‘Medicines to avoid in 2023’ list published by French medical review

The annual list of medicines that people should avoid in France has been published by the specialist journal Prescrire, with the drugs judged to offer more risks than benefits.

The journal has published an updated list in France every year for 12 years. A panel of health professionals helps to create the final recommendations, which are reevaluated annually.

This year, the list is of 107 medicines that are considered either ineffective, or too dangerous for health. Of these, 88 are still sold in France.

People taking the medicines, or who are offered them by doctors, are advised to seek replacements.

Read more: Why are ‘medicines to avoid’ allowed to stay in circulation in France?

The journal stated: “Some medicines have been added, others have been removed, either because their marketing has been stopped by a decision of the company or a health authority, or because Prescrire is re-examining their benefit-risk balance, which may be modified by new data currently being analysed.”

Prescrire has no authority to remove drugs from sale or use, but its recommendations are considered reliable and trustworthy.

Read also: Levothyrox France: National medicines agency investigated

On the list

A range of drugs for the common cold, coughs, and sore throats are on the list, as they are every year. These include Dolirhume, the Actifed range, and Humex Rhume, as well as Maxilase and Biocalyptol.

Three new products have also been added to the list. They are:

• Palforzia - A peanut seed powder, intended to help "desensitisation in case of peanut allergy". However, the review found that in practice, this drug tends to "increase the frequency of allergic reactions in everyday life".

• Roxadustat, sold under the brand name ‘Evrenzo’ - This drug is usually prescribed to treat "anaemia related to chronic liver failure". However, Prescrire said that the drug is not more effective than usual treatments of anaemia, “has more severe side effects”, and even “appears to increase mortality in some patients”.

• Tincture of Opium (also known as Dropizol) - Described as a “soup” of various poppy constituents, this medicine is generally used to cure severe diarrhoea. However, Prescrire said that it is “no more effective than Loperamide, another marketed opioid for this situation”.

Also added to the list is nintedanib, which had previously been taken off the list in 2021.

It is used to treat "certain non-small cell bronchial cancers" (with a drug called Vargatef) as well as "certain chronic lung infections" (with another drug called Ofev).

However, Prescrire said: "The analysis of the clinical evaluation data showed that the benefit-risk balance of nintedanib is unfavourable. It is therefore once again among the drugs to be ruled out.”

Also on the list are oral aceclofenac (Cartrex or other) and diclofenac (Voltarene or other).

Prescrire said: “These products are associated with increased adverse cardiovascular events (including myocardial infarction, heart failure) and cardiovascular deaths compared with other equally effective non-steroidal anti-inflammatory drugs.”

Off the list

• Idebenone (sold under the name Raxone) - Prescrire is reassessing its benefit-risk balance to treat cases of Leber hereditary optic neuropathy.

• Teriflunomide (sold under the name Aubagio). An immunosuppressant authorised for use in multiple sclerosis. Prescrire is evaluating its benefit-risk balance when used for children aged 10 and over.

The full list of medicines to avoid, and Prescrire’s evaluation methodology, can be found and downloaded here (in French) from the Prescrire website.

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