Worst Pills, Best Pills

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

fluoxetine (PROZAC, SARAFEM, SYMBYAX)


E-ALERTS

Search results below include E-Alerts where your selected drug is a secondary subject of discussion.


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

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.
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.
thioridazine (MELLARIL)
  • We list this drug as a Do Not Use drug because it is more likely to cause irregular heartbeat than related drugs.
milnacipran (SAVELLA)
  • We list this drug as Do Not Use because it offers minimal benefit and has serious risks.

WORST PILLS, BEST PILLS NEWSLETTER ARTICLES

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

Important Drug Interactions for the Antidepressant Nortriptyline (PAMELOR)
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.
Review of the Triptan Drugs for Treating Migraines
June 2022
Public Citizen’s Health Research Group recommends that triptans only be used to treat migraine headaches after determining that acetaminophen or nonsteroidal anti-inflammatory drugs fail to work or cannot be taken due to allergies or other medical reasons.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
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.
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.
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.
Duloxetine (CYMBALTA) for Major Depressive Disorder - Nothing Special and Possible Liver Toxicity
January 2005
An FDA reviewer wrote: In the event that unconfounded cases of severe liver injury or acute liver failure related to duloxetine treatment are identified and submitted early in the postmarketing period, the division will use the threshold of three “clean” cases to initiate additional regulatory action that could range from a more prominent warning to the withdrawal of the drug product.
The Serotonin Syndrome: A Potentially Life-Threatening Adverse Drug Reaction — Fluoxetine (PROZAC), Escitalopram (LEXAPRO), Sibutramine (MERIDIA) And Other Drugs
September 2003
Canadian drug regulatory authorities reviewed reported cases of serotonin syndrome in the July 2003 issue of the Canadian Adverse Reaction Newsletter. The serotonin syndrome is a potentially life-threatening adverse drug reaction involving an excess of serotonin, a naturally occurring nerve transmitter.
Profitably Inventing New Diseases
August 2003
A recent article in Medical Marketing and Media (May 2003), aimed at the marketing departments of the pharmaceutical industry, provides an extraordinary view of this industry of which the public, unfortunately, remains unaware. Vince Parry, the “Chief Branding Officer” for a company called “InChord,” tells his pharmaceutical company readers — and potential clients — how to increase sales by combining the “creation” of a disease with a drug to treat it.
Oxybutynin Patches (OXYTROL): A Grossly Overpriced Product For Overactive Bladder
July 2003
You should check the list of drugs that can cause loss of bladder control before starting drug treatment for this condition. You may be able to change from a drug that causes loss of bladder control to a drug that does not or alter the dose. This may be enough to solve the problem.
Do Not Use Until December 2009 The New Antipsychotic Drug Aripiprazole (ABILIFY)
June 2003
You should follow the Health Research Group’s Seven Year Rule with aripiprazole. There is no evidence to suggest that aripiprazole is a “breakthrough” drug.
Do Not Use Until October 2005 Escitalopram (LEXAPRO) – The Sixth Selective Serotonin Reuptake Inhibitor (SSRI) Antidepressant
January 2003
Escitalopram (LEXAPRO) was approved by the Food and Drug Administration (FDA) in August 2002 and brings to six the number of selective serotonin reuptake inhibitor (SSRI) antidepressants now on the market in the U.S. The primary purpose for developing escitalopram appears to be nothing more than a strategy to protect sales as citalopram nears the end of its patent protection. In the long run, escitalopram will cause economic harm to individuals and the healthcare system.
Do Not Use! Dexmethylphenidate (FOCALIN) - a Methylphenidate (RITALIN) Copy
August 2002
Dexmethylphenidate (FOCALIN), approved by the Food and Drug Administration (FDA) in November 2001 for attention-deficit/hyperactivity disorder (ADHD), joins a growing list of Do Not Use drugs, so called because they primarily result in economic harm to both individuals and the health care system. These drugs exist solely to extend a manufacturer’s brand name monopoly position in a lucrative market but offer nothing better than the drugs they replace.

ADDITIONAL INFORMATION FROM PUBLIC CITIZEN

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

FDA Should Give Oral Presentations at All Advisory Committee Meetings, Public Citizen Tells Agency
Agency experts should be required to give presentations at all future Food and Drug Administration (FDA) advisory committee meetings discussing specific products, Public Citizen said in a petition filed today.
Statement before the National Academy of Sciences on the Framework for Evaluating the Safety of Dietary Supplements (HRG Publication #1594)
Since at the heart of this problem is the irrational legal distinction that has been made between those pharmacologically active chemicals which are regulated as prescription or over-the-counter drugs and those which others call dietary supplements which I call drug supplements, eventually the same standards for safety and effectiveness must be adopted.
Letter to the FDA concerning the United Kingdom's Committee on Safety of Medicine's recent warning about potentially serious drug interactions between St. John's Wort and a large number of other drugs. (HRG Publication #1513)
British physicians and patients are now being forcefully warned, for many more drugs than American physicians or patients, about potentially serious, clinically important drug interactions between the unregulated herbal St. John's Wort (Hypericum perforatum) and a large number of prescription drugs.