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Through Anne-Sophie Blot
Published on
It has become a highly anticipated list. For nine years now, the magazine To prescribe publishes a report on drugs “to be discarded better care “. And for 2021, 112 drugs, of which 93 marketed in France, are judged “More dangerous than useful”.
Each year, the independent review adds and removes drugs from this list, developed by desk research and collective analysis. Target : evaluate the risk / benefit ratio of any treatment, whether it is old or recent drugs, and based on follow-up evaluations, both on adverse effects and on drug efficacy data.
This year, some drugs for diabetes return to the list, others like finasteride (Propecia, against baldness in humans) make their entrance and three substances have been removed. Let’s take stock.
Propecia, Nootropyl: too many side effects for little effectiveness
Among the new drugs added to this blacklist, two are pinned because their adverse effects are “disproportionate to their poor efficacy or the benignity of the clinical situation in which they are licensed,” he explains. To prescribe.
This is on the one hand finastéride 1 mg, better known as Propecia (but not only), prescribed in androgenetic alopecia in men, in other words the moderate hair loss.
Not only does this treatment only slightly increase hair density, “by about 10%”, but the list of its side effects is long: sexual disorders (erection and ejaculation disorders, decreased libido), mental disorders (depression, suicidal thoughts) and sometimes breast cancer. Local minoxidil (Alostil or other) can be an alternative.
On the other hand, the piracetam, notably sold under the name Nootropyl, in various clinical situations: dizziness, cognitive and sensorineural deficits in the elderly, dyslexia in children and myoclonus of cortical origin.
In these situations, piracetam does not have a proven clinical efficacy, but exposes itself to bleeding, nervousness, agitation, weight gain.
Spravato, Elidel, Mobic – other options are preferable
In addition, Prescirsi identifies several drugs that have “some effectiveness but their side effects are disproportionate or other less dangerous options exist”.
In this category we find:
- esketamine nasal spray solution (Right) in the so-called resistant depressions: very uncertain efficacy; frequent neuropsychic side effects; consult your doctor to think about alternatives.
- the pimécrolimus (Elidel) in atopic eczema: this drug, not marketed in France, exposes people to skin cancers and lymphomas.
- the romosozumab (Evenity) in severe postmenopausal osteoporosis: this drug, not marketed in France, may expose women to an increased cardiovascular risk.
- the meloxicam (Mobic or other), piroxicam (Feldene) and the tenoxicam (Tilcotil): these non-steroidal anti-inflammatory drugs expose you to further digestive and skin disorders; It is better to give preference to ibuprofen and naproxen, in small doses and for a short time.
Return of glyphozins to avoid drugs for diabetes
After being removed from the blacklist in late 2019, To prescribe reports a good ten hypoglycemic agents from the family of glyphosate, used in Type 2 diabetes.
The review explains that since the marketing authorization issued by the European Union in the mid-2010s, the “unfavorable risk-benefit balance” of these treatments has been confirmed, in particular for:
- canagliflozin (Invokana; and combined with metformin in Vokanamet)
- dapagliflozin (Forxiga; combined with metformin in Xigduo; and combined with saxagliptin in Qtern)
- empagliflozin (Jardiance; combined with metformin in Synjardy; and combined with linagliptin in Glyxambi)
- ertugliflozin (Steglatro; combined with metformin in Segluromet; and combined with sitagliptin in Steglujan).
Drugs withdrawn from the market
Finally, To prescribe indicates that three drugs have been withdrawn from the previous list: ulipristal dosed at 5 mg (Esmya) because withdrawn from the market, nifuroxazide (Panfurex or other) which should no longer be marketed in France and nintedanib (Ofev in pulmonology, Vargatef in cancer) because the magazine is re-evaluating it.
The complete 2021 list of 112 drugs to be discarded, classified by therapeutic area, can be viewed below or downloaded in the PDF file for download at the bottom of this page.
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