Worst Pills, Best Pills

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



Search results below include Disease and Drug Family Information where your selected drug is a primary subject of discussion.

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.


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.
Search results below include Drug and Dietary Supplement Profiles where your selected drug is a primary subject of discussion.

tramadol (CONZIP, QDOLO, 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.


Search results below include Worst Pills, Best Pills Newsletter Articles where your selected drug is a primary subject of discussion.

NSAIDs Better Than Opioids for Pain Control Following Hospitalization or Minor Surgery
April 2022
Recently published research strongly suggests that treatment of acute pain after hospitalization or after outpatient dental surgery is best achieved with nonsteroidal anti-inflammatory drugs (NSAIDs) rather than opioids.
Important Drug Interactions for the Antidepressant Fluoxetine (PROZAC, SYMBYAX)
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.
Drug-Induced Constipation
January 2022
Numerous prescription and over-the-counter drugs can cause or exacerbate constipation. Knowing which medications prescribed or recommended by your doctor cause constipation will allow you to take steps to prevent or minimize this common, troubling adverse drug effect.
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.
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.
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.
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.
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.
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.
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.
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.
Serotonin Syndrome Due to Drug Interactions
April 2008
The article lists more than 30 prescription drugs that can cause the serotonin syndrome.
Do Not Use! The Pain Drug Tramadol (ULTRAM/ULTRACET) and Serotonin Syndrome
March 2002
Australian drug regulatory authorities have received 171 reports of suspected adverse reactions with the pain drugs tramadol (ULTRAM) or tramadol in combination with acetaminophen (ULTRACET) since Ultram began being marketed in Australia in late 1998. In six of these reports, a very serious adverse reaction known as the serotonin syndrome was listed as the adverse reaction.


Search results below include Additional Information from Public Citizen where your selected drug is a primary subject of discussion.

Testimony Before the FDA’s Drug Safety and Risk Management Advisory Committee and Anesthetic and Analgesic Drug Products Advisory Committee Regarding Intravenous Tramadol (HRG Publication #2619)
In testimony before a joint meeting of the Food and Drug Administration’s (FDA’s) Drug Safety and Risk Management Advisory Committee and Anesthetic and Analgesic Drug Products Advisory Committee, Public Citizen urged the committees to recommend that the FDA not approve an intravenous form of tramadol, a widely used but inadequately regulated opioid, for treatment of acute pain in a medically supervised health care setting.
Supplement to the Petition to the DEA and FDA to Reschedule the Opioid Tramadol From Schedule IV to Schedule II (HRG Publication #2525)
Public Citizen submitted a supplement to its November 2019 petition to the DEA and FDA to reschedule the opioid tramadol from the weakly controlled schedule IV under the Controlled Substances Act to the more tightly controlled schedule II because it is overprescribed, often misused, highly addictive and potentially deadly. The supplement adds new data from a careful study of the FDA’s Adverse Event Reporting System which revealed that tramadol use correlates with severe adverse events, including death.