for the Antibiotic Clarithromycin
April 2020
Patients taking the commonly prescribed antibiotic clarithromycin (BIAXIN XL) should be aware that it has clinically important interactions with many other prescription medications.
Avoid the ‘Pink Pill’ Flibanserin (ADDYI) for Low Female Sexual Desire
April 2020
Learn why flibanserin is the wrong choice for women who are burdened by persistent low sexual desire.
FDA Warns of Serious Breathing Problems with Use of Gabapentin and Pregabalin
April 2020
For patients taking opioid analgesics and other drugs that depress breathing and those with lung diseases such as chronic obstructive pulmonary disease, use of gabapentin (GRALISE, HORIZANT, NEURONTIN) or pregabalin (LYRICA) could have deadly consequences.
Important Drug Interactions for the Calcium Channel Blocker Verapamil
March 2020
Patients taking the widely prescribed calcium channel blocker verapamil — which is used to treat high blood pressure, coronary artery disease and certain abnormal heart rhythms — should be aware that it has clinically important interactions with many other prescription medications.
Court Documents Expose Purdue’s Plans to Mislead Doctors About Oxycontin’s Risks
March 2020
Recently released court documents reveal the great lengths to which senior executives at Purdue Pharma — including members of the billionaire Sackler family who founded and own the company — went to downplay Oxycontin’s risks of addiction and abuse.
Study Bolsters Evidence Linking Menopausal Hormone Therapy to Breast Cancer
March 2020
New research linking menopausal hormone use to an increased risk of breast cancer reaffirms the importance of using such hormone therapies at the lowest effective dose and for the shortest duration needed.
Do Not Use Paroxetine (BRISDELLE) for Treatment of Hot Flashes
March 2020
Learn why women should avoid using BRISDELLE, the first and only nonhormonal drug approved by the FDA for treatment of hot flashes associated with menopause.
Public Citizen Urges FDA to Ban Medication Used to Prevent Preterm Birth
March 2020
We discuss why pregnant women who have a history of spontaneous preterm birth should not take the injected synthetic hormone hydroxyprogesterone caproate (MAKENA) to prevent another preterm birth.
Commonly Used Oral Drugs That Can Cause Eye Problems; Second of a Two-Part Series
February 2020
In this second of a two-part series, we review some of the many commonly prescribed medications that can damage your eyes and the steps that you can take to protect yourself from these adverse effects. The first part in this series appeared in our December 2019 issue.
Dollar Tree’s Over-the-Counter Drugs: Cheap, But Potentially Dangerous
February 2020
A recent warning publicized by the FDA suggests that although purchasing medications from Dollar Tree may appear to be good for your pocketbook, doing so may be dangerous to your health.
Available Evidence Shows Selenium Supplements Not Useful for Preventing Cancer But May Cause Harm
February 2020
Dietary supplements containing the trace mineral selenium for many years have been widely touted for the prevention of cancer. But the available scientific evidence shows that selenium is not useful for preventing cancer.
The Heart Rhythm Drug Amiodarone and Its Adverse Effects
February 2020
Public Citizen’s Health Research Group has designated amiodarone as Limited Use because long-term use of this drug can cause many types of adverse effects that can range from mild to life threatening. The drug should be used only when other therapies are ineffective or cannot be tolerated.
FDA Reapproves Primatene Mist Inhaler for Asthma Despite Concerns
February 2020
Learn why Primatene Mist, an over-the-counter form of the bronchodilator drug epinephrine, is a poor choice for treating asthma.
News Brief: Public Citizen Seeks Tighter Restrictions on Opioid Tramadol
February 2020
In this month’s news brief, we discuss Public Citizen’s recent petition to the FDA to move the opioid tramadol to a more restrictive classification of controlled substances because it is overprescribed, often misused, highly addictive and potentially deadly.
Updated Review of the Hair Loss and Prostate Drug Finasteride (PROPECIA, PROSCAR)
January 2020
For many years, we have classified both finasteride products as Do Not Use. Read our updated review to find out why.
Despite Rising Overdose Deaths, DEA Allowed More Opioids to Flood the U.S.
January 2020
In his editor’s column, Dr. Michael Carome discusses a government watchdog’s finding that the Drug Enforcement Administration allowed drug manufacturers to produce substantially larger quantities of opioids from 2002 to 2013, thus helping to fuel the opioid overdose epidemic.
New Study Makes Case for Increased Access to the Opioid Overdose Antidote Naloxone
January 2020
Learn about the results of new research suggesting that implementation of laws expanding naloxone access by authorizing pharmacists to dispense the drug without a prescription may result in fewer opioid-related deaths.
Important Drug Interactions for Immune-Suppressing and Cancer Drug Methotrexate
January 2020
Patients taking the commonly prescribed drug methotrexate, which is used to treat certain autoimmune diseases and several types of cancer, should be aware that it has clinically important interactions with many other prescription and over-the-counter medications.
Review of the Cough Medications Dextromethorphan and Benzonatate
January 2020
Despite its importance in maintaining clear airways and lung health, cough is one of the most common symptoms for which patients seek medical attention and is responsible for millions of doctor visits in the U.S. every year. Learn why the cough medications dextromethorphan and benzonatate generally should be avoided, particularly in children.
News Brief: FDA Cautions the Maker of Diet Drug QSYMIA for Misleading Advertising
January 2020
In this month’s news brief, we highlight a recent letter that the FDA issued to drugmaker Vivus that cited the company for making false or misleading claims on a promotional consumer-directed webpage for its oral weight-loss prescription drug QSYMIA, which we have designated as Do Not Use.
Commonly Used Oral Drugs That Can Cause Eye Problems; First of a Two-Part Series
December 2019
In this first of a two-part series, we review some of the many commonly prescribed medications that can damage your eyes and the steps that you can take to protect yourself from these adverse effects. The second part in this series will appear in our February 2020 issue.
Reckless Failure to Identify Dangerous Adverse Effect of New Diabetes Drugs
December 2019
In his editor’s column, Dr. Michael Carome discusses the failure of drug companies, researchers and the FDA to recognize the overwhelming evidence dating back to the early 1900s demonstrating that the new diabetes drugs known as “flozins” can cause life-threatening ketoacidosis.
Important Drug Interactions for the Antifungal Drug Fluconazole
December 2019
Patients taking the commonly prescribed antifungal drug fluconazole (DIFLUCAN) should be aware that it has clinically important interactions with many other prescription medications. Some of these interactions can lead to an increased risk of fatal heart rhythm abnormalities.
New Research Shows Vitamin D Supplements Not Useful for Preventing Cancer, Cardiovascular Disease or Diabetes
December 2019
Learn about results of two large, well-designed, randomized clinical trials funded by the National Institutes of Health demonstrating that high-dose vitamin D supplementation was not useful for preventing cancer, cardiovascular disease or diabetes.
New Study Finds Higher Risk of Psychosis with Amphetamine Treatment for ADHD
December 2019
Read this article to find out which drug treatment for attention deficit hyperactivity disorder has a greater risk of psychosis in adolescents and young adults.
Question & Answer
December 2019
Read our response to a reader who asked whether the drug pantoprazole (PROTONIX), which suppresses stomach acid, could have caused a false-positive urine screening test result for tetrahydrocannabinol (THC) — the chemical responsible for most of marijuana’s psychological effects.
Review of the Diet Drug Orlistat
November 2019
Learn about the many dangers that make the diet drug orlistat the wrong choice for patients who are trying to lose weight.
Big Pharma Sinks to Bottom of Barrel in Public Opinion Poll
November 2019
In his editor’s column, Dr. Michael Carome reviews the results of a recent Gallup poll showing that Americans now view the pharmaceutical industry more negatively than any other major industry in the U.S.
Medications That Cause Hearing Problems
November 2019
For most people with hearing loss, the condition likely is age-related or due to long-term exposure to loud noise. But for some patients, the cause of the problem can be found in the medicine cabinet.
Most Preventive Antibiotics Before Dental Procedures Are Unnecessary, Study Finds
November 2019
Dentists often prescribe antibiotics before dental procedures as prophylaxis to prevent infection from the release of bacteria from the mouth into the bloodstream. Find out which patients should receive such preventive antibiotics before dental procedures.
New Guideline Recommends Against Thyroid Hormone Treatment for Most Adults With Mildly Underactive Thyroid
November 2019
In this article, we describe a common condition known as subclinical hypothyroidism and discuss the newest guidelines regarding which patients with this condition should be treated with thyroid hormone replacement.
News Brief: FDA Announces Discovery of Cancer-Causing Contaminant in Heartburn Medication
November 2019
In this month’s news brief, we report actions taken by the FDA and regulators in other countries in response to the discovery of a probable human carcinogen in a widely used medication that suppresses stomach acid.
How to Dispose of Unused Opioids and Other High-Risk Drugs Safely
October 2019
Unused, unneeded or expired drugs in homes present a number of risks, including intentional or accidental overdose in humans (particularly young children). Learn how to safely dispose of these drugs.
Revolving Door to FDA Commissioner’s Office Sows Distrust in Agency
October 2019
In his editor’s column, Dr. Michael Carome discusses how FDA Commissioner Scott Gottlieb’s resumption of close ties to the pharmaceutical industry following his resignation from the agency created a cloud of justifiable distrust about actions taken by the FDA under his leadership.
An Update on Drug-Induced Parkinsonism
October 2019
Next to Parkinson’s disease, drug-induced parkinsonism is the second most common cause of parkinsonism, accounting for about 8-12% of all parkinsonism cases. Find out which commonly used drugs can cause this condition.
Recent FDA Safety Warnings About Drugs for Insomnia, Dietary Supplements
October 2019
The FDA recently issued two important safety alerts for doctors and patients. The first alert described risks of serious, often fatal injuries linked to use of the three so-called “Z-drugs” for insomnia. The second warned women of childbearing age not to use vinpocetine, an ingredient found in many widely available dietary supplements.
Foreign Regulators Issue Warnings About Wakefulness Drugs Modafinil (PROVIGIL) and Armodafinil (NUVIGIL)
October 2019
This article discusses important warnings issued by drug regulators in Canada and Ireland about new evidence of an increased risk of congenital birth defects associated with use of the stimulant drugs modafinil and armodafinil.
News Brief: Federal Researchers Link Kratom to 91 Unintentional Overdose Deaths
October 2019
In this month’s news brief, we report new data from the Centers for Disease Control and Prevention regarding the public health risks posed by kratom and kratom-containing dietary supplements, which have been falsely touted by some marketers as safe treatments for a variety of conditions, including anxiety, depression, opioid use disorder and pain.
Antibiotics Not Always Necessary for Acute COPD Exacerbations
September 2019
Doctors often prescribe antibiotics to treat acute exacerbations of chronic obstructive pulmonary disease (COPD), which are characterized by increased shortness of breath, cough, sputum production and wheezing. But for some patients, the risks of such antibiotic treatment outweigh the benefits.
FDA Sued for Dangerous Delay on Petition Seeking Stronger Drug Warnings
September 2019
In his editor’s column, Dr. Michael Carome discusses Public Citizen’s most recent legal maneuver to force the FDA to respond to our June 2016 petition seeking stronger warnings about the risk of compulsive or uncontrollable behaviors in the product labeling for a class of drugs known as dopamine agonists.
Oral Itraconazole and Terbinafine: Too Dangerous for Fungal Nail Infections
September 2019
Fungal infections of the toenails and fingernails, a condition known as onychomycosis, are common. Learn why you should never take oral itraconazole or terbinafine to treat these cosmetic, non-health-threatening nail infections.
Important Drug Interactions for the Seizure Drug Phenytoin
September 2019
Patients taking the commonly prescribed epilepsy drug phenytoin (DILANTIN, PHENYTEK), one of the oldest epilepsy drugs, should be aware that it has clinically impor¬tant interactions with many other prescription and over-the-counter medications. Some of these interactions can lead to phenytoin toxicity, and others can lead to ineffective seizure control.
An Updated Look at the Treatments for Rosacea
September 2019
Rosacea is a chronic skin condition affecting 13 million Americans. Find out steps to take to prevent symptom flare-ups and learn which topical drug therapies are most effective and safest for treating this condition.
Numerous Drugs Have Dangerous Interactions with Alcohol
August 2019
Most U.S. adults drink alcohol at least occasionally. Many also take prescription or over-the-counter drugs that have the potential to inter¬act adversely with alcohol. Avoid serious harm by knowing which drugs should not be taken in combination with alcohol.
44 States Sue Generic Drugmakers for Price-Fixing Scheme
August 2019
Allegations made in a recent lawsuit filed in federal court by 44 states suggest that 20 generic drug companies perpetrated a multi-billion-dollar fraud on the American public over the past decade.
Do Not Take Central Nervous System Stimulants for Weight Loss!
August 2019
Learn why Public Citizen’s Health Research Group advises against using any central nervous system stimulant drugs for weight loss.
Use of Tramadol for Arthritis Linked to Increased Risk of Death
August 2019
The FDA has approved five medications for treatment of cold sores — sometimes referred to as fever blisters, oral herpes or herpes labialis. Find out which of these drugs offer the most benefit.
Treatments for Cold Sores: An Updated Review
August 2019
Accounting for approximately 41 million prescriptions dis¬pensed in the U.S. in 2017, the opioid analgesic tramadol is among the most widely used painkillers. New research linking tramadol to an increased risk of death reinforces our long-standing Do Not Use designation for this drug.
Review of the Popular Stomach-Acid Suppressant Proton Pump Inhibitor Drugs
July 2019
Learn why the widely used proton pump inhibitors should be reserved for certain patients with stomach-acid disorders and only taken at the lowest possible dose for the shortest possible duration needed.
Rare Justice for Pharma Execs Who Illegally Marketed Dangerous Opioid
July 2019
Too often, senior executives of leading pharmaceutical companies that engage in illegal marketing of drugs and other serious crimes escape criminal prosecution. But this was not the case for the billionaire founder of Insys Therapeutics.
Fluoroquinolone Antibiotics Can Increase the Risk of Aortic Rupture, FDA Warns
July 2019
Read about the growing body of evidence showing that the commonly prescribed fluoroquinolone antibiotics increase the risk of potentially fatal ruptures or tears of the aorta, the largest blood vessel in the body.
Question & Answer
July 2019
A reader asked whether the FDA reviews and approves homeopathic drugs. Our answer should make you think twice about using these products.
Potentially Dangerous Interactions Between Erectile Dysfunction Drugs and Other Medications
July 2019
Find out about the many prescription medications that can interact in dangerous ways with the four drugs approved by the FDA for treating erectile dysfunction in men.
Patients Infrequently Screened Before Immunosuppressive Specialty Drug Therapy, Study Finds
July 2019
More and more patients are being treated with an expanding array of potent immunosuppressive drugs that require special screening and monitoring to minimize the risk of serious harm. But new research reveals that too many patients receiving these drugs are not undergoing the appropriate screening and monitoring tests.
For Some Drugs, Crushing Tablets or Opening Capsules Can Yield Fatal Consequences
June 2019
Patients who have difficulty swallowing pills will sometimes crush tablets or open capsules and sprinkle the resulting powder, fragments or granules into food or liquids. Other patients will resort to chewing their pills before swallowing. Find out the dangers posed by taking such measures.
Time to End Tax Breaks for Direct-to-Consumer Prescription Drug Ads
June 2019
In his editor’s column, Dr. Michael Carome advocates federal legislation that would abolish the harmful tax breaks given to Big Pharma for the costs of direct-to-consumer prescription drug advertising.
Review of the Asthma Drugs Montelukast (SINGULAIR) and Zafirlukast (ACCOLATE)
June 2019
Learn why Public Citizen’s Health Research Group has designated the asthma drugs montelukast and zafirlukast as Do Not Use.
Taking These Medications With Grapefruit Can Be Dangerous!
June 2019
Read about the many prescription drugs that can interact in dangerous ways with grapefruit or grapefruit products.
FDA Warns of Life-Threatening Blood Clots with Use of High-Dose Tofacitinib
June 2019
In this article, we discuss preliminary data from an ongoing clinical trial that prompted the FDA to issue a new warning about potentially fatal blood clots caused by tofacitinib, an oral drug used to treat rheumatoid arthritis and other inflammatory diseases.
Review of Testosterone Products
May 2019
Approximately 10 years ago, testosterone makers launched a massive direct-to-consumer advertising campaign to promote the use of testosterone for normal age-related declines in testosterone in men. Learn why such use of testosterone can be dangerous without providing any proven benefit.
Beware of Companies Hawking Snake Oil for Alzheimer’s Disease
May 2019
The FDA’s recent warning about a dozen companies that marketed illegal products purported to treat or prevent Alzheimer’s disease highlights the importance of ignoring advertisements promoting miracle cures for serious diseases.
Indacaterol (ARCAPTA NEOHALER): The Wrong Choice for COPD
May 2019
In this article, we explain why the FDA should not have approved indacaterol, a long-acting inhaled bronchodilator, for long-term treatment of COPD without first requiring further clinical trials testing lower doses of the drug than the currently approved dose.
Colchicine Interactions with Other Drugs Can Be Life-Threatening
May 2019
Read about the many prescription medications that can interact in dangerous ways with colchicine, a commonly used drug for treatment of acute gout attacks.
Medications That Induce Breast Enlargement in Men
May 2019
For men, abnormally large breasts can be distressing and embarrassing. Find out about the numerous drugs that can cause breast enlargement in men.
Review of the Osteoporosis Drug Denosumab (PROLIA)
April 2019
Learn why we have designated Prolia as Do Not Use for treatment of osteoporosis in women and men.
Pharma's Price Gouging on Insulin Is Literally Killing Patients
April 2019
Many diabetes patients, including some with health insurance, can no longer afford to take the dosage of life-saving insulin prescribed by their doctors because of price gouging by the pharmaceutical industry. For some of these patients, the rationing of unaffordable insulin has proved to be fatal.
Medications that Cause Taste Disorders
April 2019
Drugs are the most frequent cause of taste disturbances. In this article, we identify more than 60 commonly used prescription medications that have been linked to problems with taste.
Suicidal Thoughts: Latest Risk for Baldness and Prostate Drug Finasteride (PROPECIA, PROSCAR)
April 2019
In this article, we discuss a new reason for why finasteride should not be used by men to treat symptoms of prostate enlargement or male pattern baldness.
New Research Finds Increased Water Intake Helps Prevent Recurrent Bladder Infections, Reduces Use of Antibiotics in Premenopausal Women
April 2019
Many women are plagued by frequent bladder infections, and use of antibiotics to treat bladder infections comprises a major proportion of antibiotic use around the globe. Read about new research showing that increased water intake in women markedly reduces the frequency of bladder infections and the need for antibiotics.
News Brief: Dangerous Gout Medication Withdrawn from Market
April 2019
In this month’s news brief, we report on Ironwood Pharmaceuticals’ recent decision to cease marketing its dangerous gout drug lesinurad (ZURAMPIC, DUZALLO). Several years ago, we had designated the drug as Do Not Use because its substantial risks far outweighed its benefits.
Study Reveals Increased Risk of Bleeding, Stroke from Combined Use of Oral Blood Thinners and NSAIDs
March 2019
Millions of Americans take anticoagulants on a long-term basis to prevent the formation of potentially harmful clots. Learn why such patients should avoid using nonsteroidal anti-inflammatory drugs.
Caving To Industry, FDA Kills Proposed Safety Rule on Generic Drug Labeling
March 2019
In his editor’s column, Dr. Michael Carome laments the FDA’s troubling decision to withdraw a proposed rule that would have allowed generic drug companies to promptly update safety warnings in their product labels.
Potentially Dangerous Lithium Drug Interactions
March 2019
Read about the many prescription medications that can interact in dangerous ways with lithium, the drug of choice for treating bipolar disorder, also known as manic depression.
Drug-Induced Restless Legs Syndrome
March 2019
Restless legs syndrome is a common neurological movement and sensory disorder that affects 5 to 10 percent of the population. In this article, we identify some of the many drugs that can cause or worsen this disorder.
Review of the Synthetic Human Growth Hormone Drug Somatropin
March 2019
Somatropin was first approved by the FDA in 1987 for the treatment of short stature in children with growth hormone (GH) deficiency. Find out why we recommend not using somatropin in children with short stature who have normal GH levels; people who develop GH deficiency in adulthood; or in healthy individuals as an anti-aging agent, to improve athletic performance or for body-building.
New Research Shows Aspirin Is Not Beneficial for Older Adults Without Cardiovascular Disease
February 2019
Aspirin is widely used to prevent heart attacks and strokes in the elderly. Read this article to learn whether such use of aspirin is the right choice for you.
In Face of Raging Opioid Addiction Crisis, FDA Fuels the Fire
February 2019
In his editor’s column, Dr. Michael Carome slams the FDA for its reckless approval of a dangerous new opioid that will be marketed under the brand name Dsuvia.
New Study Finds Frequent Unsafe Use of the Sleep Aid Zolpidem
February 2019
For many years, we have designated the prescription sleep medication zolpidem as Do Not Use. We review the results of new research exposing the frequent misuse of this dangerous medication.
News Brief: FDA Bans Imports of All Drugs from Chinese Drug Manufacturer That Produced Tainted Valsartan
February 2019
In this month’s news brief, we report on actions taken by the FDA to stop the flow of tainted medications made by a Chinese drug manufacturer into the U.S.
Systemic Corticosteroids Ineffective for Low Back Pain
February 2019
Low back pain is a frequent reason for outpatient and emergency room visits among adults. Read why treatment with corticosteroids is a poor choice for treating this common condition.
New Study Supports Link Between Oral Pain Reliever Diclofenac and Cardiovascular Risks
February 2019
This article discusses new research linking use of oral diclofenac, a nonsteroidal anti-inflammatory drug, to an increased risk of heart attacks, strokes and other adverse cardiovascular events.
Important Clopidogrel (PLAVIX) Drug Interactions
January 2019
Read about the many prescription and over-the-counter medications that can interact in dangerous ways with clopidogrel, a widely used anti-platelet drug.
Florida Clinic Brazenly Deceives Patients About a Cancer “Treatment”
January 2019
In his editor’s column, Dr. Michael Carome recounts how a Florida medical clinic deceived patients by falsifying scientific journal citations in its promotion of a now-illegal heart-toxic drug called cesium chloride for treatment of cancer.
FDA Warns About Serious Genital Infections With Newest Class of Diabetes Drugs
January 2019
Learn about a rare but potentially fatal bacterial infection in the area of the genitals that has been linked to the diabetes drugs known as sodium-glucose cotransporter-2 inhibitors, commonly called “flozins.”
New Study Links Statins to a Rare Autoimmune Muscle Disorder
January 2019
In this article, we review new research showing that statins are associated with a potentially disabling autoimmune muscle disorder known as idiopathic inflammatory myositis, a rare disorder that is distinct from the much more common type of muscle injury seen with statins.
Review of the Parkinson’s Disease Drug Apomorphine (APOKYN)
January 2019
Find out about the risks and benefits of apomorphine, an injectable medicine approved by the FDA for treatment of specific symptoms that occur in patients with advanced Parkinson’s disease.
Question & Answer
January 2019
In response to a reader’s question about our article “Metformin: First-Choice Drug for Type 2 Diabetes” in the August 2018 issue, we discuss the risk of diarrhea and other adverse gastrointestinal effects that may occur when taking metformin.
Public Citizen Seeks Ban of Dangerous Cesium Dietary Supplements
December 2018
Dietary supplements containing cesium chloride or other types of cesium salts are among the most hazardous supplements currently marketed in the U.S. Read this article to find out why.
Our Assessments of Medications Sometimes Change Over Time
December 2018
In his editor’s column, Dr. Michael Carome, prompted by a recent letter from one of our readers, discusses why our recommendations and designations for specific drugs sometimes change based on new information.
Baricitinib (OLUMIANT): The Wrong Choice for Rheumatoid Arthritis
December 2018
Baricitinib is the most recent drug approved by the FDA for treatment of patients with rheumatoid arthritis. Read our assessment of this dangerous drug.
Study Suggests Frequent Improper Use of Systemic Corticosteroids for Respiratory Illnesses
December 2018
In this article we discuss new research showing that patients with acute respiratory illnesses too often are treated inappropriately with corticosteroid drugs, exposing them to unnecessary risks.
Patient-Initiated Deprescribing of Benzodiazepines
December 2018
Learn how patients can initiate a discussion with their doctors to begin the process of weaning off benzodiazepines, a class of highly overprescribed sedative hypnotic drugs primarily used to treat anxiety and insomnia.
Potentially Dangerous Digoxin Drug Interactions
November 2018
Read about the numerous medications that can interact with digoxin, a drug commonly prescribed for heart failure and atrial fibrillation. These interactions can result in either digoxin toxicity or decreased digoxin effectiveness depending on the other drug being used concomitantly.
Hospitals Band Together to Bypass Big Pharma, Start Their Own Drug Company
November 2018
In his editor’s column, Dr. Michael Carome discusses the implications of a major initiative by a large group of U.S. hospitals to establish their own not-for-profit generic pharmaceutical company.
Review of Varenicline (CHANTIX) for Smoking Cessation
November 2018
If you are a smoker, quitting is the most important thing you can do for your health. Learn why we recommend that varenicline only be used a last-resort drug for smoking cessation.
New USPSTF Recommendations Address How Older Adults Can Prevent Falls and Fractures
November 2018
This article reviews the recent recommendation issued by the U.S. Preventive Services Task Force (USPSTF), an independent volunteer panel of national experts in disease prevention, against older adults taking extra vitamin D to prevent falls.
Valproic Acid and Divalproex: High Risk of Birth Defects
November 2018
Find out why women of child-bearing age should avoid taking valproate for migraines and should use it only for seizure or bipolar disorder if other medicines fail to adequately control these conditions or cause unacceptable adverse effects.
News Brief: FDA Responds to Public Citizen Petition to Block Use of Dangerous Cancer Treatment
November 2018
In this month’s news brief, we report on the Food and Drug Administration’s recent action regarding our petition to prohibit the use of heart-toxic cesium chloride — which has been promoted as an alternative treatment for cancer — in pharmacy compounding.
False-Hope Alzheimer’s Disease Drugs
October 2018
The FDA has approved four drugs for treating Alzheimer’s disease, a devastating brain disorder that affects nearly 6 million Americans, most of whom are elderly. Learn why we have designated each of these drugs as Do Not Use.
New Research Shows Drugs Associated with a Risk of Depression Are Widely Used
October 2018
In this article, we summarize the results of a recent research study showing that use of medications that have depression as a potential adverse effect is very common. We also identify some of the many prescription medications that can cause depression symptoms, including suicidal thoughts or behavior.
Review of Lamotrigine (LAMICTAL)
October 2018
For certain types of epilepsy, lamotrigine is an appropriate treatment for preventing seizures. Learn about the common and serious adverse effects that can occur while taking this drug and how to take this drug safely.
FDA Announces Recalls of Certain Valsartan-Containing Medications Because of Cancer-Causing Contaminant
October 2018
We have received numerous questions from readers asking what to do about the recent recalls of valsartan-containing drugs sold by certain companies that were found to be tainted with a probable carcinogen. In this article, we offer advice for those patients who have been taking valsartan.
Question & Answer
October 2018
Several readers have asked us whether the FDA’s recent approval of a drug that reverses the anticoagulant effect of apixaban (ELIQUIS) and rivaroxaban (XARELTO) alters our classification of these two drugs as Do Not Use. Read our answer.
HHS Inspector General Documents Big Pharma’s Price Gouging of Seniors
October 2018
In his editor’s column, Dr. Michael Carome discusses the implications of a recent government report which found that annual out-of-pocket expenses for brand-name drugs covered under Medicare Part D have skyrocketed in recent years.
Aripiprazole (ABILIFY) Drug Interactions
September 2018
Read about the more than two dozen medications that can have clinically important interactions with aripiprazole, one of the widely used newer atypical antipsychotic drugs that is approved by the FDA for treatment of several disorders including schizophrenia, bipolar disorder and depression.
New Study Links Fluoroquinolones to Life-Threatening Blood Vessel Complication
September 2018
In this article, we discuss results of new research linking the widely overused fluoroquinolone antibiotics to an increased risk of life-threatening damage to the body’s largest blood vessel, the aorta.
Review of Medroxyprogesterone (DEPO-PROVERA, DEPO-SUBQ PROVERA 104, PROVERA)
September 2018
Hear our recommendations on the use of medroxyprogesterone, a prescription medication containing a synthetic form of the female hormone progesterone that is most commonly used for contraception and hormone therapy in women.
Prompted by Public Citizen Lawsuit, FDA Finally Acts to Protect Infants from Dangerous Benzocaine Teething Gels
September 2018
Learn why benzocaine-containing gels and liquids should never be used to treat teething discomfort and about Public Citizen’s Health Research Group’s successful campaign to force the FDA to pull these products from the market.
Agency Insiders Recount FDA’s Cozy Relationship with Industry
September 2018
In his editor’s column, Dr. Michael Carome reviews the relationship between the development of a deeply entrenched industry-friendly culture within the FDA and the agency’s increasingly lax oversight of prescription drugs.
Metformin: First-Choice Drug for Type 2 Diabetes
August 2018
Learn why metformin is the drug of choice for the initial treatment of patients with type 2 diabetes who are not able to control their blood sugar through diet and exercise alone and who do not have severe kidney impairment.
NIH-Funded Clinical Trial Finds Omega-3 Fatty Acid Supplements Not Helpful for Treating Dry Eyes
August 2018
Countless companies heavily promote dietary supplements containing omega-3 fatty acids as the solution to many health problems, including dry eyes. But results of a new research study funded by the National Institutes of Health demonstrate that omega-3 fatty acids are not a good choice for treating dry eyes.
FDA Warns Against Use of Opioid-Containing Cough and Cold Medications in Children
August 2018
In this article, we review the dangers of using opioid-containing cough and cold medicines in children younger than age 18.
Illegally Promoting a Dangerous Opioid With Sex, Guns and Cash
August 2018
In his editor’s column, Dr. Michael Carome discusses the outrageous tactics that sales representatives from drugmaker Insys Therapeutics allegedly used to illegally promote fentanyl sublingual spray (SUBSYS), a rapid-acting, highly addictive, dangerous opioid that is sprayed under the tongue.
Bupropion (ZYBAN) for Smoking Cessation
August 2018
If you are a smoker, quitting is the most important thing you can do for your health. Find out whether bupropion (ZYBAN) is an appropriate treatment option to increase your chances of successfully quitting.
Many People Overdose on Ibuprofen (ADVIL, IBU-TAB, MOTRIN) and Similar Drugs
July 2018
Overdosing on commonly used nonsteroidal anti-inflammatory drugs can increase your risk of potentially serious adverse effects, including gastrointestinal bleeding and kidney damage. Learn how to protect yourself from unintentional overdoses of these medications.
Making Opioid Overdose Antidote Affordable Would Save Lives
July 2018
In his editor’s column, Dr. Michael Carome discusses a rarely used authority of the federal government that would lower the price for the opioid-overdose antidote naloxone and save lives.
High-Dose Inhaled Corticosteroids for Asthma Exacerbations: Helpful in Adults and Adolescents, But Not in Children
July 2018
Inhaled corticosteroids are one of the mainstays of asthma treatment in adults and children, and increasing the dose of these medications when early signs of worsening asthma control occur is a commonly recommended strategy. Find out whether this treatment strategy is a safe and effective choice.
Drug-Induced Tremor
July 2018
Tremor is the single most common movement disorder, affecting millions of people in the U.S. If you have tremors, could one of your drugs be the cause? Read this article to learn the answer.
New Report on Big Pharma Settlements Highlights Need for Tougher Enforcement
July 2018
In this article, we present the findings of our most recent report cataloging all major financial settlements that the pharmaceutical industry has been forced to sign with federal and state governments since 1991. The report’s most striking finding is a recent precipitous drop in federal criminal penalties against drug companies.
News Brief: Multiple Sclerosis Drug Withdrawn Because of Serious Safety Concerns
July 2018
In this month’s news brief, we report on the Food and Drug Administration’s announcement that a medication for multiple sclerosis is being withdrawn from the market because of serious safety concerns.
Preventing Heat-Induced Death and Illness
June 2018
This article lists practical steps to take to avoid death, hospitalization or other medical problems caused by heat stress. It also identifies over 100 drugs that can impair your response to heat and thereby increase your risk of heat-induced illness and death.
FDA's "Breakthrough Therapies" Designation Often Misleading
June 2018
In his editor’s column, Dr. Michael Carome discusses an analysis by researchers at Harvard University that suggests that patients and doctors are being misled about the benefits of drugs approved under the FDA’s “breakthrough therapies” pathway.
Antibiotic Clarithromycin May Increase Risk of Death, FDA Warns
June 2018
Clarithromycin is an oral antibiotic that is commonly used to treat a wide range of bacterial infections. Learn why patients with heart disease should avoid this antibiotic unless no other suitable antibiotic is available.
Do Not Use the New Oral Blood Thinner Apixaban (ELIQUIS)
June 2018
Apixaban is a new oral anticoagulant (blood thinner) that was first approved by the FDA in 2012 for decreasing the risk of blood clots in certain patients. Find out why older anticoagulant drugs, such as warfarin (COUMADIN, JANTOVEN), are a better choice.
Topical Clobetasol Propionate: Only Use to Treat Severe Skin Disorders
June 2018
All but one of the clobetasol propionate products are classified as super-high potency topical corticosteroids. They are approximately 1,000 times more potent than over-the-counter 1-percent hydrocortisone. This article offers advice on how to use these products safely.
Overview of the Antiplatelet Drug Prasugrel (EFFIENT)
May 2018
Prasugrel is an oral antiplatelet drug that was approved by the FDA in 2009 as an add-on treatment to aspirin to prevent clots from forming that may cause a heart attack or stroke in certain patients with coronary artery disease. Learn why we recommend avoiding this medication.
TV Drug Ads Routinely Fail to Comply with FDA Requirements
May 2018
Pharmaceutical companies spend billions of dollars annually advertising their products directly to consumers on TV. But as Worst Pills, Best Pills News Editor Dr. Michael Carome explains, prescription drug TV ads often fail to fully adhere to FDA regulations governing direct-to-consumer ads.
News Brief for May 2018
May 2018
In this month’s News Brief, we report the sentencing of the former supervisory pharmacist at the now-shuttered New England Compounding Center located in Framingham, Massachusetts to eight years in prison for his role in the deadly nationwide fungal meningitis outbreak in 2012 that had been linked to tainted steroid drugs made by the company.
Gout Drug Febuxostat (ULORIC): Risks Outweigh Benefits
May 2018
When the FDA approved febuxostat in 2009 for treating high uric acid blood levels in patients with gout, we advised readers not to use the drug until at least February 2016 based on our longstanding “Seven-Year Rule.” Read this article to hear results of new research that prompted us to now designate febuxostat as Do Not Use.
USPSTF Recommends Against Hormone Therapy to Prevent Chronic Conditions in Postmenopausal Women
May 2018
This article reviews the recent recommendation issued by the U.S. Preventive Services Task Force, an independent volunteer panel of national experts in disease prevention, against the use of hormone replacement therapy in postmenopausal women in order to prevent chronic conditions such as heart disease, stroke, diabetes, dementia, cancer and osteoporosis.
Oral Baclofen Effective Only for Multiple Sclerosis
May 2018
Find out why the muscle relaxant baclofen is a reasonable choice for treating reversible muscle spasms in patients with multiple sclerosis but should not be used to treat spasticity due to spinal cord injuries or other spinal cord diseases.
Public Citizen Urges FDA to Improve Drug Ad Requirements
May 2018
In 2017, the FDA announced its intention to consider allowing drug companies to reduce the amount of risk information they disclose to consumers in direct-to-consumer prescription drug television or radio ads. This article discusses why the FDA’s proposal would be bad for consumers.
Beware of Companies Peddling Illegal Opioid Addiction Remedies
April 2018
In his editor’s column, Dr. Michael Carome offers advice on how to avoid being conned by unscrupulous companies promising miracle treatments for opioid addiction and withdrawal.
Topiramate: Limit Use to Treatment of Seizures, Do Not Use for Other Conditions
April 2018
Topiramate is a second-generation antiepileptic drug that was originally approved by the FDA in 1996. In this article, we discuss why topiramate is an appropriate option for treating certain seizure disorders but should not be used for treatment of migraine headaches.
Extended-Release Niacin (NIASPAN): Now Designated as Do Not Use
April 2018
Extended-release niacin is approved by the FDA to reduce elevated cholesterol levels and to reduce the risk of recurrent, nonfatal heart attacks in patients with histories of previous heart attacks and elevated cholesterol levels. Learn why we just changed the designation of niacin extended-release tablets from Limited Use to Do Not Use.
Nebivolol (BYSTOLIC): Limited Use for Hypertension
April 2018
When the beta blocker nebivolol was approved by the FDA in 2007, we advised readers not to use the drug until 2015, in accordance with our seven-year rule. Find out why we now have designated nebivolol as Limited Use and whether it is the right choice for treating hypertension.
FDA Issues a Public Health Advisory Regarding the Dangerous Plant Kratom
April 2018
Read this article to learn about recent FDA public health advisories warning against the use of kratom and kratom-containing dietary supplements, which have been falsely touted by some marketers as safe treatments that have broad healing properties.
10 Rules for Safer Drug Use
March 2018
Patients often wonder what steps they can take to minimize their chances of suffering a serious adverse drug reaction. This article reviews 10 simple rules developed by Public Citizen’s Health Research Group for ensuring safer drug use.
Big Pharma Rings in New Year with More Price Gouging
March 2018
In his editor’s column, Dr. Michael Carome highlights the most recent wave of price hikes by major pharmaceutical companies at the start of 2018.
Review of Gabapentin
March 2018
The FDA has approved gabapentin (NEURONTIN) for several conditions, including a type of seizure disorder, shingles pain and restless leg syndrome. Hear our recommendations for who should use gabapentin and who should avoid it.
FDA: Drug for Treating High Blood Potassium Levels Should Not Be Combined with Other Medications
March 2018
Last year, the FDA warned that a drug used to treat high blood potassium levels can interfere with the absorption of many other oral medications. Learn the name of this drug and how to take it safely when using other drugs.
Questions & Answers
March 2018
We respond to readers’ questions about our October 2017 article regarding the use of vitamin E for preventing or treating mild cognitive impairment or Alzheimer’s disease and our December 2017 article regarding the use of desmopressin spray (NOCTIVA) for treating nighttime urination symptoms.
Meclizine: A Risky and Possibly Ineffective Drug
March 2018
Meclizine is a drug that is commonly used to treat symptoms of motion sickness. Find out why we have designated this drug as Do Not Use.
Do Not Use Fentanyl for Non-Cancer Pain
February 2018
Fentanyl is a dangerous synthetic opioid that has been involved in an increasing number of overdose deaths in the U.S. Learn why this drug should be used only by cancer patients with breakthrough cancer-related pain.
FDA Dragging Its Feet on Improving Presentation of Risk Information in TV Drug Ads
February 2018
In 2007, Congress passed legislation aimed at improving the disclosure of risk information in TV ads for prescription drugs by mandating that ads present this information in a “clear, conspicuous, and neutral manner.” Worst Pills, Best Pills News Editor Dr. Michael Carome takes the FDA to task for never implementing the requirements of this 2007 law.
Incorrect Dosing of Obeticholic Acid (OCALIVA) Could Be Fatal, FDA Warns
February 2018
Obeticholic acid is a second-line treatment for patients with a rare liver disease called primary biliary cholangitis. In this article, we discuss how to appropriately dose the drug in order to avoid life-threatening liver damage.
Clozapine for Treatment-Resistant Schizophrenia: Use With Great Caution
February 2018
No other schizophrenia medicine is more dangerous than clozapine. Learn about the drug’s serious unique risks and why it should be used only by severely ill schizophrenia patients who have failed to respond adequately to other antipsychotic medications.
Drug-Induced Movement Disorders
February 2018
Abnormal involuntary movements (movement disorders) occur as adverse events associated with many widely used medications and can cause substantial hardship for affected individuals. Find out which drugs are associated with these adverse effects.
News Brief for February 2018
February 2018
In this month’s News Brief, we report on Public Citizen’s Health Research Group’s petition to the FDA to ban a cancer treatment ingredient from use in pharmacy compounding because of serious health risks to humans and no evidence of benefit.
Do Not Use Olmesartan for High Blood Pressure
January 2018
Olmesartan (BENICAR) is one of eight drugs in the family of commonly used blood pressure-lowering medications known as angiotensin II receptor blockers. Learn about the severe, life-threatening gastrointestinal adverse effects of olmesartan that could land you in the hospital.
Opioid Maker Executives “No Better Than Street-Level Drug Dealers”
January 2018
Worst Pills, Best Pills News Editor Dr. Michael Carome discusses the recent arrest of John Kapoor, the billionaire founder of Insys Therapeutics — the drug company that markets fentanyl sublingual spray (SUBSYS), a highly addictive, dangerous opioid drug. Kapoor has been charged with “leading a nationwide conspiracy” to profit by bribing doctors to inappropriately prescribe the company’s fentanyl spray product.
Study Links Sleeping Pills to Hip Fractures in the Elderly
January 2018
Every year, more than 300,000 older Americans are hospitalized due to hip fractures, and almost all of these fractures are caused by falls. Read about new research further linking use of sleeping pills to an increased risk of falls and serious injury.
Milnacipran For Fibromyalgia: Do Not Use
January 2018
Milnacipran (SAVELLA) was approved by the Food and Drug Administration in 2009 for the treatment of fibromyalgia in adults, which remains its only approved use. In this article, we review data showing that the drug is ineffective for treating fibromyalgia and dangerous.
Do Not Use Mirabegron (MYRBETRIQ) for Overactive Bladder
January 2018
Overactive bladder is a bothersome — but not serious — medical problem that becomes more common with age. Find out why mirabegron is the wrong choice for treating this condition.
The Dangerous Diabetes Drug Pramlintide: Do Not Use
December 2017
In this article, we explain why the serious adverse effects of the injected diabetes drug pramlintide far outweigh the drug’s limited benefits.
At the Behest of the Opioid Drug Industry, Congress Undermined the DEA
December 2017
Worst Pills, Best Pills News Editor Dr. Michael Carome discusses how the opioid drug industry successfully lobbied Congress to pass a dangerous bill that effectively stripped the Drug Enforcement Agency of one of its strongest enforcement tools for fighting the illegal diversion of opioid drugs.
Drugs That Cause Weight Gain
December 2017
Weight gain is an adverse event associated with many widely used medications and may lead to significant overweight and obesity, especially in susceptible individuals. Find out which drugs have this adverse effect.
Drug for Treating Nighttime Urination Too Dangerous
December 2017
Nighttime urination is a common symptom that becomes more common with increasing age. Learn why the only drug approved for treating this symptom offers only meager benefits along with unacceptable risks.
Rifaximin (XIFAXAN): Another Poor Choice for Treating Irritable Bowel Syndrome
December 2017
Rifaximin was approved by the FDA in May 2015 for treating irritable bowel syndrome with diarrhea as the predominant symptom in adults. Find out about the drug’s serious adverse effects that outweigh its limited benefits.
Do Not Use the New Blood Thinner Edoxaban (SAVAYSA)
November 2017
Learn why edoxaban, one of the new blood thinners approved by the FDA, is not the best option for preventing dangerous blood clots in patients with atrial fibrillation.
FDA Cracks Down on Illegal Stem Cell Treatments
November 2017
Over the past decade, the number of clinics in the U.S. that peddle unproven stem cell "treatments" directly to consumers exploded from a handful in 2010 to as many as 570 in 2016. Find out what the FDA is finally doing to clamp down on the marketing of illegal stem cell treatments.
Corticosteroid Injections Not Beneficial for Knee Osteoarthritis
November 2017
The injection of corticosteroids into the knee joints of patients with osteoarthritis of the knee is a widespread practice. Find out the results of new research funded by the National Institutes of Health showing that such injections actually may accelerate joint damage.
Subclinical Hypothyroidism: When to Treat
November 2017
In this article, we describe a common condition known as subclinical hypothyroidism and discuss which patients with this condition should be treated with thyroid hormone replacement.
News Brief for November 2017
November 2017
In this month’s news brief, we report the FDA’s reckless decision to deny Public Citizen’s petition to ban a dangerous anti-fungal drug.
Pregabalin (LYRICA): Neither Effective nor Safe for Treating Sciatica Leg Pain
November 2017
Doctors often prescribe pregabalin for a neuropathic pain condition known as sciatica, a use that is not approved by FDA. Find out why pregabalin is a bad choice for treating sciatica.
U.S. Senate Passes 'False-Hope' Act
October 2017
In August, the U.S. Senate unanimously passed the so-called Right to Try Act. Worst Pills, Best Pills News Editor Dr. Michael Carome explains how this deceptively named bill would put countless patients at risk by undermining important FDA safety rules related to the use of unapproved, experimental medications.
News Brief for October 2017
October 2017
In this month’s news brief, we report on the FDA’s recent decision to partially grant a petition from Public Citizen to require the addition of a warning about a dangerous drug-drug interaction to product labeling of repaglinide-containing diabetes medications.
Tofacitinib (XELJANZ): The Wrong Choice for Rheumatoid Arthritis
October 2017
Tofacitinib is one of the newer medications approved by the FDA for treatment of rheumatoid arthritis. Learn why we have designated this drug as Do Not Use.
Diabetes Drug Canagliflozin Doubles Risk of Amputations, FDA Warns
October 2017
Canagliflozin is one of three medications in the newest diabetes drug class. In this article, we discuss why the FDA recently required that a black-box warning about the risk of amputations be added to the product labeling of canagliflozin.
Vitamin E Does Not Prevent Declines in Memory and Cognitive Function
October 2017
Dietary supplement makers often tout vitamin E products for a variety of purported health benefits, including the promotion of brain health. Find out why vitamin E supplements are unlikely to prevent cognitive decline and may cause serious harm if taken in doses exceeding the recommended dietary allowance.
Injected Naltrexone for Opioid Addiction
October 2017
Hear how drugmaker Alkermes has engaged in a novel but troubling marketing campaign to increase sales of its once-monthly injected version of naltrexone (VIVITROL) for treatment of opioid addiction.
Owner of Drugmaker Linked to Meningitis Outbreak Convicted of Racketeering But Acquitted of Murder
September 2017
In March 2017, a federal jury found the co-owner of a now-bankrupt Massachusetts compounding pharmacy guilty on more than 50 counts of racketeering and mail fraud for his role in the deadly nationwide fungal meningitis outbreak in 2012, which had been linked to tainted steroid drugs. Read the troubling details of how the company’s co-owner escaped being convicted of second-degree murder.
A Dangerous Proposal to Roll Back Pharmacy Compounding Rules
September 2017
Following a deadly fungal meningitis outbreak linked to a Massachusetts compounding pharmacy’s tainted steroid drugs, Congress in 2013 passed a law to strengthen the FDA’s oversight of the compounding pharmacy industry. Learn about reckless legislation now being considered by Congress that would reverse the 2013 law.
New Evidence Refutes Testosterone Benefits for Age-Related Symptoms
September 2017
In this article, we discuss new data from well-designed randomized controlled trials that show that testosterone treatment in older men with low testosterone blood levels does not improve memory or other cognitive functions and actually increases the buildup of cholesterol in coronary arteries.
Naltrexone-Bupropion (CONTRAVE): Another Dangerous Weight-Loss Drug
September 2017
Learn why Public Citizen’s Health Research Group has designated CONTRAVE, a combination weight-loss medication that was approved by the FDA in 2014, as Do Not Use.
Black-Box Warning Added to Hepatitis C Drugs
September 2017
The FDA recently required that the product labeling for several of the newest hepatitis C drugs be revised to include a black-box warning, the strongest warning that the agency can require. Find out what the new warning says.
Abuse-deterrent Opioids
September 2017
To address the growing epidemic of prescription opioid drug overdoses in the U.S., many drugmakers have attempted to develop opioid pills that are supposedly resistant to being manipulated in ways that make them easier to abuse. In this article, we highlight problems with these so-called abuse-deterrent opioid formulations.
FDA Calls for Withdrawal of Dangerous Opioid That Never Should Have Been Approved
August 2017
Worst Pills, Best Pills News Editor Dr. Michael Carome assesses the implications of the FDA’s recent request that a major pharmaceutical company remove from the market its reformulated extended-release opioid product.
Anti-Clotting Drugs Increase Risk of Dangerous Bleeding In the Head
August 2017
Millions of people in the U.S. take blood thinners or antiplatelet medications to prevent the formation of potentially harmful clots in the heart, large veins or arteries. In this article, we report new research that examined the risk of one of the most serious bleeding complications associated with these drugs: subdural hematomas in the head.
Food-Drug Interactions You Should Know About
August 2017
Although health care professionals often advise patients on whether the medications they are taking may interact with each other, they do not always discuss how various foods may interact with medications. Learn about some of these dangerous food-drug interactions and how to protect yourself.
Drugs That Cause Diarrhea
August 2017
Many medicines can cause diarrhea, which can be severe and life-threatening in some cases. Find out which drugs have this adverse effect.
Medications for Hair Loss
August 2017
Alopecia, or excessive hair loss, is a common problem among both men and women, and it can have a considerable negative impact on the body image and emotional well-being of affected individuals. In this article, we present our recommendations regarding drugs that are approved for treating hair loss.
Do Not Use Eluxadoline (VIBERZI) for Irritable Bowel Syndrome
July 2017
Eluxadoline was approved by the FDA in May 2015 for treating irritable bowel syndrome with diarrhea as the predominant symptom in adults. Learn about the drug’s serious adverse effects that outweigh its limited benefits.
Supplements Purported to Boost Female Sex Drive Were Tainted
July 2017
For years, the Food and Drug Administration has repeatedly warned the public about dietary supplements that have been spiked illegally with hidden drugs. Find out which dangerous drug is now showing up in dietary supplements that are being promoted for increasing sexual desire and libido in women.
Acid-Suppressing Drugs Associated with Serious Infectious Diarrhea
July 2017
In this article, we discuss how two families of commonly used stomach acid suppressants may make patients more susceptible to Clostridium difficile infection, which can lead to severe, sometimes life-threatening diarrhea.
Magnesium Supplements Not Helpful for Nighttime Leg Cramps
July 2017
Nocturnal or nighttime leg cramps (charley horses) are very common in adults, afflicting nearly half of those over the age of 50. Find out why magnesium supplements are not the solution for this often distressing condition.
“Natural” Teething Remedies Also May Be Deadly
July 2017
Parents may be tempted to try assorted teething remedies for their infants. Learn about certain homeopathic products for teething that have been recalled because they were linked to a large number of serious injuries in infants.
Questions & Answers
July 2017
In this month’s Question & Answer section, we respond to a reader's question about how patients with high blood pressure should increase their dietary intake of potassium.
Benefits of Probiotics Remain Unproven
June 2017
The food and dietary supplement industries have been swift to capitalize on the excitement surrounding the microbes living on or within our bodies by selling products that contain probiotics, or live microor¬ganisms purported to improve health by altering the microbiome. In this article, we explain which claims about probiotics have been tested in clinical trials — and why many probiotic supplements are very likely a waste of money.
A Prescription for Making Medicines More Affordable in the U.S.
June 2017
Learn about landmark legislation recently introduced in the U.S. Senate that would lower the cost of prescription medications for all Americans, increase access to drugs for consumers and hold pharma¬ceutical corporations accountable for wrongdoing.
Drugs That Are Most Likely to Land Patients in the Emergency Room
June 2017
Many adverse drug reactions are severe enough to cause serious injury, hospitalization and even death. Find out which outpatient medications are most likely to cause adverse events that necessitate a visit to the emergency room.
Study Uncovers Serious Underreporting of Harms in Orlistat’s Trials
June 2017
For many years, we have designated the weight-loss drug orlistat (XENICAL, ALLI) as Do Not Use because it exposes patients to serious risks that greatly outweigh its minimal benefits. In this article, we describe data from a new study showing that orlistat’s side effects were seriously underreported in published medical journal articles for the clinical trials that the drugmaker conducted to support the drug’s approval.
Side Effects of Blood Pressure Drugs Often Unmonitored, Unaddressed
June 2017
We discuss new studies confirming that the widely used angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers can potentially harm the kidneys and cause dangerous elevations in blood potassium levels. These studies also indicated that many doctors are not heeding recommenda¬tions to look out for these side effects.
FDA Warning: Commonly Used Diarrhea Drug Can Cause Life-Threatening Heart Problems
May 2017
Find out which commonly used prescription and over-the-counter diarrhea medications can cause dangerous abnormal heart rhythms and cardiac arrest if taken at higher-than-recommended doses.
Nominee for FDA Commissioner: Too Cozy With Big Pharma
May 2017
On March 10, President Donald Trump nominated Dr. Scott Gottlieb to be the next FDA commissioner. Worst Pills, Best Pills News Editor Dr. Michael Carome explains why Gottlieb’s appointment would fur¬ther accelerate a decades-long trend in which FDA leadership too often makes decisions that are aligned more with the interests of the pharmaceutical industry than with those of patients.
Researchers Fight to Undo a Depression Drug's Dark History
May 2017
We describe the troubling story of how a pharmaceutical company manipulated the scientific literature to inappropriately promote the use of citalopram (CELEXA) for the treatment of de¬pression in children and teens despite the fact that the drug was not approved by the FDA for this use.
Budesonide and Formoterol (SYMBICORT): A Review
May 2017
The lung diseases asthma and chronic obstructive pulmonary disease together afflict 40 million Americans and can result in disability and life-threatening complications for many affected individuals. In this article, we present our recommendations for using SYMBICORT, a combination of the long-acting beta agonist formoterol and the inhaled corticosteroid budesonide, to treat these lung diseases.
Nonsurgical Treatments for Urinary Incontinence
May 2017
Urinary incontinence — the inability to control the passage of urine — is a widespread problem that affects an estimated 25 million American adults. Learn about lifestyle changes and non-drug therapies that should be the first-choice treatments for incontinence, as well as the best drugs to use as second-choice treatment options.
Study Rebuts Health Benefit Claims for Off-Label Testosterone
April 2017
Overall, use of testosterone medications in the U.S. grew by nearly 10-fold from 2000 to 2011, and by 2013, more than 5 million U.S. prescriptions for testosterone were being filled annually. In this article, we discuss new research findings showing that testosterone products fail to provide benefit to many of the men who are using them.
Big Pharma’s Self-Promoting Media Campaign
April 2017
Worst Pills, Best Pills News Editor Dr. Michael Carome warns readers not to be deceived by the slick advertising campaign recently launched by the Pharmaceutical Research and Manufacturers of America — the leading industry trade group representing brand-name pharmaceutical companies.
Many Psoriasis Drugs Unsafe During Pregnancy
April 2017
Find out which medications that are used to treat psoriasis (a chronic condition that causes patches of scaly and inflamed skin) are particularly dangerous during pregnancy because they carry well-established, high risks of birth defects.
Maker of ‘Female Viagra’ Sued as Sales Fizzle
April 2017
Flibanserin (ADDYI) was billed as the "female Viagra" because it was intended to increase sexual desire in women with "hypoactive sexual desire disorder," or low interest in sex. Learn why this dangerous drug fortunately has failed to be the blockbuster that many expected it to be.
A Review of Anti-Seizure Drug Levetiracetam
April 2017
Levetiracetam (KEPPRA, ROWEEPRA, SPRITAM) and its long-acting variant, levetiracetam extended-release (KEPPRA XR), are approved by the FDA for preventing seizures in patients with epilepsy. Find out who is most likely to benefit from using these drugs and what adverse reactions to watch out for when taking them.
New Research Links Testosterone to Risk of Dangerous Blood Clots
April 2017
We review the results of a new study demonstrating that patients using testosterone products have a significantly increased risk of developing life-threatening blood clots in large veins, most often in the legs.
Beware of Ads for ‘Memory- Enhancing’ Dietary Supplement
March 2017
If you regularly watch nightly national news on TV, you have probably seen ads promising improved memory if you take the dietary supplement apoaequorin (PREVAGEN). Learn why these claims from the maker of PREVAGEN represent an apparent elaborate hoax.
FDA Removal of Black-Box Warning Sets Dangerous Precedent
March 2017
In October 2014, Public Citizen joined four other consumer advocacy and research groups to petition the FDA to strengthen the existing black-box warning on the label of the smoking cessation drug varenicline. In December, the agency instead decided to move recklessly in the opposite direction by removing the black-box warning from the label. In this article, we discuss the dangerous precedent set by this decision.
Year in Review: Troubling New Drug Approvals in 2016
March 2017
In this article, we discuss three new drugs approved by the FDA in 2016 that Worst Pills, Best Pills News has identified as ineffective or lacking in evidence to support key claims made on products’ labels. The drugs discussed include one intended to treat a rare form of muscular dystrophy and two supposedly abuse-deterrent opioid pain drugs.
Spironolactone: Review of a ‘Water Pill’
March 2017
Spironolactone is a diuretic (water pill) that has been used for decades to treat certain patients with high blood pressure, heart failure, swelling (water retention) and other conditions. Find out who is most likely to benefit from using this drug and who should avoid it because of its dangerous adverse effects.
Medications for Bipolar Disorder
March 2017
Bipolar disorder, also known as manic depression, is a serious chronic mental illness that afflicts approximately 5.4 million people in the U.S. In this article, we review the benefits and safety of several drugs that are commonly used to treat this disorder.
Lorcaserin (BELVIQ): Another Do Not Use Diet Drug
March 2017
Learn about the unacceptable dangers posed by lorcaserin, a diet drug that was approved by the FDA in 2012 and that has similarities to the previously banned diet drug fenfluramine.
FDA Requires Stronger Warnings for Commonly Used Antibiotics
February 2017
One of the biggest-selling but most overprescribed classes of antibiotics in the U.S. is the family called fluoroquinolones. Learn why the FDA required the addition of new black-box warnings to the labels of these antibiotics that describe risks of several disabling and potentially permanent side effects.
21st Century Cures: Gift to Big Pharma, Bad Deal for Patients
February 2017
Worst Pills, Best Pills News editor Dr. Michael Carome discusses the dangerous giveaways to the pharmaceutical and medical device industries that are buried within the massive 21st Century Cures Act passed by the lame-duck Congress in December 2016.
Beta Blockers Not for Most Hypertension Patients
February 2017
Beta blockers have long been a mainstay of hypertension drug treatment. While these drugs remain useful for some patients, we now no longer recommend them as the starting treatment for hypertension except in special circumstances. Read this article to find out why our views on beta blockers have changed.
Dangerous Dosing Errors Rampant Among Parents Measuring Liquid Medications
February 2017
This article presents the results of new research showing that many parents make significant errors when measuring the dose of liquid medications for their children. Learn how to minimize dosing errors when administering children’s liquid medications.
Buprenorphine for Opioid Addiction
February 2017
From 2000 to 2014, almost half a million people died of drug overdoses in the U.S. Many of these deaths were fatal opioid overdoses, which have quadrupled in the U.S. since 1999. Learn why buprenorphine now outpaces methadone as a treatment of choice for opioid addiction.
Questions & Answers
February 2017
In this month's Questions & Answers section, we respond to two readers' important questions about our recent article about the treatment of attention deficit hyperactivity disorder.
Drugs That Increase the Risk of Falling
January 2017
Falls remain by far the leading cause of injuries among adults age 65 and older in the U.S. In this article, we identify many of the drugs that can increase your risk of falling and offer advice on how to protect yourself from fall-related injuries.
Patient Safety Advocates, Industry Spar Over Off-Label Promotion
January 2017
Worst Pills, Best Pills News editor Dr. Michael Carome discusses highlights of the debate between the pharmaceutical and medical device industry and patient safety advocates at a recent FDA public hearing regarding the agency’s rules on off-label promotion — the pharmaceutical and medical device industry practice of promoting prod¬ucts for unapproved uses.
Many Older Adults Do Not Take Blood Pressure Medications as Prescribed
January 2017
Keeping high blood pressure under control is essential to preventing long-term complications of hypertension, including cardiovascular disease, stroke and kidney failure. Learn about the steps you can take to boost your adherence to your blood pressure medication treatment.
Do Not Use Linaclotide (LINZESS) for Irritable Bowel Syndrome or Constipation
January 2017
Find out why the risks of linaclotide far exceed its benefits for treating patients with irritable bowel syndrome and constipation, and learn about safer alternative treatments for these conditions.
FDA Advisory Committee Split on Black-Box Warning on Varenicline (CHANTIX)
January 2017
In October 2014, Public Citizen joined four other consumer advocacy and research groups to petition the FDA to strengthen the existing black-box warning on the label of the smoking cessation drug varenicline. Find out why the FDA now is considering moving recklessly in the opposite direction by removing the black-box warning from the label.
Questions & Answers
January 2017
In this month Questions & Answers section, we respond to a reader's question about whether calcium-containing antacids, such as TUMS, for heartburn may increase the risk of adverse cardiovascular events.
The Rising Cost of Generic Drugs
December 2016
The ever-increasing prices for prescription medications are often in the news these days, with some products carrying eye-popping price tags of more than $100,000 per year. Typically the highest prices are for newer, brand-name products. Yet a more surprising pricing story has begun to emerge over the past few years: the rising cost of generic medications.
FDA Leadership Ignores Science, Approves Ineffective Drug
December 2016
Learn why the decision by FDA’s leaders to approve a new medication for a rare muscle disorder, over the strenuous objections of the agency’s scientific experts, threatens to undermine public health.
Endocrine Society Recommends Against Routine Use of Compounded Hormones
December 2016
In this article, we explain why FDA-approved bioidentical hormone medications are preferred over custom-mixed (compounded) products for treating hormone-related disorders.
Ropinirole: A Second-Choice Drug for Parkinson’s Disease
December 2016
In this article, we explore recent research showing that the older drug levodopa-carbidopa has a more favorable benefit-risk balance than ropinirole and other newer dopamine agonists for initial treatment of early Parkinson’s disease.
Dangers of Sleep Drug Suvorexant Still Outweigh Minimal Benefits
December 2016
Find out why Public Citizen’s Health Research Group has designated suvorexant as Do Not Use and what steps you can take to improve your sleep without relying on medications.
EpiPen Maker Mylan Becomes Lead Pharma Villain
November 2016
Worst Pills, Best Pills News editor Dr. Michael Carome discusses how drug manufacturer Mylan assumed the banner of most infamous price gouger among pharmaceutical corporations in the U.S.
Adding Aliskiren to an ACE Inhibitor in Heart Failure Harmful, Without Benefit
November 2016
For many years we have recommended never combining the high blood pressure medications aliskiren and ACE inhibitors. In this article, we review new research showing that this combination of drugs poses unacceptable risks in heart failure patients and provides no additional benefit over an ACE inhibitor alone.
Oral Treatments for Hypothyroidism
November 2016
Not all thyroid hormone replacement medications are the same, and some are not even approved for use in the U.S. Learn which of these medications you should take — and which ones you should not take — to treat hypothyroidism (underactive thyroid).
Insulin Glargine (TOUJEO): Do Not Use for Seven Years
November 2016
TOUJEO is a newer, long-acting, once-daily insulin approved by the Food and Drug Administration for the treatment of Type 1 and Type 2 diabetes in adults. Learn why you should avoid using this drug until at least 2022.
News Brief for November 2016
November 2016
In this month's News Brief section, we report on action taken by the Food and Drug Administration to add important new warnings to the labeling of all opioid and benzodiazepines drugs.
Commonly Used Antibiotic Can Cause Serious Psychiatric Side Effects
November 2016
Find out which commonly used antibiotic can cause psychosis, hallucinations, delirium, mood disorders, sleep disturbances and cognitive impairment.
A Guide to Treatment for ADHD
October 2016
The number of children diagnosed with attention deficit hyperactivity disorder (ADHD) and treated with drugs has increased dramatically over the past decade. Learn the steps needed for an accurate ADHD diagnosis and understand the variety of treatments available before working with your child's doctor on a plan for treatment.
Most Patients’ Groups Opposing Medicare Drug Pricing Reforms Have Ties to Big Pharma
October 2016
Worst Pills, Best Pills News editor Dr. Michael Carome discusses the implications of a recent Public Citizen report showing that the overwhelming majority of patient groups that opposed a recent Medicare Part B plan to rein in drug costs have financial ties to pharmaceutical corporations.
Treatment of Bacterial Skin Infections
October 2016
Bacterial skin infections are very common, resulting in several million visits to health care professionals annually. In this article, we explain the best treatment options for different types of bacterial skin infections.
FDA Issues Multiple Warnings For Newest Class of Diabetes Drugs
October 2016
Over the past year, the Food and Drug Administration has issued a series of new warnings about serious and, in some cases, potentially fatal events linked to the newest class of diabetes drugs. These drugs, known as "flozins," are being heavily promoted in TV ads. Learn more about these newly identified dangers and why you should avoid all flozins.
First-Choice Treatment for Young Children With ADHD Largely Underused
October 2016
For children younger than 6 with ADHD, drug treatment is not the first choice. Find out the non-drug approach recommended by the American Academy of Pediatrics that parents and teachers can use to manage these very young ADHD patients.
Questions & Answers
October 2016
In this month Questions & Answers section, we respond to a reader's question asking for advice on how patients can find out if their doctors have taken money from the pharmaceutical industry.
A Price-Gouging, Tax-Dodging Drug Company
September 2016
Find out which leading drugmaker has reaped billions of dollars in profits in the U.S. by charging unaffordable prices for its hepatitis C drugs, then shifting those profits offshore, enabling it to dodge nearly $10 billion in U.S. taxes.
New Gout Drug Lesinurad (ZURAMPIC) Too Dangerous
September 2016
The FDA's approval of lesinurad despite serious safety concerns and limited evidence of benefits represents another example of the agency's reckless approach to the oversight of prescription drugs. Read our independent analysis of the data considered by the FDA when it approved this new gout drug and our assessment of why you should not use it.
Gabapentin and the Criminal Manipulation of Science, a Decade Later
September 2016
In 2004, Parke-Davis, the manufacturer of gabapentin (NEURONTIN), pleaded guilty to felony charges for illegal marketing of the drug, including for "off-label" uses not approved by the FDA. Protect yourself and your loved ones from unnecessary risk by learning which claims about gabapentin are supported by sound science and which are not.
Questions & Answers
September 2016
In this month Questions & Answers section, we offer advice on how readers can approach their doctors about medicines that we have designated as either Do Not Use or Do Not Use for Seven Years.
Opioids and Benzodiazepines: A Deadly Combination
September 2016
Readers of Worst Pills, Best Pills News are aware that all benzodiazepine tranquilizers and sleeping pills, except for alprazolam (XANAX) and clonazepam (KLONOPIN), are now considered Do Not Use drugs. In this article, we explain why combining these drugs with opioid painkillers could kill you.
Do NOT ‘Go With the Flow’ for Dabigatran (PRADAXA)!
September 2016
Dabigatran is one of several new, heavily promoted anticoagulant drugs (blood thinners) approved by the FDA in recent years. Learn why you should ignore the television ads and not use this dangerous drug.
Doctors Accepting Bribes, Betraying Patients
August 2016
Worst Pills, Best Pills News editor Dr. Michael Carome discusses the recent arrest of two former drug company employees for allegedly running a brazen scheme to bribe doctors to prescribe millions of dollars' worth of a powerful synthetic opioid.
Incretin-Mimetic Drugs: Do Not Use to Treat Diabetes
August 2016
Incretin mimetics, one of the newer classes of diabetes drugs, are widely prescribed in the U.S. Find out why Public Citizen's Health Research Group recommends against using any of these medications.
Starting Beta Blockers Before Noncardiac Surgery May Be Harmful
August 2016
Beta blockers, which are widely used and effective in treating high blood pressure, heart disease and heart failure, are often started in patients prior to surgery in an effort to prevent cardiovascular complications. Learn why starting beta blockers immediately before undergoing surgery may be dangerous.
Proton Pump Inhibitors Linked to Dementia in the Elderly
August 2016
In this article, we review new research linking use of the heartburn and ulcer medications known as proton pump inhibitors to an increased risk of dementia.
Supplements for Age-Related Macular Degeneration
August 2016
Numerous high-dose dietary supplements are now broadly marketed to promote general eye health. Find out who can benefit from — and who should not take — these supplements and which ingredients to look for on the label.
News Brief for August 2016
August 2016
In this month's news briefs, we report on the FDA's decision to require new black-box warnings in the labeling of all immediate-release opioid drugs about the risks of abuse, addiction, overdose and death, as well as the agency's recent drug safety alert reminding consumers not to purchase over-the-counter chelation products. We also discuss the decision of a major drugmaker to terminate its involvement in the marketing of an inhaled form of insulin.
Proton Pump Inhibitors Might Cause Chronic Kidney Disease
July 2016
Public Citizen's Health Research Group has long warned about the serious risks of the commonly used group of heartburn drugs known as proton pump inhibitors. In this article, we discuss new research suggesting that chronic kidney disease is another potential side effect of these drugs.
Antibiotic Misuse: Dangerous for Everyone
July 2016
When health care providers prescribe antibiotics to patients who do not need them, these drugs endanger both the patients taking them and the public at large. Find out why.
Vitamin D for Preventing Falls in the Elderly: Less Is Safer
July 2016
Many people take vitamin supplements to promote bone and muscle health. But taking too much vitamin D may have dangerous consequences. Read this article to find out how much vitamin D is safe.
Drugs That Cause Sun-Related Skin Reactions
July 2016
Summer is a terrific time for healthy outdoor activities, such as walking, hiking, biking and swim¬ming. But for an unlucky few, certain medications can lead to adverse skin reactions following exposure to the sun. Find out whether you are at risk and how to protect yourself.
Drug-Induced Hair Loss
July 2016
For most people with hair loss, the condition usually is age-related or due to the genes they inherited from their parents. But for some patients, the cause of the problem can be found in the medicine cabinet. Learn about some commonly used medications that can cause hair loss.
Industry Money Undermines the Doctor-Patient Relationship
June 2016
Worst Pills, Best Pills News editor Dr. Michael Carome highlights new research showing that the large sums of money pharmaceutical and medical device companies funnel to physicians too often play an inappropriate role in physicians’ prescribing decisions.
Prostate Drugs Increase Risks of Falls, Fractures
June 2016
Symptoms of benign (noncancerous) prostate enlargement afflict most men age 60 or older. In this article, we discuss new research showing that a group of drugs often used to treat this condition slightly increase the risk of falls and fractures. We offer important advice on how to minimize these risks.
What Is a Drug Label?
June 2016
Drug labels provide important information regarding the benefits and risks of prescription medications. In this article, we offer guidance on where to find these drug labels and identify the sections of the label that provide the most useful information for patients.
Important Questions About Shingles
June 2016
Shingles is a very common disease caused by the chicken (herpes zoster) virus. Elderly adults are particularly vulnerable to developing this painful and sometimes debilitating condition. Learn the facts about shingles and how you can lower your risk of developing it.
SPIRIVA for COPD: Find Out Which Inhaler Is Safe
June 2016
Tiotropium (SPIRIVA) is a frequently prescribed drug administered via oral inhalers for chronic obstructive pulmonary disease (COPD). The drug is available in two types of inhaler devices. One of these should never be used. Find out which one.
A Guide to Drugs for Uncomplicated Urinary Tract Infections
May 2016
Urinary tract infections (UTIs) are very common, accounting for more than 10 million visits to doctors’ offices and 2 million to 3 million emergency department visits in the U.S. in 2007. Hear our take on which antibiotics are safest for treating these infections.
FDA to Investigate Effect of Using Cartoon Characters to Peddle Drugs
May 2016
Animated characters are a feature of an increasing number of TV ads for prescription drugs. Find out why the FDA is concerned that these characters may mislead consumers about the risks and benefits of the medications being promoted and what the agency intends to do about this.
Memantine: Still a Poor Choice for Alzheimer’s Disease
May 2016
Memantine (NAMENDA) recently has been one of the drugs for Alzheimer’s disease most heavily promoted through direct-to-consumer advertising. Learn why we have designated memantine as Do Not Use.
Questions & Answers
May 2016
In this month’s Question & Answer feature, we respond to a reader’s request to explain why we recommend use of bisphosphonates for certain patients with osteoporosis despite our warnings about their risks.
Another Look at First-Generation Antihistamines
May 2016
Last month, we discussed the risks and benefits of second- and third-generation antihistamines for treatment of nasal allergies. In this second of a two-part series, we explain why first-generation or "sedating" antihistamines are not a safe option for managing nasal allergies.
Responsible Disposal of Prescription Drugs
May 2016
For various reasons, many prescribed medications go unused. Such leftover medications can pose a hazard to family members, especially young children, and the environment. Find out the best ways to safely dispose of unused prescription medications.
New FDA Commissioner: Unfit for Duty
April 2016
Worst Pills, Best Pills News editor Dr. Michael Carome explains why the new FDA Commissioner, who was confirmed by the Senate in February, was a poor choice to lead such a critically important agency of the U.S. Public Health Service.
Is XARELTO Really the 'Right Move' for Patients With Blood Clots or Risk for Stroke?
April 2016
If you watch TV, you likely have seen ads touting the advantages of the new oral antico-agulant (blood thinner) rivaroxaban (XARELTO). Learn why we have designated this drug as Do Not Use for Seven Years (until at least July 2018).
Treatment for Nasal Allergies: An Updated Review
April 2016
With spring time pollen counts soaring, many patients with seasonal nasal allergies will be looking for relief from allergy medications. Learn the best available treatments to stay safe and relatively symptom-free during allergy season and throughout the year.
The Best Drug for Severe Acute Low Back Pain
April 2016
Low back pain is the fifth most common reason for outpatient doc¬tor visits and leads to 2.6 million emergency room visits in the U.S. every year. This article reviews results of the newest research on which pain relievers are safest and most effective for managing severe low back pain.
Fluoroquinolones Linked to Life-Threatening Blood Vessel Complications
April 2016
In this article, we discuss results of new research linking the widely overused fluoroquinolone antibiotics to an increased risk of life-threatening damage to the body’s largest blood vessel, the aorta.
Year in Review: Troubling New Drug Approvals in 2015
March 2016
Learn about six new drugs approved by the FDA in 2015 that Worst Pills, Best Pills News has identified as dangerous or ineffective. The drugs include two for lowering high cholesterol levels, one for removing excess fat below the chin, and another for treating gout, among others.
CDC Seeks to Rein In Overprescribing of Opioids for Chronic Pain
March 2016
Since 1999, more than 140,000 people in the U.S. have died from overdoses related to opioid pain medication. Worst Pills, Best Pills News editor Dr. Michael Carome applauds a new proposal from the Centers for Disease Control and Prevention to rein in the overprescribing of opioids and reverse this rising death toll.
News Brief for March 2016
March 2016
In this month’s news brief, we report on the Department of Justice taking long-overdue action against a Dallas-area compounding pharmacy for making contaminated drugs and for unsanitary production conditions.
Feds Finally Crack Down on Illegal Dietary Supplement Makers
March 2016
Too often, consumers are exposed to dietary supplements that have been spiked illegally with hidden drug ingredients or contaminated with other potentially dangerous substances. In this article, we report on recent legal actions taken by the FDA, the Department of Justice, and the Federal Trade Commission to stem the flow of these dangerous products.
Some SNRIs Useful for Depression; Avoid Others
March 2016
This article explores one of the newer classes of drugs for treating depression: serotonin-norepinephrine reuptake inhibitors (SNRIs). Find out which SNRIs are safe for treating depression and which should be avoided.
New Biologic Drugs for Rheumatoid Arthritis: Which Are Safe?
March 2016
Patients with rheumatoid arthritis have a wide array of medication choices for reducing joint pain and inflammation and slowing the progression of joint damage. The most potent such drugs are a group of medications known as disease-modifying anti-rheumatic drugs (DMARDs). Learn about the serious risks posed by these drugs and when they should be used.
FDA Joins Hands With Industry to Weaken Its Own Rules
February 2016
Worst Pills, Best Pills News editor Dr. Michael Carome expresses outrage over disclosures that senior Food and Drug Administration representatives colluded with a leading medical device trade association in writing legislation that would weaken regulatory standards for medical devices.
St. John’s Wort: No ‘Wonder Remedy’ for Depression
February 2016
St. John’s wort, an over-the-counter herbal supplement, has been around for centuries, and many patients have been using it in recent years to self-medicate for depression. In this article, we explain why St. John’s wort should not be used to treat this disease.
Commonly Used Gout, Kidney Stone Drug Too Dangerous for Unproven Uses
February 2016
Allopurinol (LOPURIN, ZYLOPRIM) is an appropriate first-choice drug for treating gout and kidney stones caused by excess uric acid levels in the blood or urine. But you should not use allopurinol to treat high blood uric acid levels if you don’t have these disorders. Read this article to learn why.
Drugs That Cause Loss of Bladder Control
February 2016
Urinary incontinence, or loss of bladder control, is a common and often embarrassing problem that can have a huge impact on quality of life. Find out which drugs can cause this problem.
News Brief for February 2016
February 2016
In our news brief this month, we report on two recent warnings issued by the Food and Drug Administration about the diabetes drugs known as SGLT2 inhibitors, more commonly known as “flozins.” This family of drugs, all designated as Do Not Use, includes canagliflozin (INVOKAMET, INVOKANA), dapagliflozin (FARXIGA) and empagliflozin (JARDIANCE).
Still No Good Evidence That Nonstatin Drugs Prevent Heart Attacks and Strokes
February 2016
Statins have long been a mainstay of treatment for patients with high LDL (“bad” cholesterol) and cardiovascular disease. In this article, we explain why you should avoid combining a nonstatin cholesterol-lowering dug with a statin.
New Evidence That Off-Label Drug Use Increases Risk of Harm
January 2016
Worst Pills, Best Pills News editor Dr. Michael Carome discusses the implications of new research showing that patients taking prescription drugs for uses not approved by the Food and Drug Administration are more likely to suffer adverse reactions.
Health Canada Warns of Dangerous Drug Interaction
January 2016
Learn why Health Canada, an agency similar to the Food and Drug Administration, warned Canadian consumers not to combine repaglinide-containing diabetes medications (PRANDIN or PRANDIMET) with the anti-platelet drug clopidogrel (PLAVIX).
Questions & Answers
January 2016
In this month’s Questions & Answers feature, we address readers’ questions about using several non-traditional treatments for osteoarthritis pain, including cetyl myristoleate, s-adenosylmethionine or SAMe, and aloe vera.
Drug Treatments for Chronic Heart Failure
January 2016
For the approximately 5 million Americans suffering from chronic heart failure, there is a wide array of lifesaving drug treatments. Find out our take on the most recent expert guidelines for treating this disease.
Omega-3 Fatty Acid, Antioxidant Supplements Useless for Improving Cognitive Function
January 2016
In this article, we review results from a well-designed clinical trial funded by the National Institutes of Health that debunks the cognitive health claims for dietary supplements containing omega-3 fatty acids or the antioxidants lutein and zeaxanthin.
Dangers of Post-Surgery Delay in Resuming Blood Pressure Drugs
January 2016
Patients taking drugs to treat high blood pressure often are directed to stop their medication at least 24 hours before surgery. Learn why restarting these medications as soon as possible after surgery could save your life.
Inhaled Insulin AFREZZA Ineffective, Can Damage Lungs
December 2015
Find out why this new form of insulin, which is inhaled as a powder, is a dangerous alternative to injected forms of insulin and never should have been approved by the Food and Drug Administration for the treatment of diabetes.
Outrage Over Price Gouging by Pharma Companies Reaches New Heights
December 2015
Worst Pills, Best Pills News editor Dr. Michael Carome examines the possible implications of the rising tide of public anger over the high prices charged by pharma¬ceutical companies in the U.S.
Dangerous Atypical Antipsychotics Minimally Effective for Depression
December 2015
Some powerful antipsychotic drugs originally developed to treat schizophrenia now have been approved to treat depression. Learn about the serious side effects of these drugs that make it advisable to explore other, safer options for managing depression.
Long-Acting Opioids: Extra Caution Needed
December 2015
In this article, we review new evidence suggesting that long-acting opioids are associated with a higher risk of unintentional life-threatening over¬doses than short-acting forms of these drugs.
Many Atrial Fibrillation Patients With Lowest Stroke Risk Receive Unnecessary Blood Thinners
December 2015
A recent study revealed that some cardiologists prescribe blood thinners to atrial fibrillation patients who don’t need them because their risk of stroke is very low. Read this article to learn who these patients are.
News Brief for December 2015
December 2015
In our news brief this month, we discuss Public Citizen's recent petition to the Food and Drug Administration to correct the labeling of a new drug approved for treatment of an uncommon sleep disorder in totally blind people. The agency mistakenly approved a label that expanded the drug's use to nonblind patients.
Drug Industry’s Unacceptable Delays in Reporting Adverse Events To the FDA
November 2015
Worst Pills, Best Pills News editor Dr. Michael Carome discusses disturbing results from a recent study revealing that pharmaceutical companies too often violate the law by failing to promptly report unexpected serious adverse events linked to use of their products. Delays in report¬ing such events undermine a key component of our nation’s system for monitoring the safety of prescription drugs.
News Brief for November 2015
November 2015
In our news brief this month, we report on the Food and Drug Administration's reckless decision to approve flibanserin (ADDYI), the first drug to treat hypo¬active sexual desire disorder in premenopausal women.
Insulin Pumps Need More Scrutiny, Say American and European Diabetes Groups
November 2015
Insulin pumps have been promoted as an important technological advancement in diabetes care. Find out why Public Citizen’s Health Research Group considers these devices too dangerous to use.
Update on the Long-Term Treatment Of Chronic Obstructive Pulmonary Disease
November 2015
In this article, we provide a detailed update of the various drugs available for the long-term management of chronic obstructive pulmonary disease (COPD). Learn which drugs are safest for treating COPD and which ones we have designated as Do Not Use.
Drugs That Cause Hearing Problems
November 2015
For most people with hearing loss, the condition likely is age-related or due to long-term exposure to loud noise. But for some patients, the cause of the problem can be found in the medicine cabinet. Learn about some commonly used medications that can cause hearing disorders.
Questions & Answers
October 2015
In this month's Question and Answers feature, we respond to readers' questions about our June article on injected drugs for age-related macular degeneration.
Initial Ruling in Industry Lawsuit Threatens FDA's Regulation Of Drugs
October 2015
Learn more about a recent federal court decision that threatens to return us to the days of the late 19th and early 20th centuries, when snake-oil salesmen touted "remedies" that were too often ineffective — and sometimes dangerous.
Liraglutide (SAXENDA) for Weight Loss
October 2015
Find out why the recently approved high-dose form of liraglutide, which was originally marketed for treatment of Type 2 diabetes, is not a safe option for managing weight loss
Often-Misused Fluoroquinolone Antibiotics Pose Serious Risks
October 2015
Fluoroquinolones are the biggest-selling and most overprescribed classes of antibiotics in the U.S. Learn why Public Citizen's Health Research Group designates two of the five available fluoroquinolones as Do Not Use and why the other three should be used only in limited circumstances.
More Evidence Linking Hormone Therapy To Cardiovascular Harm in Postmenopausal Women
October 2015
In this article, we discuss the most recent evidence linking the use of hormone replacement therapy in women after menopause to increased risk of heart attacks, strokes and other serious cardiovascular problems.
News Brief for September 2015
September 2015
In our news brief this month, we report on a recent FDA safety warning about permanent disfiguring skin color changes caused by a medication patch used for treating attention-deficit hyperactivity disorder.
Selling More Drugs by Misrepresenting Their Safety
September 2015
Last year, the FDA proposed a guidance that would give drug com¬panies free rein to tell doctors that medications are less dangerous than the FDA has concluded. Find out the serious threat posed by this guidance and action you can take to stop it.
Questions & Answers
September 2015
In response to our recent article on osteoporosis, a reader asks for our opinion regarding the use of the dietary supplement PROSTEON for this disorder. See our independent assessment of this supplement.
Warning From FDA on Prescription Drops for Ear Pain
September 2015
In July, the FDA announced that the agency will be requiring manufacturers to stop selling 16 types of prescription ear drops. These drugs have never been approved as safe and effective for their marketed uses. Find out the names of these drugs so you can protect yourself and your family members from these potentially harmful and unproven remedies.
VYVANSE for Binge Eating: Old Pill, New ‘Disease’
September 2015
Don't fall prey to a drug company's slick marketing campaign of a dangerous drug recently approved by the FDA for treatment of a newly designated disease called "binge eating disorder."
FDA Bolsters Warnings About Heart Attack, Stroke Risks for Commonly Used Pain Drugs
September 2015
Worst Pills, Best Pills News editor Dr. Michael Carome discusses the FDA’s recent safety alert announcing that the agency is strengthening existing warnings in the product labels for all non-aspirin nonsteroidal anti-inflammatory drugs about increased risk of heart attack and stroke.
DUAVEE, Hot Flashes and Bone Health
September 2015
Learn why the new combination of conjugated estrogens plus bazedoxifene (DUAVEE) is a bad choice for treating hot flashes and improving bone health in menopausal women.
Pharma Companies Buying Old Drugs, Dramatically Increasing Prices
August 2015
Learn about one disturbing pharmaceutical industry trend contributing to skyrocketing prices of certain lifesaving medications that have been on the market for decades.
Antibiotics, Common Heartburn Drugs And Spread of Potentially Fatal Intestinal Infection
August 2015
Proton pump inhibitors, a widely used class of heartburn drugs, and essentially all antibiotics increase your risk of C. difficile infections, which can cause severe, even life-threatening diarrhea illness. Read this article to find out how to protect yourself from this dangerous infection.
Update: Treatment of Chronic Asthma
August 2015
Asthma is a common disease afflicting more than 16 million American adults and 6 million children. Find out the safest and most effective options for managing this chronic lung disease.
Questions & Answers for August 2015
August 2015
A reader asks whether a recent change in her thyroid disorder symptoms could have been caused by switching from a brand name to generic thyroid hormone replacement drug. See our advice regarding concerns about such thyroid medication changes.
Risks but No Benefits to Taking Newest Drugs For Type 2 Diabetes
August 2015
The airwaves are filled with ads promoting the newest class of diabetes medications, often referred to as “flozins.” In this article, we review the serious safety concerns that have prompted us to designate all flozins as Do Not Use.
Anticholinergics May Increase Dementia Risk in Elderly
August 2015
Learn about recent evidence suggesting that anticholinergic drugs — which include many antidepressants, antihistamines and overactive bladder control medications — may increase the risk for developing Alzheimer’s disease and other types of dementia in the elderly.
Public Citizen Shines a Light on Off-Label Promotion of Diabetes Drugs
July 2015
In a recent complaint to the FDA, we took several makers of diabetes drugs to task for direct-to-consumer ads that promote the drugs for unapproved uses. Find out the names of the drugs targeted in our complaint and the nature of the off-label uses being promoted in the ads.
New Study Reveals Many Patients at Risk for Dangerous Alcohol-Drug Interactions
July 2015
Recent research revealed that many patients consume alcohol while using drugs that may can cause dangerous side effects when combined with alcohol. Read this article to learn about the many ways alcohol can adversely interact with prescription and over-the-counter medications.
Industry Lawsuit Threatens FDA's Regulation of Drugs
July 2015
Worst Pills, Best Pills News editor Dr. Michael Carome discusses an unusual lawsuit filed by a drug company against the FDA that seeks to bypass the agency’s drug approval process and the prohibition against off-label promotion.
Eight Treatments Commonly Used for Osteoarthritis Pain
July 2015
Patients with osteoarthritis have many treatment options. Find out which ones are safest for relieving osteoarthritis pain.
News Brief for July 2015
July 2015
In this month’s news brief, we discuss Public Citizen’s recent petition to the FDA calling for a ban on all oral forms of a commonly used antifungal drug.
Risk of Sudden Death With Some Hypertension Drug-Antibiotic Combinations
June 2015
Find out which commonly used antibiotic can increase your risk of sudden death if it is combined with either an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin II receptor blocker (ARB), which are among the most widely prescribed drugs in the U.S.
More Evidence of Dietary Supplements’ Dangers, Lack of Quality
June 2015
Worst Pills, Best Pills News editor Dr. Michael Carome discusses three recent events that reinforce the importance of being wary when considering the use of dietary supplements.
News Briefs for June 2015
June 2015
In our news briefs this month, we report on a recent FDA warning about the dangers of relying on over-the-counter homeopathic products to treat asthma. We also discuss the FDA’s very first approval of a biosimilar, which is essentially a generic version of a biologic drug.
More Dietary Potassium Can Reduce Occurrence of Hypertension, Amount of Drugs Needed for Its Treatment
June 2015
Learn why increasing the amount of potassium in your diet can help lower your blood pressure and reduce your risk of suffering a stroke. To help readers assess their potassium intake, we offer a list of potassium-rich foods.
Canada Issues Warnings on Alzheimer’s Disease Drugs
June 2015
Health Canada, the Canadian equivalent of the U.S. Food and Drug Administration, recently warned physicians and patients about safety concerns regarding two drugs commonly used to treat Alzheimer’s disease. Find out the names of these drugs and the newly identified serious adverse events linked to them.
Injections for Age-Related Macular Degeneration
June 2015
Age-related macular degeneration is a leading cause of blindness and serious decreases in vision among patients age 50 and older. In this article, we provide our independent expert assessment of the available drug treatments for this disorder.
A Guide to Treatments for Osteoporosis
May 2015
Drug treatment can prevent broken bones in some women with osteoporosis. But drugs are not always necessary and can cause harmful side effects, especially when treatment lasts longer than needed. Read this article to learn who should take osteoporosis drugs, which drugs to take and for how long.
FDA Belatedly Requires Warnings About Heart Attack, Stroke Risks for Testosterone Products
May 2015
On March 3, the Food and Drug Administration finally announced that it was requiring that the labels of all approved prescription testosterone products include a warning about the possible increased risk of heart attacks and strokes. Worst Pills, Best Pills News editor Dr. Michael Carome criticizes the agency for recklessly dragging its feet prior to requiring these warnings.
Painkiller Tramadol Increases Risk of Low Blood Sugar
May 2015
For years, Public Citizen’s Health Research Group has designated tramadol as a Do Not Use drug. We discuss results of a new study providing an additional reason for avoiding tramadol: The drug has been linked to the occurrence of dangerously low blood sugar.
Falls in Elderly People: The Role of Blood Pressure Drugs
May 2015
Recent studies have confirmed that a significant cause of falls in the elderly is medication (and often overmedication) with drugs for high blood pressure, resulting in blood pressures low enough to increase the risk of falling — with attendant fractures and head injuries. Learn who is most at risk and what the blood pressure goal should be for patients age 60 or older.
Studies Cast Doubt on the Benefits of Raising HDL (‘Good’) Cholesterol
May 2015
This article discusses evidence from recent research that calls into question the benefits of taking drugs, such as niacin, to raise blood levels of high-density lipoprotein (HDL), often called “good” cholesterol.
Further Evidence Confirms Danger Of Blood Pressure Drugs Used Together
April 2015
Patients should never take more than one of the following drugs used to treat high blood pressure at the same time: an angiotensin-converting enzyme (ACE) inhibitor, an angiotensin II receptor blocker (ARB), and aliskiren. Learn why doing so could have serious, even fatal consequences.
Health Insurers Find New Way To Discriminate Against Sick Patients
April 2015
Worst Pills, Best Pills News editor Dr. Michael Carome reviews a new scheme being perpetrated by some health insurance companies in order to maximize profits: to discourage certain high-cost patients from enrolling in their health plans.
A Look at Treatments for Rosacea
April 2015
Rosacea is a chronic skin condition affecting 13 million Americans. Find out steps to take to prevent symptom flare-ups, and learn which topical drug therapies are most effective and safest for treating this condition.
Owner, Lead Compounding Pharmacist of Drugmaker Linked to Meningitis Outbreak Charged With Murder
April 2015
In December 2014, a federal grand jury in Boston indicted 14 executives and employees of a Massachusetts compounding phar¬macy on 131 criminal charges in connec¬tion with a deadly nationwide fungal meningitis outbreak. Learn the shocking details of how the company put the lives of thousands of patients around the country at risk.
Benzodiazepines: Widely Prescribed, Dangerous Sleep and Tranquilizer Drugs
April 2015
This article discusses recent research showing increasing frequency of benzodiazepine use as people get older in the U.S. We also review results of a new study showing a possible link between use of these drugs and an increased risk of developing Alzheimer’s disease.
Ten Rules for Safer Drug Use
March 2015
Patients often wonder what steps they can take to minimize their chances of suffering a serious adverse drug reaction. This article reviews 10 simple rules developed by Public Citizen’s Health Research Group for ensuring safer drug use.
Public Citizen Highlights Efforts By Biologics Industry to Maintain Monopolies
March 2015
In his editor’s column, Dr. Michael Carome discusses how companies that make biologic medications are using their political clout to price-gouge and maintain indefinite monopolies on their products, costing consumers billions of dollars.
Public Citizen Joins Other Groups in Requesting Additional Warnings on CHANTIX Label
March 2015
In October 2014, Public Citizen joined four other consumer advocacy and research groups to petition the FDA to require stronger warnings on the label of the smoking cessation drug varenicline (CHANTIX). Learn about the drug’s severe psychiatric and neurological side effects that could potentially lead to fatal consequences.
Big Pharma’s Drug Assistance Programs: Harmless Charity?
March 2015
Pharmaceutical companies market patient assistance programs as a goodwill solution to assist patients who are struggling to pay for expensive prescription drugs. Find out why these programs may encourage physicians to prescribe more expensive drugs instead of less expensive, equally effective alternatives, including generic products.
More on Overprescribing Statins
March 2015
The most recently issued prescribing guidelines for cholesterol-lowering statin drugs were partly based on a new patient risk calculator that significantly overestimates patients’ risk of developing cardiovascular disease. Learn how this overestimation will lead to overprescribing of statin drugs to patients who will not benefit from using them.
News Brief for March 2015
March 2015
In our news brief this month, we report on the FDA’s recent approval of a new, high-dose, extended-release formulation of the opioid drug oxycodone (HYSLINGA). Although this new version of the drug is designed to deter abuse, it may be more dangerous than other oxycodone products. Read this article to find out why.
Questions & Answers for March 2015
March 2015
In a new feature that will appear periodically in issues of Worst Pills, Best Pills News, we respond to some selected questions posed by our readers. In this month’s issue, we respond to questions regarding (a) whether the widely advertised drug adalimumab (HUMIRA) is a new wonder drug, and (b) what should you do if you are already taking rivaroxaban (XARELTO).
With Some Drugs, Crushing Tablets Or Opening Capsules Could Have Fatal Consequences
February 2015
Patients who have difficulty swallowing pills will sometimes crush tablets or open capsules and sprinkle the resulting powder, fragments or granules into food or liquids. Other patients will resort to chewing their pills before swallowing. Find out the dangers posed by taking such measures.
Congress, Justice Department Investigate Spiked Generic Drug Prices
February 2015
In 2014, alarm bells sounded as the prices of many commonly used generic drugs spiked, in some cases by staggering amounts. Read Dr. Michael Carome’s column to find out how Congress and the Justice Department are investigating this price gouging.
New Warnings on Common Heartburn Drugs: Too Little — and, for Some, Too Late
February 2015
After a more than three-year delay and a Public Citizen lawsuit filed against the FDA, the agency finally responded to our petition for stronger label warnings on a class of medications, known as proton pump inhibitors, commonly used to treat heartburn. This article discusses the new warnings that the FDA has required in response to our petition.
Does $760m a Year of Industry Funding Affect the FDA’s Drug Approval Process?
February 2015
This reprint of a British Medical Journal column by Health Research Group founder and former Worst Pills, Best Pills News editor Dr. Sidney Wolfe discusses how user fees paid by the drug industry to the FDA have compromised the agency’s drug review process and undermined drug safety.
New Recommendations to Prevent Complications During Pregnancy
February 2015
In 2014, the U.S. Preventive Services Task Force issued new recommendations regarding the use of low-dose aspirin by pregnant women to reduce the risk of developing preeclampsia, a potentially life-threatening condition. Learn about the risk factors for this serious condition and who is most likely to benefit from taking low-dose aspirin.
Gambling, Hypersexuality And Compulsive Shopping: Drugs That Make You Lose Control
January 2015
Find out which drugs used to treat Parkinson’s disease, restless legs syndrome and the hormone disorder hyperprolactinemia can cause uncontrollable impulsive behaviors, including compulsive gambling and shopping, hypersexuality, and binge eating.
Republican Takeover of Senate Imperils Drug Safety
January 2015
Given the changes in the makeup of the U.S. Senate following the November elections, Congress is likely to pass new legislation that will weaken the FDA’s rules for ensuring that drugs are safe and effective. Read Dr. Michael Carome’s column to find out why.
New Evidence of Flaws in Approach to PRADAXA Dosing
January 2015
One of the supposed major advantages of the anticoagulant dabigatran (PRADAXA) touted by its manufacturer is that patients can take a fixed dose of the drug and do not need to undergo periodic monitoring with blood tests to adjust the dose. This article presents new research data that casts doubt on the safety of this fixed-dose approach.
News Briefs for January 2015
January 2015
In a new feature that will appear periodically in issues of Worst Pills, Best Pills News, we highlight recent important news items related to drug safety. In this month’s news briefs, we report on (a) a recent FDA warning about over-the-counter drugs that can make you drowsy; (b) action taken by the Federal Trade Commission against a company for false advertising of green coffee beans as a miracle weight loss remedy; and (c) the American Academy of Neurology’s position statement cautioning against the use of narcotic drugs for treatment of chronic noncancer pain.
CRESTOR Lacks Any Health Benefit for High Cholesterol; Likely to Increase Risk of Diabetes
January 2015
Since 2003, Public Citizen’s Health Research Group has advised readers not to use rosuvastatin (CRESTOR). Learn about the newest research indicating that rosuvastatin is more dangerous than other available statin drugs.
Sleep Disorder Treatment for Blind Persons May Be Marketed More Widely
January 2015
The FDA recently approved a drug for treatment of a sleep disorder that occurs primarily in people who are totally blind. Find out the name of this new drug and learn about concerns that the company may seek to market the drug to a much wider population of patients who are not blind.
Pregabalin (LYRICA): OK for Certain Seizures, but Not Pain
December 2014
LYRICA is heavily promoted for treatment of chronic pain due to fibromyalgia and other conditions. Learn why Public Citizen’s Health Research Group advises against using the drug to treat these painful conditions.
Sunshine Law Exposes Vast Industry Payments to Physicians
December 2014
In his editor’s column, Dr. Michael Carome discusses the implications of data recently released by the federal government that reveals the staggering amount of money drug and medical device companies are paying doctors and teaching hospitals.
Restless Legs Syndrome: Overdiagnosed and Overtreated
December 2014
In this review of restless legs syndrome (RLS), we discuss the limitations of the available drug treatments for the disorder and the nondrug approaches that are the safest options for people with mild to moderate RLS symptoms.
Albiglutide (TANZEUM): Another Me-Too Drug for Type 2 Diabetes
December 2014
Read about the dangers posed by albiglutide, yet another new diabetes drug designated as Do Not Use by Public Citizen’s Health Research Group because it offers no unique benefits but does pose unique risks.
Adding NSAIDS or Aspirin to Anticoagulants Increases Bleeding Danger
December 2014
If you are one of the millions of patients in the U.S. who take blood thinners on a long-term basis to prevent potentially harmful clots in the heart, veins or arteries, read this article to learn why you should avoid taking NSAIDS or aspirin unless absolutely necessary.
New Cholesterol Treatment Guidelines Recommend Statins for More Patients
November 2014
One year ago, the American College of Cardiology and the American Heart Association released controversial new guidelines on treating high cholesterol. Get Public Citizen’s Health Research Group’s independent take on these new guidelines.
The FDA Should Not Be Promoting Products It Regulates
November 2014
In his editor’s column, Dr. Carome takes the FDA to task for using the agency’s homepage to promote specific medical devices and medications. By becoming the promoter of the products it regulates, the FDA undermines its objectivity and independence.
Combining Diabetes Drugs With Certain Antibiotics May Cause Dangerous Drops in Blood Sugar Levels
November 2014
Serious adverse reactions often occur when different drugs are taken together. Find out which antibiotics diabetic patients taking glipizide (GLUCOTROL, GLUCOTROL XL) or glyburide (DIABETA, GLUCOVANCE, GLYNASE) should avoid because of an increased risk of life-threatening drops in blood sugar levels.
FDA Approves Suvorexant, Latest Dangerous Sleep Drug
November 2014
For many years, Public Citizen’s Health Research Group has recommended against using sleeping pills to treat insomnia. This article reviews the serious risks of the newest sleep medication approved by the FDA.
New Warnings for Bone Drug Denosumab (PROLIA)
November 2014
Learn about new warnings recently issued by the FDA about the bone drug denosumab, a medicine previously designated as Do Not Use by Public Citizen’s Health Research Group.
Benzocaine Teething Gels Associated With Life-Threatening Condition
October 2014
Learn why benzocaine-containing gels and liquids should never be used to treat teething discomfort and about the actions Public Citizen’s Health Research Group has taken to end the use of these dangerous products in infants.
Generic Drugs: Don’t Let Appearances Fool You
October 2014
Stopping beneficial medications threatens patient health. In his monthly editor’s column, Dr. Michael Carome discusses an intriguing new study showing that patients are more likely to stop taking important medications when pharmacies substitute one generic version of a drug for another differing in shape or color.
Widely Used Prostate Cancer Treatment Not Beneficial for Most
October 2014
Many men with localized prostate cancer are being treated unnecessarily with a commonly used class of drugs. Find out which drugs are being overused.
Eszopiclone (LUNESTA): Too Dangerous at Any Dose
October 2014
The Food and Drug Administration’s recent recommendation to lower the starting dose of the insomnia drug eszopiclone is insufficient to address the drug’s dangers. Learn why Public Citizen’s Health Research Group continues to designate eszopiclone as Do Not Use.
Severe Allergic Reactions to Acne Treatments
October 2014
Many commonly used over-the-counter acne products pose a risk of serious allergic reactions in children and adults. This article provides information on how to minimize the risk when starting treatment with one of these products.
New Diabetes Drug Dapagliflozin (FARXIGA): Risks Outweigh Benefits
September 2014
Learn about the many dangers of one of the newest diabetes drugs approved in the U.S., dapagliflozin, which has been designated as Do Not Use by Public Citizen’s Health Research Group.
A Dangerous Gap in FDA Recall Authority
September 2014
The recent refusal of two companies to immediately recall potentially contaminated sterile drugs when requested to do so by the Food and Drug Administration highlights a serious gap in the agency’s regulatory authority. Learn more about the companies involved and the action that must be taken by Congress to address the public health threat posed by such industry obstinacy.
New Blood Pressure Treatment Guidelines Released
September 2014
In December 2013, new guidelines for treatment of high blood pressure were issued by a group of experts appointed by the National Institutes of Health. The guidelines stirred much controversy in the medical community. Get the Public Citizen Health Research Group’s independent take on these new guidelines.
Should You Take Aspirin to Prevent Pancreatic Cancer?
September 2014
Perhaps you have seen some of the recent newspaper coverage of a National Cancer Institute-funded study suggesting that long-term aspirin use may be associated with a decreased risk of pancreatic cancer. In this article, Public Citizen’s Health Research Group reviews the study, compares it with earlier evidence and offers our recommendations.
A Brief Guide to Understanding Medical Studies
September 2014
News stories often excitedly report about the results of the latest medical study. Learn about the three main types of medical studies and find out which type provides the most reliable information for assessing the risks and benefits of drugs and other medical treatments.
New Atrial Fibrillation Treatment Guidelines Released
August 2014
Atrial fibrillation is one of the most common heart rhythm disorders, afflicting more than 2.7 million Americans. Learn about the most recent guidelines for treating this disorder, issued by the American College of Cardiology and the American Heart Association, and about Public Citizen’s Health Research Group’s assessment of those guidelines.
FDA’s Recent Action on Testosterone Products: Grossly Insufficient
August 2014
The FDA recently required manufacturers of all approved testosterone products to include a general warning on the product labeling about the risk of developing blood clots in veins. Find out why the new warning is dangerously incomplete.
Human Growth Hormone, ‘the Sweet Syringe of Youth’: Myths, Evidence and Controversy
August 2014
Numerous advertisements in magazines and on television and the Internet tout the miraculous age-reversing and bodybuilding properties of synthetic growth hormone treatment. This article critically reviews the evidence surrounding these health claims.
Type 2 Diabetes Drug Alogliptin Causes Liver Toxicity
August 2014
Learn why Public Citizen’s Health Research Group has designated the following three new Type 2 diabetes drugs as Do Not Use: alogliptin (NESINA), the combination of alogliptin and metformin (KAZANO), and the combination of alogliptin and pioglitazone (OSENI).
New Study Shows Increased Risk Of Death With Sleeping Pills And Tranquilizers
July 2014
For many years, Public Citizen’s Health Research Group has recommended against using tranquilizers and sleeping pills to treat insomnia and anxiety. This article presents new evidence linking use of these drugs to an increased risk of premature death.
Assessing FDA Performance: Approval Speed Is Not the Answer
July 2014
In his editor’s column, Dr. Carome takes the Food and Drug Administration (FDA) to task for its obsessive focus on drug approval times as a measure of agency success. Focusing on such metrics to assess the agency’s performance is misguided and dangerous.
Genetic Tests Not Useful for Managing Warfarin Dosing, According to New Studies
July 2014
In 2007, the FDA enthusiastically suggested that newly available genetic tests would help doctors select the best dose of warfarin — one of the oldest and most widely prescribed blood thinners (anticoagulants) — for individual patients. Find out why the FDA’s enthusiasm about the promise of genetic testing in the management of warfarin dosing was premature and overstated.
High-Dose Selenium May Increase Prostate Cancer Risk
July 2014
Dietary supplement companies tout the mineral selenium as possibly being able to reduce the risk of prostate cancer and other diseases. Learn about new evidence showing that high doses of selenium may actually increase the risk of prostate cancer.
Do Not Use Steroid Injections for Back Pain
July 2014
Steroid injections are very commonly used to treat back pain. Find out why Public Citizen’s Health Research Group now recommends against such treatment.
Risks of Ospemifene For Menopause-Related Pain During Intercourse
June 2014
Learn about the dangers of the heavily promoted drug ospemifene (OSPHENA), which was recently approved by the FDA to treat pain during sexual intercourse, and about much safer alternatives for treating this condition.
FDA 'Partnerships' Incompatible With Agency's Regulatory Role
June 2014
In his editor’s column, Dr. Carome explains why the FDA’s distorted view of itself as a part¬ner with the pharmaceutical and medical device industries is incompatible with its role as the regulator of these industries and its mission to protect public health.
Further Evidence That CELEBREX Is a Do Not Use Drug; New Designation of Diclofenac (VOLTAREN) as a Do Not Use Drug; and Other Do Not Use NSAIDS
June 2014
Learn about new research that provides further evidence affirming our designation of celecoxib (CE¬LEBREX) as a Do Not Use drug and that has prompted us to reclassify diclofenac (VOLTAREN) from Limited Use to Do Not Use. Also find out which NSAIDs are least likely to cause adverse cardiovascular events, such as heart attacks and strokes.
Important Information to Know About Clopidogrel
June 2014
Clopidogrel is a widely used drug for reducing the risk of a new heart attack or stroke or cardiovascular death in patients who have had a recent heart attack, stroke or established pe-ripheral vascular disease. This article provides a detailed overview of the drug, including potential serious side effects and important precautions to follow when taking the drug.
Do Not Use MIACALCIN Nasal Spray or Other Calcitonin-Containing Drugs for Osteoporosis
May 2014
Learn about the dangers of using calcitonin-containing drugs for treatment of osteoporosis and find out why the Food and Drug Administration, in contrast to regulators in Canada and Europe, has acted recklessly by failing to ban nasal calcitonin products.
Proposed FDA Rule Change on Generic Drug Labeling Essential for Patient Safety
May 2014
In a desperate attempt to prevent the FDA’s November 2013 proposed rule on generic drug labeling from being finalized, the generic drug industry has offered up many groundless objections. In his editor’s column, Dr. Carome outlines the reasons why this rule must be implemented to ensure patient safety.
Type 2 Diabetes: A Guide to Prevention and Treatment
May 2014
The treatment options for Type 2 diabetes can be overwhelming. This article provides a comprehensive summary of our independent expert views on the best approaches for preventing and treating this common disease.
Beta Blockers Save Lives in COPD Patients After Heart Attacks
May 2014
If you have chronic obstructive pulmonary disease (COPD) and suffer or have suffered a heart attack, you should be treated with a beta blocker. Such treatment could save your life. Find out why and learn which beta blockers are safest for COPD patients.
Risk of Serious Harm from Sodium Phosphate Products for Constipation
April 2014
The FDA recently issued an alert about serious, and even fatal, kidney and heart risks from exceeding the recommended dose of over-the counter sodium phosphate products used to treat constipation. This article reviews the data that led to the FDA’s alert and provides advice on how to avoid these serious harms when taking sodium phosphate products.
The FDA Must Aggressively Inspect Foreign Drug Factories
April 2014
On Jan. 23, 2014, the FDA issued an order banning from the U.S. market any drugs produced by a factory owned by a leading manufacturer of generic drugs sold in the U.S. Read this commentary to find out why.
NUVARING: Do Not Use
April 2014
Do not use the contraceptive drug NUVARING. Multiple studies have shown increased risk of blood clotting with drugs from the same family as NUVARING, and some have shown increased risk with NUVARING itself. Learn about safer, equally effective forms of contraception that are widely available.
Calcium Channel Blockers Plus Most Macrolide Antibiotics: A Dangerous Combination
April 2014
Learn about new evidence demonstrating the dangers of combining calcium channel blockers, a widely used class of drugs for treating high blood pressure, with the commonly used macrolide antibiotic clarithromycin and other related antibiotics. Also find out which macrolide antibiotic does not have this dangerous interaction with calcium channel blockers.
Testosterone Use Linked to Increased Risk of Heart Attacks
March 2014
There is a growing body of evidence indicating that testosterone treatment exposes men to an increased risk of adverse cardiovascular events, such as heart attack and stroke, as well as death. This article reviews the results of two recently published studies that provide the most compelling evidence yet linking testosterone use to increased cardiovascular risk.
A Bad Law on Compounded Drugs Made Worse by Poor FDA Messaging
March 2014
In his first column as the editor of Worst Pills, Best Pills News, Dr. Michael Carome highlights the major flaws in a new federal law on compounded drugs and criticizes the FDA’s initial failure to clearly communicate to the public that compounded drugs are riskier than FDA-approved drugs.
Year in Review: Troubling New Drug Approvals of 2013
March 2014
Learn about new drugs approved by the FDA in 2013 that Worst Pills Best Pills has identified as dangerous or ineffective. The drugs include two for diabetes, two for chronic obstructive pulmonary disease and an over-the-counter drug for overactive bladder, among others.
Escalating Criminal and Civil Violations: Pharma Has Corporate Integrity? Not Really
March 2014
Dr. Sidney Wolfe, founding editor of Worst Pills, Best Pills News, concludes that “there is pathological lack of corporate integrity in many drug companies.” Read this article to find out why.
The New Diabetes Drug Canagliflozin (INVOKANA)
February 2014
Do not use the newly approved diabetes drug INVOKANA. It offers no benefits over existing drugs but can result in serious risks, including hypotension and impaired kidney function, outlined in the article.
Passing the Editorial Baton for Worst Pills, Best Pills News and WorstPills.org
February 2014
Learn about the new editor of the Worst Pills, Best Pills newsletter and website, Dr. Michael Carome. The founding editor, Dr. Sidney Wolfe, will continue writing articles for the newsletter, including some of his new regular columns for the British Medical Journal.
Painkiller Patches Cause Accidental Deaths in Children
February 2014
The FDA has announced that accidental exposure to a prescription narcotic patch has been fatal to children. Learn what precautions to take to protect the young people around you.
How Effective Are Antidepressants for Depression?
February 2014
Some degrees of depression are less likely to respond to treatment with an antidepressant. This article reviews the evidence and evaluates 27 different antidepressants, labeling many as Do Not Use or Limited Use.
Do Not Use Paroxetine (BRISDELLE) For Treatment of Hot Flashes
January 2014
A newly marketed drug for treating hot flashes of menopause, BRISDELLE, is a lower dose of the familiar antidepressant PAXIL. This article discusses its risks and barely-evident effectiveness.
Selling Amphetamine-Emblazoned Athletic Shirts Versus Overselling Amphetamines: A Tale of Two Entrepreneurs
January 2014
When the manufacturer of the amphetamine ADDERALL criticized a Los Angeles boutique for selling T-shirts emblazoned with the drug’s name, it stated that the shirts “glorify[y] the misuse and diversion of a federally controlled prescription drug.” But the pharmaceutical company itself was cited by the Food and Drug Administration for overpromoting the drug to increase sales.
Hormone Replacement Therapy: Use at the Lowest Dose for the Shortest Amount of Time
January 2014
The dangers of hormone replacement therapy (HRT) are in direct proportion to the length of time for which they are used. This article discusses strategies for keeping dosage and exposure to a minimum and recommends only using HRT for debilitating hot flash symptoms. Nondrug remedies for milder symptoms also are discussed.
FDA Restricts, EMA Moves to Ban Ketoconazole Tablets
January 2014
A dangerous and easily substituted antifungal drug presents yet another example of Europeans being more protected from dangerous medicines by their regulatory authorities than Americans.
All Sleeping Pills Are Still Risky, But Safer Alternatives Exist
December 2013
We oppose the use of all sleeping pills, based on experts’ findings that “nonpharmacological treatments not only cause fewer side effects, but … can sustain long-term improvements more successfully than pharmacological treatments.” Read this article to learn about some suggested nondrug approaches.
Lax FDA Ethics Policy Helps Pharma
December 2013
Public Citizen stopped the chair of an FDA advisory committee from being the star attraction at an expensive conference for drug industry personnel. The planned session was intended to help the industry more easily get drugs approved by FDA advisory committees. Such activity demeans and undermines the crucial advisory committee process and highlights the need for an explicit FDA ethics policy.
Life-Threatening Liver Toxicity Linked to Supplement
December 2013
Yet another dietary supplement — this one intended for weight reduction and body-building — turns out to have life-threatening toxicity. In this case, the supplement has been linked to an outbreak of acute hepatitis.
When EMA and FDA Decisions Conflict: Differences in Patients or in Regulation?
December 2013
Are Americans more resistant to the risks and more likely to benefit from certain drugs than Europeans? Or is the European Medicines Agency (EMA) more resistant than the U.S. Food and Drug Administration (FDA) to the drug industry’s desire to get approval for drugs with unique risks but without compensating benefits? This article discusses two recently FDA-approved diet drugs deemed too unsafe for Europeans.
Unproven Laxative Widely Used for Childhood Constipation
December 2013
Learn about the problems of a common over-the-counter laxative, widely used for children but never approved for their use. We discuss the preferable, safer alternatives for treating constipation.
Zinc as a Cold Remedy: Still Waiting for Good Evidence
November 2013
A familiar and heavily promoted remedy for colds, zinc has not been found to have very important benefits. This article analyzes studies purporting to show such benefits.
The Continuing Exploitation Of Menopausal Women
November 2013
This month will see the launch of yet another highly promoted drug to treat the hot flashes of menopause. Like almost all of its predecessors, it has clear risks and also lacks strong evidence of usefulness.
Human Papilloma Virus Vaccine: Get the Facts
November 2013
Read about the benefits and risks of this vaccine for women, as well as the doubts about its usefulness for men.
Lomitapide: A Risky Drug for Lowering Cholesterol
November 2013
Lomitapide is approved to treat a rare genetic condition affecting approximately 300 people in the U.S. Yet it may ultimately be used to lower cholesterol in many more people, and it presents serious safety concerns.
New Government Guidelines Discourage Use of Antipsychotic Drugs in Dementia Care
October 2013
The federal government recently issued guidelines discouraging the use of antipsychotic medications to treat dementia in nursing home patients, promoting nonpharmacologic approaches to such treatment. Antipsychotic use among elderly patients is associated with increased chances of death, as well as other serious side effects.
Pharma’s Foreign Corrupt Practices Accompany Its Domestic Violations
October 2013
Several major drug companies have been implicated in scandals involving bribery of foreign doctors and illegal payments to foreign government officials. Learn which companies have paid penalties to the U.S. Securities and Exchange Commission to settle charges of corrupt foreign practices.
Steroid Treatment for COPD Exacerbations: Five Days Just as Effective as 14 Days
October 2013
If you or a loved one has chronic obstructive pulmonary disease (COPD), sometimes known as emphysema, and suffers from periodic acute COPD exacerbations requiring steroids, you should know that new research demonstrates that a five-day course of steroids for treating such exacerbations works just as well as a conventional 14-day course.
FDA Warns of Risks of Kidney Failure, Death With Hydroxyethyl Starch Solution
October 2013
The FDA recently issued a safety alert warning consumers that an intravenous fluid known as hydroxyethyl starch, sometimes used to replenish fluids in critically ill patients, can cause serious kidney damage and death. Learn about the basis for this warning and the available safer, less expensive alternatives.
FDA Moves to Loosen Restrictions on Diabetes Drug Avandia
September 2013
The FDA is considering relaxing the restrictions on the unacceptably dangerous drug rosiglitazone (AVANDIA) so that more people can access it, even while it remains banned in European countries.
TV Ads Expand the Market for Statins, At the Expense of the Public's Health
September 2013
Many doctors lack knowledge of how to prescribe statins appropriately. Learn what happens with this is combined with patients watching TV ads about these drugs.
Excitement Fades for Off-Label Alzheimer’s Treatment
September 2013
This article discusses the latest example of a failed drug for treating Alzheimer's disease. It also examines other ineffective FDA-approved drugs for treating the condition, as well as recent promising evidence for successful nondrug approaches, especially for those with mild cognitive impairment.
“Medicalizing Normality”: Potent Acid Reflux Drugs Overused in Infants
September 2013
The overuse of acid reflux drugs in adults has been well documented. Even worse, there is now evidence of an 11-fold increase in the use of these drugs to treat infants, mostly due to a benign condition for which the risks clearly outweigh any benefit. The article discusses effective, time-honored, nondrug remedies for this benign condition.
Niacin Ineffective in Treating Cardiovascular Disease
August 2013
A new study casts serious doubt on the usefulness of long-popular niacin products to treat or prevent cardiovascular disease.
Drug Company CEOs: Rewarded For Illegal Acts?
August 2013
CEOs of major drug companies are getting increasingly large benefits packages while their companies are paying massively larger criminal and civil penalties for illegal activities.
Do Not Use Over-the-Counter Oxybutynin Without First Checking With Your Doctor
August 2013
If you are thinking of using newly approved over-the-counter oxybutyin (OXYTROL FOR WOMEN) to treat overactive bladder, find out why you should first check with your doctor and learn about possible adverse reactions.
Diabetes Drugs Linked to Pancreas Disease
August 2013
Six recently approved diabetes drugs have been linked to an increased risk of pancreatitis and possibly pancreatic cancer.
Dr. Sidney Wolfe Turns Health Research Group Leadership Over to Dr. Michael Carome
July 2013
Dr. Carome will be directing Public Citizen’s Health Research Group, but Dr. Wolfe will still be working on the issues he has previously focused on, such as drug safety.
Off Diabetes Pills!
July 2013
A recently published article mirrors our now-35-year-old publication “Off Diabetes Pills” in suggesting alternatives to pharmaceutical treatment for a large proportion of adult-onset diabetics.
Asthma Drug Linked to Adverse Psychiatric Events
July 2013
The article reviews evidence that one of the biggest-selling asthma drugs lacks evidence of a unique benefit and has been found to cause a variety of adverse psychiatric events, including nightmares, hallucinations and aggressiveness, especially in children.
Chlorthalidone Versus Hydrochlorothiazide for Hypertension
July 2013
These two widely used diuretics (water pills) are equally effective in lowering blood pressure, but one of them is linked to many more adverse effects than the other.
Online Drug Promotion: A Prescription for Deception
July 2013
Learn tips for bypassing deceptive drug advertising to obtain truly unbiased, noncommercial health information.
Osteoporosis Drug May Lead to Atypical Fractures
June 2013
This article provides the newest information on a big-selling osteoporosis drug that can actually cause fractures as well as numerous other adverse reactions, further explaining its categorization on WorstPills.org as DO NOT USE.
Overprescribed Antibiotics Hurt One, Hurt All
June 2013
To protect yourself and others, when your doctor pulls out a pen to write a prescription for an antibiotic, you should ask him or her, especially if you are not feeling very sick: Do I really need this? And why?
Vitamin D Ineffective in Treating Osteoarthritis Of the Knee
June 2013
A recent study contradicted earlier beliefs by finding that vitamin D supplements (CALCIFEROL) given to people with osteoarthritis of the knee were ineffective in relieving knee pain or slowing damage to the knee joint.
Statins for Primary Prevention: Risks Without Benefits
June 2013
For people who have had heart attacks, strokes and other cardiovascular diseases, statins can prevent further damage. But for primary prevention — in people without such disease — a number of articles raise serious questions about whether the risks of statins outweigh the benefits.
Updates: Pain, High Cholesterol and ADHD Drugs
June 2013
These updates provide new information that has become available since we published our last articles regarding these three categories of drugs.
What Dangers Are Hidden in Your Weight-Loss Supplement?
May 2013
The article reviews evidence that quite often, to "enhance" the effectiveness of usually ineffective dietary supplements for weight loss, companies are illegally lacing such products with the dangerous, now-banned prescription weight-loss drug sibutramine (MERIDIA). Male-enhancement and muscle-building supplements also often illegally hide dangerous drugs in unknown quantities.
Accentuate the Positive, Eliminate the Negative
May 2013
A study documents how little information about important drug risks is disclosed by the drug salespeople who visit so many doctors. Their strategy for increasing sales: Accentuate the positive and almost entirely eliminate the negative about these medicines.
Rheumatoid Arthritis Drugs Linked to Increased Shingles Risk
May 2013
The article discusses evidence that five widely used drugs for rheumatoid arthritis can increase the risk of shingles. If you are using one of these drugs, learn what you can do to reduce such risks.
More on the New Stroke Prevention Drugs
May 2013
An update on last month's article about three relatively new, widely used stroke prevention drugs: dabigatran (PRADAXA), rivaroxaban (XARELTO) and apixaban (ELIQUIS).
New Hypertension Drug Poses Breathing Risks
May 2013
The article discusses possible breathing risks of nebivolol (BYSTOLIC)and how other, older drugs — just as effective as this relatively new high blood pressure drug — are preferred because more is known about their risks.
Hypertension Drugs Plus NSAIDs May Injure Kidneys
April 2013
Recent evidence points to increased acute kidney injury associated with combining nonsteroidal anti-inflammatory drugs (NSAIDs) with two antihypertensive drugs: a diuretic plus either an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin II receptor blocker (ARB). Find out the names of these drugs. This is especially important for patients with hypertension, diabetes, congestive heart failure or chronic kidney disease, because such patients are routinely treated with diuretics, ACE inhibitors and ARBs.
Are European Women Different From U.S. Women?
April 2013
Last summer, the European equivalent of the Food and Drug Administration told Europeans not to use a particular drug for osteoporosis. Learn about this drug, which has been used by more than 100,000 U.S. women since then despite evidence of increased cancer risk.
Emerging Risks With New Stroke Prevention Drugs
April 2013
Learn about three new drugs to prevent stroke – so new that their risks relative to those of a much older drug, warfarin (Coumadin), are unknown.
Sleeping Pill Poses Safety Risks
April 2013
Learn about new warnings concerning multiple formulations of a widely used sleeping pill. The levels of the drug remaining in the blood the morning after use may be high enough to impair activities requiring mental alertness, including driving.
Overusing Medications Can Cause Headaches
March 2013
What kind of headache is not relieved by pain medications but actually caused by their frequent overuse? The article describes which painkillers can cause medication overuse headaches (MOH) when used too frequently over specified durations of time.
The FDA Must Restrict the Use of Prescription Narcotic Hydrocodone
March 2013
Find out why the most commonly prescribed drug of any kind in the U.S., hydrocodone, needs tighter restrictions to prevent emergency room visits, overdose deaths and other serious consequences of its massive overuse. Production and use of hydrocodone in this country amounts to 99 percent of that for the entire world. Is the rest of the world wrong and we are right?
Troubling New Drug Approvals in 2012
March 2013
Find out which drugs approved in 2012 have risks greatly exceeding their benefits or no meaningful benefits. If you are using any of the DO NOT USE drugs reviewed in the article, talk to your doctor before stopping their use.
Inappropriate Prescribing of Medicines in the Elderly: A Persistent Problem
March 2013
Approximately 20 percent of prescriptions for elderly patients in primary care settings are inappropriate, leading to adverse reactions that are entirely preventable. The article lists some of the most common inappropriately prescribed drugs.
Drug for Parkinson’s Disease and Restless Leg Syndrome May Increase Heart Failure Risk
February 2013
MIRAPEX (pramipexole) is a drug frequently used for restless leg syndrome, for which there are other safer, effective nondrug treatments, as discussed in the article. It also is used for Parkinson's disease. A recent review has found that this drug can increase the risk of heart failure. Find out how to recognize early symptoms of heart failure.
Harming Tuberculosis Patients Instead of Helping Them?
February 2013
Although there are not many cases in the United States, multiple drug-resistant tuberculosis (MDR TB) is a serious international problem. In a trial for a new drug for MDR TB, bedaquiline (SIRTURO), those receiving the drug were five times more likely to die than those receiving a placebo. Instead of looking into this more carefully, the Food and Drug Administration (FDA) approved the drug with the warning: “In one clinical trial, more deaths were seen in people who were treated with SIRTURO compared to people who did not receive SIRTURO.”
Treatment for Chronic Obstructive Pulmonary Disease
February 2013
Commonly known as emphysema, chronic obstructive pulmonary disease (COPD) affects an estimated 24 million Americans, only half of whom are diagnosed. This article presents recent information regarding the use of drug treatments, including inhaled anti-inflammatory steroids, as well as important nondrug treatments that can be used as an adjunct to drug therapy.
FDA Fails to Ban Toxic Lice and Scabies Treatment
February 2013
Even though safer treatments than lindane for lice and scabies are available, and despite Public Citizen’s efforts to ban this dangerous pesticide, the FDA continues to allow it on the market. This article discusses safer alternative treatments.
Warning: Nasal Sprays, Eye Drops Pose Serious Risk to Young Children
January 2013
Find out the serious risks, often requiring hospitalization, to infants and young children who accidentally swallow the liquids in nasal sprays or eye drops. The article lists the three most dangerous ingredients that are found in several big-selling brand name products, also listed in the article.
What Did Bayer Have in Common with Street Drug Dealers?
January 2013
Read about the history, from an investigation by the London Times, of how the world's first major drug company, Bayer, developed and got the trademark on one of the most dangerous over-the-counter drugs in history, Heroin. It was given this name because Bayer employees, given the drug as part of an experiment, felt "heroic" after using it. Read on.....
Benzodiazepines May Increase Dementia Risk
January 2013
Find out the names of 11 different drugs in this popular family of tranquillizers and sleeping pills that can increase the risk of dementia 30 to 40 percent in older adults.
Managing Herbal Medicines in Patients Undergoing Surgery
January 2013
Find out why, if you are using any of nine different popular dietary supplements and you are planning to have surgery, you need to tell your doctor so you can stop using them at a safe interval before your operation. The intervals range from at least 24 hours before surgery to two weeks, the latter the case for most of the nine supplements.
Vitamin D and Calcium for Bone Health: Getting the Right Amount
January 2013
This article reviews the latest recommendations on how much calcium and vitamin D are best for people. The right amount depends on both your age and whether you are male or female. Also, learn about the upper safe levels of both calcium and Vitamin D so that you do not take amounts that can be dangerous.
Fungal Meningitis Outbreak Highlights the Dangers of Compounding Pharmacies
December 2012
Public Citizen has a long history of opposing the dangerous under-regulation of large-scale pharmacy compounders such as the New England Compounding Center, which is at the center of the recent outbreak of fungal meningitis caused by contaminated injectable steroids. Learn how this current nationwide disaster, and its related deaths, could have been prevented.
Did Drug Companies and the FDA Collude to Harm Patients with Alzheimer’s Disease?
December 2012
The FDA sided with a large drug company in refusing to pull from the market a dangerous drug for treating Alzheimer's disease, which Public Citizen had asked the government to ban. What went wrong and why?
Updates: Migraine, Depression, Hypertension Drugs
December 2012
Topics discussed include evidence that overuse of migraine drugs may cause headache rather than relieve it. Also, a widely prescribed antidepressant, in higher doses, can cause heart arrhythmias, manifested as dizziness, palpitations or fainting. Finally, another widely used antidepressant can cause a life-threatening condition called neuroleptic malignant syndrome, which can include extremely high body temperature, fast heart rate, rapidly changing blood pressure and mental changes.
Do Not Use These Blood Pressure Drugs in Combination
December 2012
It is dangerous to take any of the 18 popular blood pressure drugs of one type (ACE inhibitors) in combination with any of the 14 blood pressure drugs of another type (ARBs). It also is dangerous to take a drug in either of these classes in combination with a newer high blood pressure drug, aliskiren (TEKTURNA). Find out why.
Settlements for Prosecution of Fraud by Big Pharma at Record High
November 2012
Find out the latest about the pharmaceutical industry continuing to remain the number one defrauder of the Federal government. Why does this continue and what are an increasing number of states doing about it?
A Healthy Dose of Skepticism Is Well Justified
November 2012
Find out why many doctors are skeptical of medical journal articles reporting the results of drug industry-funded studies. Apparently for self-interested reasons, the editor of a leading medical journal unfortunately disagrees with this healthy skepticism.
Over-the-Counter Topical Pain Relievers May Cause Burns
November 2012
Find out the names and ingredients of topical muscle and joint pain relievers that can cause moderate to severe local burns and how you can protect yourself.
Steroid Injections and Other Treatments for Lower Back Pain
November 2012
The recent epidemic of life-threatening and fatal infections from contaminated spinal steroid injections is a reminder of the larger issue of their use, even if not contaminated. The article discusses risks that remain even with properly manufactured medications, describing how patients and physicians should know when not to use steroids, consider the risks and benefits of the procedure, and understand other treatment options before using steroids to treat lower back pain.
Statins Frequently Cause Fatigue, Reduce Energy Levels
November 2012
Find out about the latest evidence that statins such as LIPITOR, LESCOL, ALTOPREV, MEVACOR, LIVALO, PRAVACHOL, CRESTOR and ZOCOR can cause fatigue and reduced energy levels, especially in women. The authors concluded that "These effects, germane to quality of life, merit consideration when prescribing or contemplating use of statins, particularly in groups without expected net morbidity/mortality benefit."
Dietary Supplements Offer Little to No Benefit and May Be Harmful
October 2012
The article reviews current evidence on 16 dietary supplements based on a large number of studies testing their effectiveness.
Editorial: The Seven-Year Rule for Safer Prescribing
October 2012
An invited editorial by Worst Pills, Best Pills News editor Dr. Sidney Wolfe in the October Australian Prescriber explains the factual basis for our recommendation not to use any new drug — except for relatively rare breakthrough drugs — until it has been on the market for seven years.
Diet and Exercise: Still the Best Medicine for Losing Weight or Keeping Fit
October 2012
The recent FDA approval of the first two new diet drugs in 13 years occasions our review of the safety problems of both drugs and the history of previous diet drugs, taken off the market because of serious cardiovascular dangers. Two recent well-controlled studies, one in adults and one in children, document the benefit of reasonable diet and exercise programs as the only safe and effective way to lose weight.
New Study on the Effectiveness of Statin Use in Women
October 2012
A recent study challenges the assumption that men and women with pre-existing cardiovascular disease benefit equally from the use of statins to prevent subsequent death or strokes.
Pfizer Includes Foreign Corrupt Practices Act Violations in Its Arsenal of Illegal Activities
September 2012
Learn about the wide range of countries in which Pfizer illegally bribed government officials in order to sell more of the company's drugs.
Smoking Cessation: What Works and What Doesn’t
September 2012
The article reviews the effectiveness and safety of a variety of drugs and strategies to help people stop smoking but also stresses the importance of interpersonal support for those trying to quit this deadly habit.
FDA Should Change Labels On Opioid Painkillers to Deter Misprescribing
September 2012
The article reviews a recent petition to the FDA seeking improvements on the labels of prescription opioids (narcotics). The label change would prevent drug companies from promoting these drugs for noncancer pain for dangerously long periods of time, at doses that are too high, and for uses other than severe pain in noncancer patients. The petition was signed by 37 public health experts, including leaders in the fields of pain medicine, addiction and primary care; the health commissioners of New York City and New York state; and Dr. Sidney Wolfe, director of Public Citizen’s Health Research Group.
New Advice on Treating Sinus Infections With Antibiotics
August 2012
Learn the details of the large problem of misprescribing antibiotics for sinusitis, symptoms of the condition, limited indications for antibiotic use and alternative treatments for this very common illness.
Settlement Not Enough to Deter Illegal Pharmaceutical Industry Behavior
August 2012
Find out how a seemingly large $3 billion criminal and civil penalty levied against GlaxoSmithKline — because of its small size relative to the drugmaker’s profits and the absence of jail time for any of the company’s officials — tacitly encourages drug companies to continue illegal activities.
Warning Against Benzocaine Treatment for Teething or Other Oral Pain in Babies
August 2012
Find out how using seemingly benign benzocaine gels and liquids for mouth and gum pain can lead to a rare but serious, and sometimes fatal, condition in infants and babies.
Antidepressants and Dementia in the Elderly
August 2012
We review a recent study concerning the lack of evidence that antidepressants are effective in elderly, demented people. Find out the risks involved with antidepressant use in this population and learn about the safer, more effective nondrug approaches to treating depression in elderly adults.
Increased Risk of Cardiovascular Death With Azithromycin and Levofloxacin
August 2012
We review recent evidence that azithromycin (ZITHROMAX, as in Z-PAK) and levofloxacin (LEVAQUIN), used for relatively short periods, significantly increased the risk of cardiovascular risks such as sudden cardiac death in some patients, compared to the risks in people not taking antibiotics. The overprescribing of these drugs is also discussed.
Fluoroquinolone Antibiotics Associated With Increased Risk of Retinal Detachment
July 2012
Find out the most common symptoms of the vision-threatening condition retinal detachment and how, although rarely, it can be caused by commonly used antibiotics such as ciprofloxacin (CIPRO) and levofloxacin (LEVAQUIN). We also discuss evidence that these antibiotics are overused.
Pfizer Succeeds at Slowing Loss of LIPITOR Sales After Patent Expires
July 2012
We discuss how Pfizer, after its patent on the billions-a-year-selling LIPITOR went off patent, used desperate means to delay giving patients options for much less expensive generic versions of the drug, marketed as atorvastatin.
Do Not Use Azilsartan (EDARBI) for High Blood Pressure
July 2012
Find out why we recommend that you do not use the recently approved high blood pressure drug azilsartan.
Update on Grapefruit Juice-Drug Interactions
July 2012
This article updates and expands our earlier list of drugs that can have harmful interactions with grapefruit juice. The list now includes 82 different drugs.
Do Not Use: Duloxetine (CYMBALTA)
June 2012
We review the dangers of the extremely popular drug duloxetine (CYMBALTA) and discuss why you should not use it to treat depression, anxiety or pain.
‘Dollars for Docs’
June 2012
Do large "gifts" from drug companies to doctors make a difference in the care that patients get? Find out how to view a partial list of drug companies to check whether your physician is getting such payments and how the government is delaying the disclosure of payments from all drug companies.
Preventing Heat-Induced Death and Illness
June 2012
This article lists practical steps to take to avoid death, hospitalization or other medical problems caused by heat stress. It also contains a list of 123 drugs that can impair your response to heat.
Some Anti-Hypertensive Drugs Increase the Risk of Gout
May 2012
The article lists many drugs that treat high blood pressure but can also increase the risk of gout. If you have gout, ask your doctor whether your dose of any of these drugs could be reduced or whether you should switch to a medication with a lower gout risk. However, hypertension control is of utmost importance.
Drug Companies Eager to Market And Sell to Older Adults but Not To Adequately Test Them
May 2012
The proportion of patients 65 or older in drug trial reports was lower than half the proportion in the treated population who were 65 or older, leading authors of a recent analysis to conclude that drugmakers should study an appropriate and larger proportion of older adults for drugs that will predictably be used by them.
Exenatide (BYDUREON) Injection to Control Blood Sugar in Type 2 Diabetes
May 2012
The article explains why you should not use the newly approved diabetes drug exenatide (BYDUREON), a long-acting dosage form of the previously approved BYETTA. Important safety concerns cited in the drug’s label and FDA warnings are also discussed.
Does Aspirin Prevent Heart Disease and Cancer?
May 2012
There is little doubt from earlier studies that using aspirin to prevent cardiovascular death in patients who already have cardiovascular disease is effective. A new review found that aspirin, taken daily or every other day in low doses for primary prevention of cardiovascular death in patients without existing cardiovascular disease, was not effective in these patients in either reducing cardiovascular death or death from cancer. It did, however, increase clinically important bleeding events in these patients.
Applying the Life-Saving 7-Year Rule: An Antiarrhythmic and 3 Anticoagulants
April 2012
Find out why you should not use four recently approved heart drugs — dronedarone (MULTAQ), prasugrel (EFFIENT), dabigatran (PRADAXA) and rivaroxaban (XARELTO) — for at least seven years.
More About Generic Drugs: A Trillion Dollar Finding
April 2012
A thorough review of studies that document the benefits — $1 trillion saved in the past 10 years — of our increasing use of generic drugs.
Benefits and Risks of Popular Allergy Medications
April 2012
This article discusses drugs you should and should not use as the allergy season commences.
A Review of the ‘Gliptin’ Diabetes Drugs
March 2012
Find out why you should not use any of the three recently-approved diabetes drugs known as "gliptins".
FDA’s About-Face on Financial Conflicts of Interest
March 2012
Last year, FDA Commissioner Dr. Margaret Hamburg told an audience at our D.C. Headquarters that FDA needed to allow more people with drug industry financial conflicts in order to get enough qualified doctors to fill its advisory committees. Find out why she was wrong and how she backed off this dangerous idea.
Sitagliptin With Simvastatin (JUVISYNC): A New Drug Combination to Avoid
March 2012
The article discusses the reasons why we have categorized JUVISYNC as a DO NOT USE drug.
Risk of Bleeding and Use of Antidepressants After Heart Attack
March 2012
The article discusses why taking certain antidepressants after a heart attack may increase the risk of bleeding. Find out which ones are the culprits.
Accidental Child Poisoning From Medications: A Growing Epidemic
February 2012
What kinds of prescription and over-the-counter products are responsible for the unintentional ingestion of these drugs by children? Such poisonings result in the hospitalization, admission to intensive care units and injury of thousands of children a year. How can they be prevented?
Overuse of Antibiotics in Children
February 2012
A very recent study found that each year, children in this country get 10 million antibiotic prescriptions that are clearly unnecessary, creating risks of adverse reactions without any possible benefit.
Fenofibric Acid (TRILIPIX) May Not Lower Heart Attack/Stroke Risk
February 2012
Over 15.2 million prescriptions were filled in 2010 for the brand-name or generic versions of two essentially identical drugs (fenofibrate [TRICOR] and fenofibric acid [TRILIPIX]) that clearly do not add any benefits to taking statin drugs alone but add to the risks.
Update: ‘Removal of Dr. Wolfe From FDA Advisory Committee Meeting Is Bad Policy’
February 2012
Shortly after allowing our editor only allotted time to present his views during the public session of an FDA committee meeting discussing the drugs YAZ and YASMIN, the FDA reconsidered and said he could participate as a committee member but would not be allowed to vote at the meeting. Ultimately, Dr. Wolfe participated as a nonvoting member, under protest.
Increased Prostate Cancer Risk With Vitamin E Supplements
February 2012
A recent study shows there is significant harm from using widely advertised vitamin E dietary supplements. Not surprisingly, the study was not funded by vitamin E manufacturers but by the U.S. National Institutes of Health.
Inadvertent Adverse Reactions With Commonly Used Drugs
January 2012
Find out how to prevent emergency hospitalizations from two commonly used drugs, warfarin (COUMADIN) and clopidogrel (PLAVIX). There are approximately 33,000 emergency hospitalizations a year from warfarin alone. This article includes a list of more than 50 drugs that can have harmful interactions with warfarin and/or clopidogrel.
Removal of Dr. Wolfe From FDA Advisory Committee Meeting Is Bad Policy
January 2012
Read about how the Worst Pills, Best Pills News editor was not allowed to vote on the safety of a big-selling drug because he thought it was unsafe.
Quetiapine (SEROQUEL) Drug Interactions and Heart Trouble
December 2011
Find out about 12 drugs that can interact with widely prescribed quetiapine -- 12 million prescriptions sold in 2010 -- to cause serious, sometimes fatal, heart arrhythmias.
More Patients Being Ripped off by Pay-for-Delay
December 2011
Patients pay more when brand-name drug companies legally "bribe" generic companies to delay the selling of less expensive products.
New Drug Interaction With Widely Used Antibacterial Drug and Common Diuretic
December 2011
Find out how using a combination of two commonly prescribed drugs (a total of 30 million prescriptions filled annually in the U.S.) can cause life-threatening increases in blood potassium, a risk that has led to hospitalization.
Saw Palmetto Extract: Ineffective for Enlarged Prostate Symptoms
December 2011
Read about the results of a study comparing higher doses of saw palmetto extract with a placebo for treating some common symptoms of benign prostate enlargement (such as urinary retention and incomplete emptying of the bladder).
Bladder Cancer Warning for Pioglitazone (ACTOS)
November 2011
Find out the full list of serious problems with pioglitazone (ACTOS) that cause it to be a DO NOT USE drug, of which bladder cancer is but the latest.
Dangerously Blind Faith in Drug Advertising and the FDA Drug-Approval Process
November 2011
Learn about the results of a study concerning people's faith in the validity of the FDA drug-approval process and in the agency's restrictions on drug advertising.
Proton Pump Inhibitors: Dangerous and Habit-Forming Heartburn Drugs
November 2011
PPIs are now one of the most widely used classes of prescription drugs, with an estimated one out of every 20 people in the developed world currently taking one of these medications. However, given that recent research shows PPIs may be habit-forming, that the majority of PPI use is probably inappropriate, with minimal or no benefit to the patient, and that new, life-threatening risks with long-term therapy are continually emerging, it is time for the medical community to re-evaluate the role of PPIs in everyday practice.
Do Not Use 5-Alpha Reductase Inhibitors for Enlarged Prostate
October 2011
Treatment for enlarged prostate is not always required. Find out which family of drugs is best should treatment be needed.
U.S. Approves Cancer Drugs Faster Than Europe
October 2011
We share the results of a 2011 Health Affairs study.
Risk for Men Using Inhaled Anticholinergic Drugs
October 2011
Read more for information on inhaled anticholinergic drugs and the risk they pose to older men with chronic obstructive pulmonary disease (COPD).
FDA Should Remove Weight-Loss Drugs ALLI and XENICAL From the Market
October 2011
Following our April 2011 petition to the FDA to have weight-loss drug orlistat removed from the market, we review the serious adverse effects associated with its over-the-counter and prescription forms.
Dangers of Taking Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers Together
September 2011
Find out how using a combination of two drugs, one from each of these two families, can increase the risks of kidney toxicity and dangerously higher blood levels of potassium compared to use of one of these two families of drugs alone. The article lists 10 different drugs in the first class and seven in the second class. Worse yet, most of the patients in the study were prescribed the combination to treat conditions for which the combination has not proven to be beneficial.
Hypocrites at Merck -- Not Just in Washington, D.C.
September 2011
Find out how Merck tried, unsuccessfully, to keep from being sued by stockholders who accused the company of withholding information about the risks of Vioxx.
New Heart-Risk Safety Warning for Varenicline (CHANTIX): Do Not Use Until 2013
September 2011
Find out why the FDA is now requiring patient warnings on this drug about an increased risk of cardiovascular adverse events in patients with existing cardiovascular disease. This adds to the growing list, including many psychiatric adverse effects, of problems associated with varenicline.
Warning About Surgical Mesh Devices Used in Women
September 2011
Each year 67,000 women undergo surgery for pelvic organ prolapse (POP) involving transvaginal placement of nonabsorbable surgical mesh that commonly results in many serious and potentially life-threatening complications. Find out why safer, equally effective non-mesh surgery is a better alternative.
Proton-Pump Inhibitors: Dangerous and Habit-Forming Heartburn Drugs
September 2011
PPIs are now one of the most widely used classes of prescription drugs, with an estimated one out of every 20 people in the developed world currently taking one of these medications. However, given that recent research shows PPIs may be habit-forming, that the majority of PPI use is probably inappropriate, with minimal or no benefit to the patient, and that new, life-threatening risks with long-term therapy are continually emerging, it is time for the medical community to re-evaluate the role of PPIs in everyday practice.
Too Much Levothyroxine Increases the Risk of Fractures in Older Adults
August 2011
Many of the millions of older adults who take thyroid pills are taking too much each day, with significantly increased risks of bone fractures. Find out what to do.
Cholesterol-Lowering Combination of Extended-Release Niacin (NIASPAN) Plus Simvastatin (ZOCOR) Misses the Mark
August 2011
NIASPAN (extended-dose niacin) alone may still be useful, but in a study published in 2011, it did not add any benefit when taken along with the statin simvastatin.
Inappropriate Prescribing of Atypical Antipsychotic Drugs in the Elderly: Inexcusable Deaths and Medicare Dollars Wasted
August 2011
Most prescriptions for antipsychotic drugs to people in nursing homes are inappropriate and quite dangerous. Find out what you can do to protect your family or friends.
Another Addition to the Annals of Prescription-Drug Price Gouging
August 2011
Find out how a generic manufacturer got an exclusive "brand name" for its previously generic gout drug, colchicine, and increased the price by 125 times.
Prescription Drugs and Increased Traffic Accident Risk
July 2011
The article reviews evidence that taking any of eight different classes of prescription drugs can significantly increase the risks of being involved in a traffic accident in which someone is injured. Find out what the classes of drugs are.
Rivastigmine (EXELON) May Be Harmful to Critically Ill Patients
July 2011
In addition to its use for Alzheimer's disease, the drug rivastigmine (EXELON) is used to treat critically ill patients with delirium in intensive care units (ICUs). In a November 2010 study, those getting the drug had a death rate almost three times higher than those getting a placebo.
Revisiting Memantine (NAMENDA) and Other Alzheimer’s Disease Drugs
July 2011
Find out what outside experts, in published medical journal articles, think about the usefulness of the currently available drugs for treating Alzheimer's disease.
Warning About SimplyThick for Premature Infants
July 2011
Find out about a life-threatening intestinal condition that can be caused by feeding premature infants infant formula or pumped breast milk treated with this thickening agent.
Remove Dangerous Alzheimer’s Drug -- ARICEPT 23 -- From the Market Immediately
July 2011
Find out why Public Citizen and an expert in Alzheimer's disease from Johns Hopkins have asked the FDA to ban the recently approved Alzheimer's drug, Aricept 23, from the market.
Correction: 'Liraglutide (VICTOZA): Add Another One to the List of "Do Not Use" Drugs for Type-2 Diabetes'
July 2011
There was an error in a paragraph describing interpretation of the results of the blood test hemoglobin A1c (HbA1c), which is used to assess the body’s control of sugar (glucose).
Dutasteride (AVODART) to Prevent Prostate Cancer
June 2011
Find out why a drug widely used to treat prostate enlargement should not be used to prevent prostate cancer.
Drug Mix-Ups
June 2011
This article lists 355 drugs with names that are often confused with similar-sounding drug names. Find out what you can do to prevent getting the wrong drug.
Foreign Corrupt Practices By the U.S. Pharmaceutical Industry
June 2011
Find out how Johnson & Johnson officials "violated the Foreign Corrupt Practices Act (FCPA) by bribing public doctors in several European countries and paying kickbacks to Iraq to illegally obtain business."
Antidepressants: Effective for Major Depression, Not for Minor Depression
May 2011
Find out the difference between major depression and minor depression and why antidepressants, which are effective with precautions for the former, are not effective for the latter.
Will Cranberry Juice Every Day Keep the Doctor Away (And Prevent Urinary Tract Infections)?
May 2011
Previous studies have shown cranberries to have some effectiveness in preventing urinary tract infections. However, in these studies the researchers and subjects knew what they were receiving, which almost always guarantees a biased result favoring the treatment. Find out what a new study, where both patients and doctors were not aware of whether they were using cranberry juice or fake cranberry juice, concluded.
Oral Contraceptives Containing Drospirenone - Increased Risk of Blood Clots
May 2011
This article reviews recent studies showing significantly increased risk of blood clots in high-selling contraceptives containing drospirenone, compared to the lower risk of blood clots with older contraceptives containing levonorgestrel. Drospirenone is an ingredient in the contraceptive pills Yaz and Yasmin, which are sold in the U.S.
What Should People Do if They Miss a Dose of Their Medicine?
May 2011
This article, adapted for U.S. patients from an excellent review of the topic in the U.K., gives answers as to what course of action to follow if you miss a dose.
Illegal Promotion of a Drug That Causes Birth Defects
May 2011
Find out why Johnson & Johnson was recently criminally prosecuted for illegally promoting an epilepsy drug that clearly causes birth defects.
Drug-Induced Acute Akathisia (Restlessness)
April 2011
The article lists 27 drugs that can cause akathisia, a condition characterized by muscular quivering and the inability to sit still. Other signs of the condition include fidgety movements, leg swinging while sitting, rocking from foot to foot or pacing and motor restlessness.
Review of Type-2 Diabetes Medication Liraglutide (VICTOZA)
April 2011
This article reviews the safety and efficacy of liraglutide (VICTOZA), a new medication used to treat type-2 diabetes.
Update on Herpes Zoster (Shingles) Vaccine: Zoster Vaccine Live (ZOSTAVAX)
April 2011
Find out what the latest study of the effectiveness of the shingles vaccine reveals.
Pharmaceutical Industry Is Biggest Defrauder of the Federal Government
April 2011
The pharmaceutical industry has now surpassed the defense industry as the largest defrauder of the federal government, as determined by payments it has made for violations of the False Claims Act (FCA).
Quality of Drug Prescribing
March 2011
The article reviews a study on the potentially dangerous, inappropriate prescribing of 77 drugs that pose a high risk to older adults. Of the 67 of these drugs that we had previously reviewed in Worst, Pills, Best Pills News, we had classified 60 (90 percent) of them as “Do Not Use,” and the other seven as "Limited Use."
No. 1 Rule for Safe Drug Use: Have ‘Brown Bag Sessions’ with Your Primary Doctor; Fill Out a Drug Worksheet
March 2011
The article details how you should review all of the medications you are using with your doctor. It also provides a drug worksheet for you to fill out with him or her. The worksheet, when shown to your doctors, may save you from being prescribed drugs that interact with each other or have other side effects that you might not have recognized as being drug-related.
‘Should the FDA Review Drugs Used for Executions?’
March 2011
We discuss the controversy about the role of the FDA in approving the use of prescription drugs used to execute prisoners.
Homeopathic Teething Tablets Recalled Due to Possible Belladonna Toxicity in Children
February 2011
This article discusses why certain homeopathic teething tablets should not be used and lists symptoms of their toxicity that parents and other child caregivers can look for.
Nine Rules for Safer Drug Use
February 2011
We discuss nine safety rules you need to know when using medications. The tenth, equally important rule will be discussed in detail in next month's issue.
Saxagliptin (ONGLYZA) - Another Diabetes Drug
February 2011
This article discusses why you should not use this newly approved diabetes drug until more is known about its safety.
Vitamins C and E and Prevention of Cataracts
February 2011
This article discusses the results of a new study involving more than 11,000 people who were given vitamin E, vitamin C, vitamin E and C together, or placebos and followed them to see if they developed new cataracts. The article also includes a review of older studies of the effects of these vitamins on colds, kidney stones, cancer, heart disease and other diseases.
Extra Dollars for Docs
February 2011
Find out how to see if your doctor is one of more than 32,000 who have taken money from pharmaceutical companies, mainly for acting as drug company speakers or as consultants. Three hundred eighty-four of these physicians have gotten more than $100,000 in little more than one year. Does this affect the way they treat you?
Update on Withdrawals of Dangerous Drugs in the U.S.
January 2011
This article lists 11 of the prescription drugs that we warned Worst Pills, Best Pills News subscribers not to use before they were banned by the FDA. Subscribers knew an average of 3.3 years before the FDA acted that these medications were unsafe to use.
FDA Consumer Warning: Dangerous Chelation Products to Treat Serious Diseases
January 2011
Learn about all of the diseases for which chelation products are illegally promoted, the products' lack of effectiveness for treating any of these diseases, and some of the products' serious risks.
Interactions Between Methotrexate (TREXALL) and Proton Pump Inhibitors (PPIs) and Many Other Drugs
January 2011
This article discusses the dangerous interactions that can occur when using methotrexate (TREXALL) with certain other drugs. See our list of 27 drugs you should never take with methotrexate.
Delayed FDA Removal of Painkiller Propoxyphene (DARVON, DARVOCET) From U.S. Market Has Cost More Than 1,000 U.S. Lives
January 2011
Learn about our efforts to ban Darvon and our warnings about the drug going back 32 years. Why did the FDA take so long to ban it compared to the United Kingdom and Europe?
Pitavastatin (LIVALO): 8th Cholesterol-Lowering Statin Marketed in the U.S.
December 2010
Find out why you should not use the newest entry into the crowded statin market.
Neuroleptic Malignant Syndrome (NMS)
December 2010
The article describes the symptoms of the life-threatening neurological disorder neuroleptic malignant syndrome (NMS) and lists 40 different prescription drugs that have been found to cause it.
Fatal Drug Interactions With Simvastatin (ZOCOR)
December 2010
Find out how simvastatin (ZOCOR) can interact with another widely used drug to greatly increase the chance of life-threatening muscle damage that can lead to kidney damage.
Erectile Dysfunction Drugs and Hearing Loss
December 2010
The article describes evidence that sudden hearing loss can occur in people using certain erectile dysfunction drugs, and tells you which drugs can cause this problem. It also describes other symptoms that can accompany the onset of this drug-induced hearing loss.
U.S. Troops: More Deaths Related to Prescription Drugs
December 2010
Two recent studies found that indiscriminate prescribing of drugs to U.S military troops has been associated with an increase in drug-associated suicides and drug-induced deaths, probably related to interactions between drugs.
Estradiol Spray (EVAMIST) for Hot Flashes — Risks for Children and Pets
November 2010
This article discusses the potential risks to children and pets when they come in contact with the skin of someone who has used estrogen sprays for hot flashes.
Corticosteroid Drug Interactions
November 2010
This article discusses 36 drugs that, when used by people also using a corticosteroid, can either cause toxic interactions with the steroid or decrease the steroid's effectiveness.
Lamotrigine (LAMICTAL): Risk of Aseptic Meningitis
November 2010
Non-bacterial (aseptic) meningitis has been found in some people using the anti-convulsant drug lamotrigine (LAMICTAL), which is also used to treat bipolar illness. This article explains the symptoms of meningitis, what to do if these symptoms occur and how to prevent drug-induced meningitis.
Adverse Drug Reactions: How Serious Is the Problem and How Often and Why Does It Occur?
November 2010
Find out how many deaths, hospitalizations and emergency room visits are caused by adverse drug reactions, many of which could have been prevented.
Drug-Induced Parkinsonism
October 2010
A study discovered that more than 1 out of every 10 people who went to a Parkinson’s disease center was found to have drug-induced Parkinsonism. These people were misdiagnosed as having the more common illness, Parkinson’s disease, which is irreversible and has unknown causes.
Lipodissolve Products for Weight Loss
October 2010
The lipodissolve procedure involves a series of injections that purport to selectively melt away pockets of fat in the body. On April 7, 2010, the Food and Drug Administration (FDA) issued warning letters to companies selling lipodissolve products and alerted consumers about the products’ risks.
Bupropion Drug Interactions
October 2010
Bupropion is used to treat depression (brand name: WELLBUTRIN) and to aid smoking cessation (brand name: ZYBAN). The drug has a number of potentially dangerous interactions, some of which are quite different from typical antidepressant interactions.
Stronger Liver Toxicity Warning for the Arthritis Drug Leflunomide (ARAVA)
October 2010
On July 13, 2010, the Food and Drug Administration (FDA) announced that the black-box warning for the arthritis drug leflunomide (ARAVA) will be updated to highlight the risk of severe liver injury with the use of this drug and to explain how this risk may be reduced.
The Dangers of Combining Sleeping Pills With Other Medication
September 2010
The article list 34 other medications that can harmfully interact with sleeping pills, increasing their sedative properties and causing excessive sedation. Excessive sedation at night could increase the risk of falls, should the person get up in the night for some reason. Moreover, excessive sedation causing respiratory depression could be dangerous for people with certain disorders, such as lung disease.
Risk of Overdose — Rivastigmine Transdermal (Exelon) Patch for Alzheimer’s Disease
September 2010
Yet another problem has arisen with this drug which we have listed as DO NOT USE for a long time. There are a growing number of people who have unintentionally overdosed with the EXELON patch, leading to symptoms of toxicity described in the article. We also discuss ways of avoiding this dangerous overdose.
Life-Threatening Side Effects With Quinine (QUALAQUIN)
September 2010
Quinine is only approved to treat malaria but most of the use is for treating or preventing nighttime leg cramps, a purpose for which there is no evidence of effectiveness. Among 38 reports of serious side effects, including two deaths and two dozen cases of serious blood reactions, almost all occurred in people using the drug for purposes other than malaria.
French Court Dismisses AstraZeneca Complaint Against French Health Insurer Regarding CRESTOR
September 2010
Another blow for Crestor occurred when a French court upheld the right of health insurers to state that the drug does not provide any significant added benefit compared to other medicines and recommended that doctors should only prescribe it in serious cases.
Beware: Bioidentical Hormones
September 2010
Many women are using so-called bioidentical hormones, "natural" and implicitly safer versions of prescription drugs such as Premarin, because the latter drugs have been found to cause breast cancer, heart disease and many other serious health problems. The article discusses the fact that these products can be expected to have the same serious adverse effects that con­ventional preparations have and that they have the added disadvantage of not being regulated and thereby having unpredictable amounts of ingredients.
New Iloperidone (FANAPT) Is Not as Effective as Older Drugs For Schizophrenia Treatment
August 2010
The article explains why you should not use the new drug for schizophrenia, FANAPT.
Possible Increased Risk of Fractures With Long-Term, High-Dose Use of Heartburn Drugs
August 2010
The article reviews evidence that patients 50 years old or older who take proton pump inhibitors (PPIs -- a list of the six approved ones is in the article) or use them for a year or more may be at increased risk of fractures of the hip, wrist and spine. Since much of the use of these drugs is inappropriate and unnecessarily dangerous, the article discusses pharmacologic and non-pharmacologic alternatives to PPIs.
Vitamins and Minerals: A User’s Guide
August 2010
Vitamin and mineral supplements are a booming business in this coun­try. Many people are misled by ad­vertising into thinking that taking a supplement will help get rid of many of their health problems. But this is not the case.
Interactions With Cancer Drug Vincristine (ONCOVIN)
August 2010
The article lists 34 prescription drugs that can have harmful interactions with vincristine. Recognizing signs of toxicity from vincristine early, as described in the article, is urgent because most of the side effects are reversible when the interacting drug is stopped and the patient receives corrective treatment.
Zolpidem (AMBIEN) Reinvented As Zolpidem Sublingual (EDLUAR) For Sleep
July 2010
Learn more about zolpidem sublingual tablets (EDLUAR), a newly approved drug for the short-term treat­ment of difficulty falling asleep.
Dexlansoprazole (KAPIDEX, DEXILANT): The Sixth Proton Pump Inhibitor for Heartburn
July 2010
This sixth drug for treating "heartburn" has no advantage for patients over older drugs such as PREVACID, generic name lansoprazole. Any advantage is for the industry because the manufacturer of DEXILANT charges three times more for this drug than the cost of generic lansoprazole, sold by another company and just as effective for patients.
Preserving Bones with Bisphosphonates: Should You Avoid NSAIDs?
July 2010
It appears likely that patients who take bisphosphonates (such as FOSAMAX) and NSAIDs at the same time have an increased risk of gastrointestinal ulcers as opposed to taking either drug alone. The article reviews the studies demonstrating this and offers some practical advice on what the cautious drug user should do.
Severe Liver Toxicity Added to Already Lengthy List of Risks for Diet Drug Orlistat (XENICAL, ALLI)
July 2010
New evidence of severe liver failure, sometimes fatal, caused by orlistat (over-the-counter as ALLI, prescription version, XENICAL) adds to the many other reasons why no one should use this drug. They include Do not use orlistat. This drug has a meager effect on weight, but its potential to cause serious side effects, including pre-cancerous lesions of the colon (aberrant crypt foci), liver damage and pancreatitis, is significant. The most common side effects of orlistat include oily spotting, gas with discharge, fecal urgency, fatty/oily stools and fre­quent bowel movements. The article lists symptoms of liver failure.
Alternatives for Sleeping Problems
July 2010
Experts in sleep and aging have stated, “It’s extraordinarily rare to find an old person who actually requires sleeping pills." This article lists many over-the-counter and prescription drugs that can actually cause difficulty with sleeping and also discusses a variety of non-pharmacologic alternatives to sleeping pills. Sleep experts have also said that “Nonpharmacological treat­ments not only cause fewer side ef­fects, but they can sustain long-term improvements more successfully than pharmacological treatments.”
Should Vitamins Be Regulated As Drugs?
June 2010
Increasing knowledge about the risks and, in some cases, lack of benefits of vitamins suggests that by classifying vitamins as drugs, companies would be forced to give patients much more information than they now provide and would have to back medical claims for efficacy and safety with evidence. The article also provides recent evidence of previously unknown harms from certain vitamins and updates on current knowledge about the 13 most commonly used vitamins.
Dextromethorphan (DELSYM, ROBITUSSIN DM) for Cough: More Reasons to Avoid It
June 2010
Find out why you should not use cough products such as ROBITUSSIN DM that contain dextromethorphan. Also view a list of 22 other drugs that can have harmful interactions with dextromethorphan.
Safety Update for Transplant Drugs Mycophenolate (CELLCEPT) and Mycophenolic Acid (MYFORTIC)
June 2010
For these drugs, approved only for people who have had organ transplants, there are more than one million prescriptions a year filled at a cost of more than $700 million dollars. There is clearly some prescribing for medical conditions for which the drugs are not approved. This has serious implications since the drugs can cause several kinds of life-threatening toxicity, described in the article.
Oral Drugs for Diabetes: Avoiding Hypoglycemia
May 2010
After explaining the symptoms of low blood sugar (hypoglycemia) the article lists 42 prescription drugs that can interact with one or more diabetes drugs to increase the chance of hypoglycemia.
Smoke & Mirror Marketing (& Other Clever Big Pharma Tricks)
May 2010
The article reviews 12 prescription drugs, many of which are top-sellers, all of which are greatly overpriced in comparison to older "versions" of the same drugs. The patents on the old drugs expired so the "innovative" companies patented these new products, gaining a patent on them, and, for all practical purposes, using them as a license to print money. There is no evidence that any of the new ones are better than the now less-expensive, old versions.
Safety Concerns Lead to Label Changes For Topical Testosterone
May 2010
The article reviews the dangers of testosterone gels and gives recommendations that adults who use testosterone gels should follow.
Drugs for Cold Sores: How Well Do They Work?
May 2010
The article reviews studies showing that widely-sold prescription drugs for treating cold sores, such as ZOVIRAX, DENAVIR, FAMVIR, and VALTREX and ABREVA have significant side effects, are expensive and, on the average, only reduce the duration of the cold sore by less than one day. The article describes other non-drug methods to treat cold sores that make more sense.
Risk of Serious Gastrointestinal Bleeding With Newer Antidepressant Drugs
April 2010
This article discusses the greatly increased risk of bleeding with some widely-used antidepressant drugs and provides information that the FDA has not yet required be included in the patient Medication Guides for these drugs.
Aripiprazole (ABILIFY) Drug Interactions
April 2010
The article lists 53 drugs that can interact with the psychiatric drug ABILIFY to either increase the amount in the body, which can lead to toxicity, or decrease the amount rendering the drug less effective.
Reporting Adverse Events from Drugs and Medical Devices to the Food and Drug Administration
April 2010
Learn how to report dangerous side effects of drugs and dietary supplements to the Food and Drug Administration (FDA).
Digoxin Drug Interactions
March 2010
The article lists 35 different interacting drugs that can either increase blood levels of digoxin, leading to the serious problem of digitalis toxicity or decrease blood levels, causing the drug to be less effective.
A New Old Drug for Depression: Desvenlafaxine (PRISTIQ)
March 2010
Find out how Pristiq and the older antidepressant drug, Effexor are, essentially, the same and why not to use the new one.
Liver Toxicity With Topical Diclofenac Sodium (VOLTAREN)
March 2010
Although skin application of drugs usually results in lower blood levels than oral use, cases of liver toxicity have been found with topical diclofenac Sodium (VOLTAREN). The article lists other names of these products and explains the warning signals that may indicate liver toxicity.
Europe Moves to Ban Sibutramine (MERIDIA): FDA Should Ban Weight-Loss Drug
March 2010
In the first study to examine the long-terms consequences of using any diet drug, sibutramine (MERIDIA) actually increased the risk of stroke, heart attack, resuscitated cardiac arrest or cardiovascular death in patients taking the drug, compared to those taking a placebo. The results of this study properly caused European drug agency to recommend banning the drug. In this country, the FDA recklessly decided to leave it on the market for now.
Quetiapine (SEROQUEL) Interactions With Other Drugs
February 2010
Quetiapine (SEROQUEL) can interact with 26 different drugs, increasing its blood levels and causing dangerous side effects such as slowed breathing, dizziness and fainting. The article also lists 10 other interacting drugs that can result in lower blood levels, rendering the drug less effective.
A Review of Drugs for Overactive Bladder
February 2010
The newest FDA-approved drug for treating overactive bladder, TOVIAX (fesoterodine) is no more effective than the older five drugs, reducing the number of urinations a day by only one. In addition, since it is a new drug, we recommend not using it now because more will be known about its dangers after it has been on the market for a longer time.
Black Box Warnings Updated on Tumor Necrosis Factor Blockers
February 2010
New warnings are being required on CIMZIA, ENBREL, HUMIRA, EMICADE and SIMPONI because of evidence that lymphoma (tumor of lymph tissue) and other malignancies, some fatal, have been reported in children and adolescents treated with TNF blockers.
Type 2 Diabetes Drugs Fail to Improve the Most Serious Long-Term Complications
February 2010
The article discusses why all of these 16 diabetes drugs carry a label stating: "There have been no clinical studies establishing conclusive evidence of macrovascular risk reduction [heart attacks, strokes, etc] with oral antidiabetic drug[s]." The article also explains why lifestlyle changes such as diet and exercise to prevent or even treat type II diabetes are not heavily promoted or usually reimbursed.
New Black Box Touts Old Warning: Drug-Induced Movement Disorders with Metoclopramide (REGLAN)
January 2010
The FDA has belatedly required a black box warning that treatment with metoclopramide (a drug for heartburn unresponsive to conventional therapy and for the symptoms of gastroparesis, a condition in which the stomach takes too long to empty its contents) can cause tardive dyskinesia, a serious movement disorder that is often irreversible. The risk of developing tardive dyskinesia increases with duration of treatment and total cumulative dose. We have warned Worst Pills readers about this for 21 years.
A Review of ADHD Drug Lisdexamfetamine (VYVANSE)
January 2010
We list this amphetamine-like drug as DO NOT USE because it is more expensive than (and does not treat ADHD better than) older, safer alternatives (such as methylphenidate [RITALIN]).
Lithium Toxicity Due to Drug Interactions
January 2010
This article lists a large number of drugs, used to treat high blood pressure and other carediovascular disease, that can interact harmfully with lithium (ESKALITH; LITHOBID; LITHONATE;generic lithium carbonate), drugs used to treat bipolar (manic/depressive) disorder. This may result in a dangerous condition known as lithium toxicity because these drugs stop the body from getting rid of lithium and lithium blood levels are increased; in severe cases, this can cause seizures, coma and even death. The article also lists other symptoms of lithium toxicity.
Think Twice About Third-Generation Oral Contraceptives and YASMIN
December 2009
Two large new studies shed light on the increased risks of so-called "third generation" oral contraceptives containing desogestrel as well as oral contraceptives containing drospirenone (such as YASMIN and YAZ) compared to older, "second-generation" oral contraceptives. This study also discusses newly discovered risks associated with YASMIN and YAZ.
The Myth Is False: Caffeine Will Not Sober You Up After Drinking Alcoholic Beverages
December 2009
Many people believe that drinking caffeine with or after drinking alcohol will sober them up, but there is no evidence to support this.
An Update on H1N1 Influenza
December 2009
As the H1N1 influenza continues to spread, we review the best ways to prevent the flu. We also discuss over 100 products that the Food and Drug Administration reprimanded for selling unapproved flu treatments online.
Supreme Court Justice Ginsburg’s Drug Interaction Is a Reminder to Pay Attention to Meds
December 2009
In mid-October, Supreme Court Justice Ruth Bader Ginsburg was kept at a hospital overnight after she became drowsy, fell from her airplane seat and had to be taken off the plane before it departed. What common drug interaction was to blame?
The Case of Neurontin: Skewed Research in the Service of Selling
December 2009
When pharmaceuticals are intent on proving that one of their products is safe and effective, they may engage in practices that are professionally suspect and morally unethical. The recent news on Neurontin is a case in point.
A Review of Exenatide (BYETTA) for Type-2 Diabetes
November 2009
Because exenatide (BYETTA) is a new drug with increasing reports of severe, hospitalization-requiring pancreatitis and offers no significant breakthrough compared to other diabetes drugs, we urge readers not to use it until 2012--seven years after its approval, by which time much more will be known about its dangers.
Middle Ear Infections and Antibiotic Use in Children
November 2009
The article explaions how parents, in consultation with their doctors, in certain circumstances can safely avoid using antibiotics for treating children's middle ear infections.
New Gout Drug Febuxostat (ULORIC) Has Important Drug Interactions: Do Not Use Until 2016
November 2009
The article explains why febuxostat (ULORIC) should not be used because of problems with both its safety and effectivness.
An Update on the HPV Vaccine GARDASIL
November 2009
The article updates our previous information on the benefits and risks of this important vaccine.
Antacid Drug Interactions
October 2009
Antacids can interact with a number of medications, either increasing or decreasing drug effect.
A Review of Homeopathy
October 2009
This article reviews how homeopathy is said to work and concludes that there is no condition for which its effectiveness has been convincingly demonstrated.
Insulin Glargine (LANTUS) and Cancer: Is There a Link?
October 2009
We review recent studies potentially implicating one form of insulin in cancer and conclude that there is insufficient evidence to link the drug to cancer at present.
Are We Now Twice as Sad? The Drug Industry and Doctors Think We Are!
October 2009
The use of anti-depressants in the U.S. nearly doubled in a 10-year period as drugs displaced "talk therapy" and the drugs came to be used for an ever-widening set of disorders.
Milnacipran (SAVELLA) Fails to Alleviate Fibromyalgia Pain, Has Safety Concerns
September 2009
This article raises serious questions about the the limited effectiveness of SAVELLA and reviews evidence of serious toxicity.
Oxycodone: Be Careful What You Take With It
September 2009
The article lists 24 drugs that can increase the toxicity of oxycodone if taken together with the drug and 11 other drugs that can weaken its effectiveness as a painkiller if they are simutaneously used.
A Review of Shingles Vaccine ZOSTAVAX
September 2009
The article reviews the benefits and risks of the new shingles vaccine and discusses who should and who should not get the vaccine.
Facts and Myths about Generic Drugs
September 2009
Common myths, often spread via the brand name drug companies who lose as a result of competition from lower-priced generic drugs, are discussed and rebutted in this article.
Ghostly Prescriptions
September 2009
The article describes how many noted physicians lent their name to articles they had not actually written resulting in much more prescribing of hormones to post-menopausal women. As a result, this misinformation caused thousands of cases of breast cancer and heart disease. Some doctors received medical school tenure on the basis of their "literary production" when they had merely agreed to stake their names (and, by extension, the reputations of their institutions) to enhance pharmaceutical company's profits and line their own pockets.
New Study Further Links Alzheimer's Drugs to Side Effects
August 2009
We review evidence from a recently-published medical journal article that syncope (fainting), often leading to falls, can be a serious side effect of the Alzheimer’s disease drugs donepezil (ARICEPT), rivastigmine (EXELON) and galantamine (REMINYL). In addition, hospitalizations for slow heart rhythms, pacemaker insertions and hip fractures — all of which can be related to syncope — increased in patients using these Alzheimer’s drugs. This, along with their questionable effectiveness, further increases the evidence underlying our recommendation not to use these drugs.
Do Automated Screening Systems for Drug Interactions Adequately Protect You?
August 2009
Many doctors and pharmacists use computerized drug interaction screening systems to prevent the prescriptions for drugs that may have a harmful interaction with drugs already being used by the patient. This article points out several significant weaknesses of these systems and provides five common sense suggestions as to how patients can avoid dangerous drug interactions despite the weaknesses of these computerized systems.
Herbal Medicines for Menopausal Symptoms? Hang Onto Your Wallet and Your Health
August 2009
The article reviews published evidence of safety and effectiveness for five herbal supplements widely used for treating menopausal symptoms. There is no convincing evidence that any of the herbal supplements promoted for relief of menopausal symptoms is beneficial. In addition, as discussed in the article, many of them have serious safety problems.
FDA Requires Warnings about Serious Mental and other Side Effects With Certain Asthma Drugs
August 2009
The FDA has just warned about about mood and behavior changes for three drugs used to treat asthma: montelukast (SINGULAIR), zafirlukast (ACCOLATE) and zileuton (ZYFLO, ZYFLO CR). The article describes these side effects and urges that patients talk with their health care providers if these events occur. However, we advise that patients should not stop any asthma medication without first consulting your physician. Abruptly stopping a medication may result in acutely deteriorating asthma control.
How Ineffectual Medical Treatments Can Misleadingly Produce “Good” Results
August 2009
Many drugs, devices, and procedures that are found to be ineffectual or even dangerous have seemed to work when initially introduced, or seemed to prove useful for selected populations. Consumers are therefore often puzzled when some therapies that are initially hailed as breakthroughs are later pronounced useless, even hazardous.
No More Free Drug Samples?
July 2009
The article discusses a variety of reasons why it is neither in the best interests of doctors to prescribe or patients to use free samples. The truism that "there is no such thing as a free lunch" rings true once again.
Another Chapter in the Long History of Exposing the Dangers of the Most Popular Drug in America
July 2009
This article documents how long it has taken the FDA to fully implement a recommendation from its own advisory committee 32 years ago stating that: "Do not exceed the recommended dosage [acetaminophen--as in Tylenol] because severe liver damage may occur." Other countries have done more.
Muscle Damage from Interactions Between Statins and Other Commonly Prescribed Drugs
July 2009
The article lists 38 prescription drugs that can harmfully interact with statin drugs. The article also advises that No matter what statin you are taking and regardless of any interacting drugs, you should notify your prescriber immediately if you develop muscle pain, weakness or a darkening of your urine. .
A Review of Lubiprostone (AMITIZA) for Irritable Bowel Syndrome with Constipation
June 2009
Do not use lubiprostone. There are safer and equally or more effective treatments for both chronic constipation and for the constipation variety of irritable bowel syndrome. We have just asked the FDA to place a black box warning on this drug because it may cause abortions in women using it who are pregnant.
Hypothyroidism: A Consumer’s Guide to Diagnosing and Treatment
June 2009
The article explains why it is not a good idea to start treatment with thyroid hormone replacement without confirmation with laboratory tests that you actually have hypothyroidism. It also discusses the kinds of symptoms that should lead you to have your thyroid level checked.
The BOTOX Label Gets Ready for its Close-up
June 2009
Sixteen months after we petitioned the FDA to greatly increase warnings to doctors and patients about BOTOX, the agency has agreed to do so. The article discusses some of the life-threatening side effects of the drug such as swallowing and breathing problems and points out that much of its use is for conditions for which it has not been approved by the FDA.
Alpha-Blockers for Prostate Enlargement: Some Important Drug Interactions
June 2009
Taking alpha-blockers in combination with drugs for erectile dysfunction and with other drugs can cause dizziness and fainting. In this article we will discuss alfuzosin (UROXATRAL), doxazosin (CARDURA), tamsulosin (FLOMAX) and terazosin (HYTRIN) and drugs with which they can have harmful interactions.
Vermont’s Pharmaceutical Laws Move Toward Fuller Disclosure
June 2009
A new Vermont law is the most extensive state law requiring the reporting of payments from drug and device companies to physicians.
What is Comparative Effectiveness Research, and Why is it Being Badmouthed?
June 2009
Comparative effectiveness research permits comparisons between existing therapies to establish whether they are safer or more effective than one another. The pharmaceutical industry opposes these studies because it doesn't want you to know the truth about these therapies.
People on Certain Beta Blockers Should Be Wary of Epinephrine
May 2009
Patients taking a non-selective beta blocker should make sure the provider is aware of this before they receive an injection of epinephrine, as your physician or other health care provider may not be aware that a systemic dose of epinephrine may produce a dangerous spike in blood pressure. The article lists the selective beta blockers that do not cause this problem because they do not interact with epinephrine.
What Aspirin Dose Is Safest and Most Effective for Preventing Heart Disease?
May 2009
This article discusses the fairly narrow range of daily aspirin doses most safe and effective for preventing heart disease.
Weight-Loss Supplements Illegally Spiked with Prescription Drugs
May 2009
The article lists 72 weight loss dietary supplements that have recently been found to have been spiked with one of nine different prescription drugs, often at dangerously high concentrations. If you have used any products containing these ingredients, you should stop taking them and consult your health care professional immediately.
WARNING: MRI Scans May Burn Patients Wearing Transdermal Drug Patches
May 2009
On March 5, 2009, the FDA sent a public health warning to patients and doctors that transdermal drug patches containing metal may overheat during a MRI scan, causing skin burns. The article discusses several precautions you can take to prevent this from happening.
Possible Interaction Between Cranberry Products and Widely Used Blood-Thinner Warfarin (COUMADIN)
April 2009
This article adds other substances, cranberry products, to the long lists of drugs we have previously stated should not be used with the important blood thinner, warfarin (COUMADIN).
LOVAZA: Limited Use Drug for Lowering Trigylcerides
April 2009
The article reviews a widely-prescribed drug that contains a specific formulation of purified fish oil that is only approved for lowering very high levels of one type of fat, triglycerides, because these high levels can increase the risk of pancreatitis. The article explains why there should only be limited use of this drug.
Drug-induced Cognitive Impairment: Part 2: Delirium and Dementia
April 2009
This second article about drug-induced dementia or delirium lists and discusses an additional 79 drugs that can cause these reversible kinds of mental deterioration. The two articles collectively review 136 drugs that can cause these serious side effects, especially in older people.
Watch Out for Interactions with Tamoxifen (NOLVADEX)
March 2009
Tamoxifen (NOLVADEX) is still widely and successfully used for treatment of breast cancer. However, when used along with certain other drugs, its effectiveness can be significantly reduced. The article explains how this can happen and lists 19 different drugs that can cause this serious problem if used with tamoxifen.
Drug-Induced Cognitive Impairment: Part One
March 2009
The article lists 57 different drugs that can cause dementia if used. This can be even more problematic if more than one of these drugs is being taken. These drugs are only one class of drugs that can cause mental deterioration and next month's issue will discuss additional drugs that can also impair thinking.
Dangerous Interaction Between Heartburn Drugs and Clopidogrel (PLAVIX)
March 2009
This article describes how and why people using both PLAVIX, a drug that prevents blood clotting, and heartburn drugs such as NEXIUM had a 27 percent increased risk of heart attacks compared with people using PLAVIX alone.
Update: Oral Sodium Phosphate Used as Preparation for Colonoscopy Can Cause Kidney Damage
March 2009
The article explains how certain commonly-used prescription and over-the-counter drugs can cause kidney damage when used as bowel preparation for colonoscopy. The article also list alternative drugs for this important screening procedure that do not cause kidney damage.
Nonsteroidal Anti-Inflammatory Drugs Can Make Blood Pressure Hard to Control
February 2009
Twenty different NSAIDS (nonsteroidal antiinflammatory drugs) are listed in this article that can adversely affect your blood pressure control. The article discusses the way in which this happens and what you can do about it.
New Study: Vitamin C and Vitamin E Do Not Prevent Cancer
February 2009
The article discusses evidence from a large, new study finding that neither Vitamin C nor E had an effect on prostate cancer, a number of other cancers total cancer. The article also reviews older evidence concerning the effects of these vitamins on cardiovascular disease and other diseases.
Reporting Side Effects from Drugs and Medical Devices to the Food and Drug Administration
February 2009
The sooner the Food and Drug Administration (FDA) finds out about serious side effects of drugs, the more quickly it can warn the public. The article explains you can easily report suspected side effects of drugs or other medical products to the FDA.
“Morning after” Contraception: Too Difficult to Get
February 2009
Despite a 2006 Food and Drug Administration decision to make the morning-after contraceptive Plan B over the counter, 31% of pharmacies in Los Angeles do not carry the product.
Watch out for Interactions Between Drugs for Erectile Dysfunction and Other Medications
January 2009
The article lists 56 drugs that can interact with the three drugs for erectile dysfunction (ED): sildenafil (VIAGRA), tadalafil (CIALIS) and vardenafil (LEVITRA). Eight of the drugs are either nitrates such as nitroglycerin or a certain group of high blood pressure drugs.In combination with ED drugs, these drugs can cause a dangerous fall in blood pressure that could lead to a heart attack or stroke. Thirty-two other drugs can inhibit the enzyme that helps the body to eliminate the ED drugs, resulting in abnormally high blood levels of the drugs and a potentially harmful "overdose" even though you are actually taking the recommended amount. The other 16 drugs speed up the metabolism of the ED drugs, thereby lowering the blood levels and reducing the effectiveness of the ED drugs.
Prescribing “Easy Fix” Placebo is Common
January 2009
In a recent survey of U.S. doctors, 55 percent of those responding stated that, in the past year, they had used a placebo, defined as “a treatment whose benefits derive from positive patient expectations and not from the physiological mechanism of the treatment itself.” However, the prescribing of these "placebos" was not limited to the traditional inert "sugar pill" but also included actual drugs such as over-the-counter analgesics,sedatives and antibiotics, products that can have serious side effects even though, for the illnesses they were being used to treat, they would not be expected to have benefits beyond the patient expectation level. The article concludes with a discussion of the basis of our opposition to the use of placebos.
Long-term Use of Bisphosphonates for Osteoporosis
January 2009
Emerging reports of a rare but unique type of fracture in patients receiving bisphosphonates for many years point toward the drug as a possible culprit. Unlike most drugs, bisphosphonates remain in your body for many years after you stop taking them. Further investigation into the risks, as well as benefits, of long-term bisphosphonate use is needed. But, because there is little evidence of benefit after five years and the long-term risks remain largely unknown, it is reasonable to discuss with your doctor discontinuing these drugs after five years. However, you should continue to take calcium and vitamin D supplements at currently suggested doses (discussed in the article) regardless of whether or not you are on bisphosphonates.
Public Citizen Urges Immediate Ban of Rosiglitazone (AVANDIA)
December 2008
On Oct. 30, Public Citizen formally petitioned the Food and Drug Administration (FDA) to immediately ban the dangerous diabetes drug rosiglitazone (AVANDIA) because the drug causes multiple types of serious toxicity.
Osteoporosis Fracture Prevention: What You Need to Know about Drugs and other Measures - Part 2
December 2008
The article discusses the difference between the benefits of drugs to prevent a first fracture (primary prevention) and to prevent further fractures in people who have already experienced a fracture (secondary prevention).In addition to discussing when it may or may not be appropriate to use drugs such as Fosamax (alendronate) or Actonel (risedronate) the article discusses ways of preventing falls and other non-pharmacologic approaches to preventing fractures.
Colchicine Interactions with Other Drugs Can Be Life-Threatening
December 2008
This article lists 27 drugs that can have life-threatening interactions with the widely-used gout drug, colchicine, resulting in dangerously elevated levels of colchicine. Too much colchicine in the body leads to toxicity such as fever, vomiting, diarrhea, abdominal pain and muscle pains. Even worse, it can impair the bone marrow’s ability to make red and white blood cells, causing severe anemia and dangerously low numbers of white blood cells. When the number of white blood cells is reduced, your body may have difficulty fighting infections. Most people who have died from colchicine toxicity have had bone marrow toxicity or had preexisting kidney problems. Every patient on colchicine — whether on other drugs or not — should be alert for evidence of colchicine toxicity as described above.
Update on Drugs that Can Cause High Blood Potassium
December 2008
This article lists 68 drugs that can cause high blood potassium (hyperkalemia) that can result in nausea, fatigue, muscle weakness or tingling sensations, as well as heart abnormalities (showing up as an abnormal electrocardiogram). In some cases it can be fatal. If you are taking any of these drugs, be especially careful if you have diabetes or kidney disease. If so, you are at increased risk, and your doctor will have to weigh the risk of giving you these drugs. Also, the older you are, the more likely you are to develop hyperkalemia. Also, make sure you are receiving appropriate laboratory monitoring.
Potassium Increases Due to Drug Interactions Can Be Dangerous
November 2008
One of the most common drug interactions occurs when patients take two or more drugs that can each increase blood potassium levels. The resulting condition, hyperkalemia (increased blood potassium levels), can cause nausea, fatigue, muscle weakness or tingling sensations, as well as heart abnormalities, showing up as an abnormal electrocardiogram. In some cases it can be fatal. The article lists 50 drugs which, especially when used in combination, can cause hyperkalemia.
Muscle Injury From Use of Simvastatin (ZOCOR) with Amiodarone (CORDARONE)
November 2008
Despite the dangers of this combination--risk of severe muscle injury, rhabdomyolysis, which can lead to kidney failure or death--many clinicians continue to prescribe them together and cases of life-threatening adverse reactions from continue to be reported to the FDA. Patients taking simvastatin at a dose greater than 20 milligrams a day in combination with amiodarone should let their physician know that this combination puts them at high risk of muscle injury. There are other statins that do not appear to interact with amiodarone that are discussed.
New Evidence of Suicidal Thinking and Behavior In Patients Using Anti-Epileptic Drugs
November 2008
Among patients taking antiepileptic drugs for epilepsy, the risk of suicidal thinking and behavior was 3.5 times greater compared to placebo. These drugs are also used to treat pain and as mood stabilizers in people with manic-depressive disorders. Pay attention to common warning signs that may indicate an increased risk of suicide, including: talking or thinking about hurting oneself or ending one’s life; withdrawal from family and friends; worsening depression; increased preoccupation with death and dying; giving away prized possessions. Do not make any medication regimen changes without consulting your provider. Unsupervised sudden changes in prescription drugs can have dangerous adverse effects
Osteoporosis Screening: What You Need to Know
November 2008
The article lists 13 risk factors for fractures. But it points out that in deciding whether to use drugs, several important risk factors other than bone mineral density are often omitted which can result in inappropriate drug treatment for people who may not necessarily need it. Examples are given of patients who are really at low risk of a fracture but who often get treated.
Mongering Diseases to Hawk Pills: The Case of Fibromyalgia
November 2008
Dr. Nortin Hadler discusses the causes of and solutions to fibromyalgia.
Botox, Mark Spitz, Nadia Comaneci vs. Willie Nelson
October 2008
The article reviews what former Olympians — swimmer Mark Spitz and gymnast Nadia Comaneci - have in common with Botox. Instead of tens of millions of people watching these athletes’ performances in the past as they strived for their personal best, people will now be able to watch videos of doctors’ performances as they inject Mark Spitz and Nadia Comaneci with BOTOX. Read about the new definition of "personal best".
Tizanidine: Watch Out for Drugs Interacting With This Muscle Relaxant
October 2008
Tizanidine (ZANAFLEX) is a muscle relaxant for which more than 3.8 million prescriptions were filled in the U.S. last year. The article lists more than 64 drugs with which it can have dangerous interactions resulting in excess sedation, difficulty breathing or dangerously low blood pressure that can result in falling.
FDA Must Warn Patients Taking Fluoroquinolone Antibiotics of Possible Tendon Ruptures
October 2008
After a petition and lawsuit by Public Citizen's Health Research Group, the FDA announced in July that it will require a “black box” warning concerning tendon rupture and tendinitis caused by fluoroquinolone antibiotics, as well as an FDA-approved medication guide to be dispensed when prescriptions are filled. Although this accomplishes two of the three steps Public Citizen has urged the agency to take for nearly two years, we are troubled that the FDA is not doing everything within its power to prevent more people from needlessly suffering disabling tendon ruptures. Nothing could be simpler and more effective than a letter to doctors in addition to what the FDA has already agreed to do.
Worst Pills, Best Pills Review: Carisoprodol (SOMA, SOMA COMPOUND)
October 2008
The European Medicines Agency (EMEA) has recently proposed removing the widely prescribed, dangerous muscle relaxant carisoprodol (SOMA, SOMA COM- POUND and SOMA COMPOUND with CODEINE) from the market in all European Union countries because “the risks of these medicines outweigh their benefits.”
Massive Misprescribing of Inappropriate Drugs to Hospitalized Elderly Patients
September 2008
A nationwide study published in spring 2008 in the Journal of Hospital Medicine showed that nearly half (49 percent) of almost 500,000 hospital patients older than 65 have been prescribed one or more of 92 drugs known to be unnecessarily unsafe for older patients. 10,000 of these patients had four or more of these inappropriate medicines prescribed during their hospitalization. Among the most common categories of adverse drug reactions these inappropriately prescribed drugs can cause are excessive sedation, abnormally low blood pressure and bleeding. We list the 92 drugs in the article and give further details about the kinds of side effects these drugs can cause.
29 Medications That May Cause Adverse Interactions with Thyroid Drugs
September 2008
Thyroid medications are among the most widely-prescribed drugs in the U.S. In this article, we review 29 different medications that can have harmful interactions with thyroid medicines such as levothyroxine (Synthroid). There are four major kinds of interaction problems that can occur: • Certain medications can decrease the absorption of levothyroxine resulting in lower levels in the blood. • Other medications can increase the rate at which the body gets rid of levothyroxine, also resulting in lower thyroid levels in the blood. • Other medications can cause changes of levothyroxine binding in blood, decreasing the body's ability to use levothyroxine. • Levothyroxine can affect the safety or effectiveness of other medications by raising or lowering the levels of these other drugs in the blood, causing them to be either infective (lower levels) or dangerous (higher levels).
Athletic Prowess and the Doping of Consumers
September 2008
Athletes once were rewarded for their prowess by appearing on a box of Wheaties, but now promote drugs in frequently played commercials during the Olympics.
Advice for Patients: New Inhaler Propellants to Replace CFC Inhalers
August 2008
With the imminent demise of CFC-propelled albuterol asthma inhalers and the substitution of HFA (hydroflouroalkane)as a more environmentally-friendly propellant, two sets of problems arise. First, and the main subject of this article, are differences between the old and new propellants that require special attention by asthmatics using the new HFA asthma inhalers because they may clog more easily than the older CFC-containing ones. The second problem is cost in that less expensive generic versions of the HFA inhalers will not be available until 2010 and the half-as-expensive generic CFC albuterol inhalers will not be manufactured or sold after December 31, 2008.
Dangers of Mixing Alcohol with Certain Medications or Diseases
August 2008
The article discusses 273 drugs that can have harmful interactions with alcohol. Also reviewed are several ways in which these harmful interactions can occur: 1/ Medications Can Increase Alcohol Blood Levels 2/ Additive effects of medications and alcohol. One of the best- known drug-alcohol interactions is when alcohol, a depressant, is taken with other sedative medications, and excessive sedation or depression of respiration can occur 3/Alcohol can increase the blood levels of some medications leading to toxicity of these drugs. 4/ Alcohol also can reduce blood levels of some medications causing them to be less effective. Although some of the interactions between alcohol and medications mainly occur in people who drink heavily (three or more drinks on one occasion), many of these interactions may occur with much lower amounts of alcohol use, such as one to two drinks on an occasion. We strongly urge you to tell your physicians and other health care providers how much alcohol you are drinking so they can effectively assess the risks and advise you about the safe use of alcohol and medications.
The Growth Hormone Craze: Why it Should Be Used only Rarely
August 2008
Growth hormone is only approved for three relatively rare conditions in adults: AIDS Wasting Syndrome, Short bowel syndrome involving malabsorption of food and Growth Hormone Deficiency. Experts in the care of patients with hGH-related problems clearly state that giving hGH for antiaging, age management or bodybuilding is not medically appropriate particularly when weighing the potential benefits and risks. The article discusses known risks including soft tissue swelling, joint pains, carpal tunnel-like syndrome, breast enlargement and diabetes. Other side effects include liver and heart enlargement, increased pressure around the brain and high blood pressure. Do not use growth hormone unless you have one of the three medical conditions for which there is actually evidence that the benefits outweigh the risks.
Update: Diabetes Drug JANUVIA (Sitagliptin)
July 2008
An increasing body of evidence documents both the risks and lack of evidence of clinical benefits associated with sitagliptin, and several reviews have cautioned against its use.
Medications and the Perils of Too Little Sodium in the Blood
July 2008
Low levels of sodium in the blood are one of the most common laboratory abnormalities and the consequences range from mild and non-specific to life-threatening. The article discusses the symptoms of low blood sodium and lists 53 prescription drugs that can cause it. We urge that both patients and health professionals be alert for symptoms that may signal the onset of hyponatremia if the patient is predisposed to this disorder as a result of their drug therapy or diseases.
New Report Sheds Light on Serious Safety Problems with Anti-Smoking Drug Varenicline (CHANTIX)
July 2008
A recent study has found large numbers of reports of psychiatric adverse effects with varenicline (CHANTIX) including hundres of reports of suicidal acts, thoughts or behaviors; possible psychosis; and hostility or aggression.
Black Box Warning for ENBREL (etanercept)
June 2008
Etanercept, an effective disease-modifying anti-rheumatic drug (DMARD), now joins adalimubab (HUMIRA) and inflixamib (REMICADE) to be the third of the arthritis disease-modifying drugs (see discussion on the following page about disease-modifying drugs) to receive a black box warning concerning infections, calling for TB testing and, if positive, TB treatment before starting these drugs. For some people, the potential benefit of etanercept outweighs the risk of infections, including the very small risk of TB infection. The article also discusses a fourth DMARD and the precautions we advise for its use.
Codeine: The Drug With Multiple Personalities
June 2008
Codeine is routinely converted to morphine in the body in order for it to be an effective painkiller. The metabolism of codeine to morphine takes place through the actions of an enzyme in the liver. The article explains how various drugs and or a person's genetic makeup can greatly influence the conversion of codeine to morphine, making its pain-relieving properties too week if not enough conversion occurs and resulting in what amounts to an overdose at the recommended dose if the conversion to morphine is too rapid. Fourteen drugs that inhibit the conversion to morphine are listed in the article.
American Heart Association Recommends Screening for Heart Disease in Children Getting Drugs for ADHD
June 2008
The American Heart Association (AHA) has just recommended specific screening for heart problems for children and adolescents before they get stimulant drugs for treating attention deficit hyperactivity disease (ADHD). The recommendations include a thorough history, a physical exam focussing on the heart and, according to the American Heart Association, that it is reasonable to obtain an electrocardiogram. The article lists the components of an adequate history and physical exam to look for the presence of pre-existing heart disease in children.
Public Citizen Petition Urges Removal of ORTHO-EVRA Patch From Market
June 2008
Last year, US women filled 2.7 million prescriptions for a contraceptive that has, compared to the pill: significantly higher estrogen levels; a possible two-fold increase in the risk of blood clots; increased painful side effects such as breast discomfort, severe menstrual pain, nausea and vomiting; an increased likelihood of discontinued contraceptive use; and no improvement in contraceptive outcomes. The article gives more details about why we want this product banned.
Backsliding on Childhood Immunization
June 2008
More and more Americans are choosing not to have their children vaccinated, and as a result, obsolete diseases are making a come-back.
Human Experimentation and Speedy For-Profit Ethical Review Boards
June 2008
The drug industry uses for-profit human experimentation companies to obtain faster results, to the detriment of the consumer.
Calcium Channel Blocker Drug Interactions
May 2008
This article lists more than 60 prescription drugs that can interact with calcium channel blocking drugs such as amlodipine (NORVASC),diltiazem (CARDIZEM, DILACOR XR TIAZAC)or nifedipine (PROCARDIA)to either cause toxicity or to lessen the effectiveness of the calcium channel blocking drugs. Included in the lists are a number of drugs that we list in Worst Pills, Best Pills as DO NOT USE or LIMITED USE drugs. The article also explains the different kinds of toxicity that can ensue from these interactions.
Nine Reasons Why Older Adults Are More Likely Than Younger Adults to Have Adverse Drug Reactions
May 2008
Older patients are especially at increased risk for adverse drug reactions because of age-related factors.The article reviews nine reasons why this is the case and discusses what you can do about these often-preventable adverse reactions. Increasing awareness of this problem should result in the prescription of far fewer drugs to older adults, and those that are prescribed will be given at lower doses in most instances.
A Review of Modafinil (PROVIGIL) For Narcolepsy
May 2008
PROVIGIL, an amphetamine-like drug, has been illegally promoted by its manufacturer for treating many conditions for which there is no evidence that its benefits outweigh its risks. Thus, a large proportion of prescriptions for this top-200 selling drug are for off-label or unapproved uses.
Serotonin Syndrome Due to Drug Interactions
April 2008
The article lists more than 30 prescription drugs that can cause the serotonin syndrome.
Drug-Induced Eye Toxicity: 62 Drugs That Can Cause Eye Disease
April 2008
This article, based on a recent review in Drug Safety, lists 62 prescription drugs that can cause eye disease. The range of drug-induced eye diseases includes diseases of the eyelids, glaucoma, cataracts, retinal damage and optic nerve damage. As is true for drug-induced diseases in other parts of the body, you should consider newly developed eye symptoms beginning shortly after starting a new medication to be possibly drug-induced and consult a physician.
Advice for Patients: Denture Cleansers
April 2008
Allergic reactions to a component of denture cleansers - persulfates - can occur with both proper and improper use of denture cleansers and can be delayed. Symptoms of an allergic reaction may include: irritation, rash, hives, gum tenderness, breathing problems and low blood pressure.
Avoiding Overuse of Proton Pump Inhibitors (PPIs)
March 2008
This article reviews evidence for the international epidemic of overuse of proton pump inhibitors (PPI), drugs used to treat ulcers and gastroesophageal reflux disease (GERD). There were 70 million prescriptions filled in U.S. pharmacies in 2006 for the four leading PPI drugs: esomeprazole (NEXIUM), lansoprazole (PREVACID), pantoprazole (PROTONIX) and rabeprazole (ACIPHIX). Find out about several serious side effects of these drugs such as increased community-acquired pneumonia, increased hip fractures and acute kidney inflammation. Learn about alternatives to using PPIs.
Get the Mercury Out! Is There a Link Between Childhood Vaccinations and Autism?
March 2008
This article explains what autism is and analyzes the latest evidence concerning its alleged link to mercury from childhood vaccines.
FDA and Drug Makers Should Have Warned Public Earlier About Zetia, Vytorin
March 2008
Find out why Worst Pills warned against the use of VYTORIN more than three years ago. Also, learn about new evidence showing that despite the fact that this drug lowers cholesterol, there is no evidence that it prevents heart attacks or strokes (though massive misleading advertising would have you believe otherwise).
Ibuprofen Can Reduce Aspirin’s Protective Effect Against Heart Attacks and Strokes
March 2008
This article explains the dangers of using ibuprofen (MOTRIN, ADVIL) because it interferes with the protective effect of low-dose aspirin to prevent blood clots and protect against heart attacks or strokes. Find out how these two widely-used therapies have a harmful interaction and what you should do.
Medical Records: Q&A
March 2008
This article reviews such topics as: Why should I have my medical record? Am I entitled to my medical record? Who has access to my medical record? Can a provider deny me access to my record? What if I change health care providers, or my provider has moved or gone out of business? What happens to my record if my provider dies?
Public Citizen Launches New Blog
March 2008
Public Citizen’s communications office launched “Citizen Vox” in February as the organization’s latest tool in spreading the word about its mission of protecting health, safety and democracy. Check out www.CitizenVox.org.
Is Less More? New Study Challenges Conventional Thought on Desirable Cholesterol Levels, Links Very Low Cholesterol to Cancer
February 2008
We review a recent study suggesting that very low cholesterol levels may be linked to an increased risk of cancer. The related issue discussed in the article is whether the current U.S. thinking that "lower is better," especially for those who have not yet had a heart attack or stroke or angina, is correct. There is also a discussion about the difference between primary and secondary prevention.
Update on Rosiglitazone (AVANDIA): More Strikes Against the Drug
February 2008
Recent updates on this diabetes drug that we have urged our readers not to use for three years are reviewed, including the delisting of the drug by the Veterans Administration because of its dangers and warnings by the Canadian government. We are renewing our call for a ban on the drug in the U.S.
Macrolide Antibiotic Drug Interactions
February 2008
The article discusses the adverse drug interactions between either of two widely-prescribed macrolide antibiotics, erythromycin (as in ERYTHROCIN) and clarithromycin (BIAXIN)and more than 40 other drugs that are listed in a table in the article. It also describes the nature of the adverse interactions that can occur.
Drug Industry Spends Almost Twice as Much on Promotion of Drugs as on Research
February 2008
A recent study examined the ways the drug industry spends an average of $61,000 per physician each year trying to convince them to buy certain drugs. The findings provide a well-documented reminder that the industry is much more financially committed to massive promotional expenses than to research and development of drugs.
Painkiller DARVOCET Now Phased Out of U.K. Market; Still Widely Prescribed in the U.S.
January 2008
Why is this big-selling, extremely dangerous, not very effective narcotic painkiller still on the market in the U.S. despite haveing been withdrawn in the U.K.? Learn about how it kills more than 200 people a year.
SSRIs Can Have Dangerous Interactions With Other Drugs
January 2008
More than 70 million prescriptions a year are filled for these popular antidepressants, including Prozac, Paxil, Zoloft, Luvox, Celexa and Lexapro. This article gives details about more than 60 other widely prescribed prescription drugs that can have harmful interactions if used with these antidepressants. The two different kinds of interactions are also discussed.
Reporting Adverse Events from Drugs and Medical Devices to the Food and Drug Administration
January 2008
Learn how you can easily report to the FDA an adverse reaction you have had to a drug or dietary supplement. The basis for most drugs being taken off the market or being required to have a black box warning are such reports. Do your part!
Pay for Performance? Incentives Gone Awry
January 2008
This article reviews an example of the growing trend of paying doctors more for "better" performance. Referring to doctors getting financial kickbacks for prescribing generic drugs, the article points out that doing the right thing for the wrong reason is not acceptable. Having doctors increasingly basing their decision-making on financial conflicts of interest is not in patients' interests.
Taking TOPAMAX to Treat Alcoholism Could Have Serious Consequences
December 2007
A recent drug industry-funded study was widely hailed as showing that TOPAMAX, a drug approved for seizures and migraines, worked well in treating alcoholism in heavy drinkers. However, upon closer inspection, the study does not convincingly prove the safety or effectiveness of the new suggested use of topiramate. The use of the drug produced only a modest decrease in the percentage of days of heavy drinking, compared to placebo. Topiramate can be unsafe if mixed with alcohol. Current FDA labeling for the approved uses of the drug states, “You should avoid drinking alcohol while taking [topiramate]. Alcohol with [topiramate] can make side effects such as sleepiness and dizziness worse.” In addition. the drug can cause metabolic acidosis, a condition that occurs when there is too much acid in your blood. Metabolic acidosis can cause symptoms such as tiredness, loss of appetite, irregular heartbeat and impaired consciousness.
Drug Interactions: Warfarin (COUMADIN)
December 2007
This article explains how to understand the International Normalized Ratio (INR), a test applied to a sample of a patient’s blood to determine how “thin” it is when you are using the blood thinner COUMADIN (warfarin). In addition, the article lists more than 50 drugs or dietary supplements that can interact harmfully with COUMADIN to cause the blood to be too thin (abnormal bleeding) or not thin enough which could result in lessening the effect of COUMADIN in stopping blood clot formation.