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February 2024
Preventing strokes is a public health priority. A recent study found, however, that the use of daily low-dose aspirin was not beneficial in preventing a first stroke in healthy older adults. Among every 1,000 subjects taking low-dose aspirin over five years, there were 2.5 fewer strokes at the expense of 3.5 cases of bleeding in the brain.
September 2023
Patients taking the oral antidepressant drug desipramine (Norpramin) should be aware that it has clinically important interactions with many other prescription medications. Public Citizen’s Health Research Group has designated desipramine, a tricyclic antidepressant, as a Limited Use drug; antidepressants in other drug classes are safer and better tolerated.
February 2023
Patients taking the frequently prescribed antidepressant nortriptyline (PAMELOR) should be aware that it has clinically important and potentially dangerous interactions with many other prescription and over-the-counter medications.
December 2022
Learn about the U.S. Preventive Services Task Force’s (USPSTF’s) updated recommendations regarding the use of daily aspirin to prevent heart attacks and strokes in patients without signs, symptoms or history of cardiovascular disease.
December 2022
Patients taking fluvoxamine (LUVOX), a selective serotonin reuptake inhibitor (SSRI), should be aware that it has clinically important interactions with many other prescription and over-the-counter medications.
October 2022
Patients taking the commonly prescribed antidepressant citalopram should be aware that it has clinically important and potentially dangerous interactions with many other prescription and over-the-counter medications.
June 2022
Learn about several drugs that can promote the formation of gallstones — stones in the gallbladder (a condition known as cholelithiasis) — and what you can do about it.
May 2022
Learn why the U.S. Preventive Services Task Force continues to recommend the use of low-dose aspirin to prevent preeclampsia in expectant mothers at high risk for the disorder.
May 2022
Patients taking any of the widely used nonsteroidal anti-inflammatory drugs (NSAIDs) should be aware that they all have clinically important interactions with many other medications.
February 2022
Patients taking the commonly prescribed antidepressant fluoxetine should be aware that it has clinically important and potentially dangerous interactions with many other prescription and over-the-counter medications.
November 2021
In this article, we discuss the results of a randomized clinical trial that compared low- and regular-dose aspirin for preventing another heart attack or stroke in patients with known atherosclerotic cardiovascular disease.
October 2021
Learn about some of the commonly used medications that may lead to hair loss, also known as alopecia.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
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.
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.
May 2009
This article discusses the fairly narrow range of daily aspirin doses most safe and effective for preventing heart disease.
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.
May 2006
If you have had a previous heart attack or stroke or have blood vessel disease, you should be on aspirin treatment rather than clopidogrel with or without aspirin. You should only take clopidogrel if you cannot tolerate aspirin.
August 2005
If you are healthy, you should not undertake aspirin treatment for the primary prevention of cardiovascular disease without consulting your physician about whether you are at high enough risk to benefit.
January 2005
If you have had a previous heart attack, stroke, or have blood vessel disease you should be on aspirin treatment rather than clopidogrel unless you cannot tolerate aspirin, or aspirin treatment has failed.
If you are now taking ticlopidine and cannot take aspirin, talk to your doctor about clopidogrel.
October 2004
A high frequency of drug intake to manage headache pain may mean that you have a condition known as medication overuse headache (MOH). According to the International Headache Society, MOH may exist when the following criteria are fulfilled: (1) there is headache on 15 or more days a month; (2) pain characteristics are dull, and of light to moderate intensity on both sides of the head; (3) drug intake includes ergots, triptans and opioids (these drugs are discussed below) for 10 or more days per month, simple painkillers 15 days or more for a minimum of 3 months; and (4) the headache disappears after withdrawal.
May 2004
Aspirin is the preferred preventive treatment for those who have already had a heart attack (secondary prevention), at least for the majority of people who are not intolerant to aspirin. However, the lack of evidence of an aspirin benefit in the primary prevention of heart attack is clearly outweighed by the increased risk of bleeding from aspirin, and you should not use aspirin for the primary prevention of heart attacks.
November 2003
Warnings: Reye’s syndrome: Children and teenagers should not use this medicine for chicken pox or flu symptoms before a doctor is consulted about Reye’s syndrome, a rare but serious illness reported to be associated with aspirin.
December 2002
Ephedra, or ma huang, the natural form of the stimulant ephedrine, the most infamous and dangerous drug found in dietary supplements sold for weight loss, is at last beginning to receive the negative notoriety it deserves. Ephedra causes heart attacks and strokes because of its ability to raise blood pressure and heart rate. Article discusses the risk of other dietary supplements.
October 2002
This is the first of a two part series on drug induced psychiatric symptoms that is based on the July 8, 2002 issue of The Medical Letter on Drugs and Therapeutics. Regular readers of Worst Pills, Best Pills News will recognize The Medical Letter as a reference source written for physicians and pharmacists that we often use because of its reputation as an objective and independent source of drug information. The article lists the drugs and their psychiatric adverse effects.
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