Worst Pills, Best Pills

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

aspirin (AGGRENOX, DURLAZA, EASPRIN, ECOTRIN, EMPIRIN, EXCEDRIN [MIGRAINE], GENUINE BAYER ASPIRIN, LANORINAL, VAZALORE)


E-ALERTS

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


DISEASE AND DRUG FAMILY INFORMATION

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

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.
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.
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.
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.
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.

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.

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, ELYXYB); 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.
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.
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.
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.

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.

Lecanemab for Alzheimer’s Disease: Do Not Use
October 2023
The FDA recently approved lecanemab (LEQEMBI) for patients with mild cognitive impairment and in the mild dementia stages of the disease. Learn why Public Citizen’s Health Research Group has classified lecanemab as a Do Not Use drug.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Adverse Drug Reactions Cause 1.4 Million Emergency Room Visits in 2004 and 2005
January 2007
An estimated 701,547 patients were treated for adverse drug reactions in emergency rooms each year in 2004 and 2005, totaling 1.4 million visits to the emergency room. Of these, an estimated 117,318 patients were hospitalized each year. According to the study. 18 drugs were each, either independently or in combination with other drugs, implicated in one percent or more of the estimated adverse drug events. These drugs are listed in the table that accompanies this article along with the annual estimates of adverse drug events.
Glucosamine and Chondroitin for Knee Arthritis - Still No Evidence of Effectiveness
May 2006
In the most rigorous study to date, there was no evidence of effectiveness for glucosamine, chondroitin or the two together. We continue to recommend against the use of these unregulated supplements.
FDA Public Health Advisory - Arthritis Drug Valdecoxib (BEXTRA) Removed From Market; Major New Warnings for Other NSAIDs
June 2005
If you are currently taking celecoxib (CELEBREX)you should contact your physician to consider alternative NSAID treatment.
Serious GI Toxicity With The Heart Drug Clopidogrel (PLAVIX)
March 2005
If you are now taking clopidogrel and do not have a severe allergy to aspirin, contact your doctor and discuss switching from clopidogrel to low dose aspirin plus a PPI.
Cutting Your Drug Bill While Reducing Your Risk Of Avoidable Adverse Drug Reactions: Six Examples
February 2005
This article will look at the potential savings for the individual consumer if the alternative treatments recommended in Worst Pills, Best Pills were used for six DO NOT USE drugs. All six are listed in the Drug Topics Magazine Top 200 selling drugs in U.S. in 2003. The drugs are: celecoxib (CELEBREX) used for arthritis and pain; the Alzheimer’s disease drug donepezil (ARICEPT); drospirenone with ethinyl estradiol (YASMIN 28), an oral contraceptive; esomeprazole (NEXIUM) the “new purple pill” for heartburn; montelukast (SINGULAIR), a drug approved for both asthma and hay fever; and valdecoxib (BEXTRA), an arthritis drug very similar to celecoxib.The combined sales of these six DO NOT USE drugs was $8.1 billion with more that 75 million prescriptions dispensed in 2003.
Blockbuster Arthritis Drug Rofecoxib (VIOXX) Withdrawn From Market
November 2004
Vioxx is the ninth prescription drug to be taken off the market in the past seven years that Worst Pills, Best Pills News readers were previously warned DO NOT USE. The average time between warning readers not to use these drugs and their removal from the market was one year and eight months.

ADDITIONAL INFORMATION FROM PUBLIC CITIZEN

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

Bextra Ban a Good Step, But FDA Should Pull Celebrex Too (HRG Publication #1734)
Statement of Sidney M. Wolfe, M.D., Director, Public Citizen's Health Research Group
Petition to remove the Cox-2 Inhibitors Celecoxcib (CELEBREX) and Valdecoxcib (BEXTRA) From the Market (HRG Publication #1720)
Petition to remove the Cox-2 Inhibitors Celecoxcib (CELEBREX) and Valdecoxcib (BEXTRA) From the Market (HRG Publication #1720)
Vioxx, Other “Super Aspirins” Are Super Disasters – Other Cox-2 Alternatives Have Safety Problems Too (HRG Publication #1707)
Today’s announcement by Merck is the latest evidence that this family of drugs, the Cox-2 inhibitors, once referred to as “super aspirins,” are turning out to be more like super disasters.
Testimony before the FDA Arthritis Drugs Advisory Committee on the Nonsteroidal Anti-Inflammatory Drugs Celecoxib and Rofecoxib (HRG Publication #1555)
A second box warning about cardiovascular toxicity needs to be added. It should warn of the lack of platelet aggregation inhibition of the drugs which protects those at risk from an increased occurrence of heart attacks. In addition, the evidence which is rapidly accumulating about the heart damage caused by these drugs must be mentioned in this cardiovascular box warning.
Statement before the Food and Drug Administration's Arthritis Drugs Advisory Committee on the nonsteroidal anti-inflammatory drug celexocib. (HRG Publication #1465)
There needs to be clear evidence from comparative long-term, higher dose randomized trials in which celecoxib or any other COX-2 type of anti-inflammatory drug is compared to the least dangerous of these older drugs, ibuprofen, that there is a statistically significantly lower amount of serious GI complications such as perforations, ulcers or bleeding with the COX-2 inhibitor drug.