Every year since 2013, the medical journal Prescribe publishes the black list of drugs to be avoided “for better treatment”.
Medicines having an “unfavorable benefit-risk balance in all clinical situations included in the marketing authorization”, she explains in the preamble.
“The assessment (between 2010 and 2024, Editor's note.) documentedly identifies drugs that are more dangerous than useful, with the aim of helping to choose quality care, not harming patients and avoiding disproportionate harm. », continues Prescribe.
Common, but effective?
In the 2025 list, which it has just revealed in its latest issue, we find 106 marketed in Europe, including 88 accessible in France, classified by therapeutic area.
In the midst of these treatments for cancer, arrhythmia or alopecia, the surprise comes from these (almost) everyday medications used for coughs, diarrhea or nausea. Common but effective? With what side effects?
Against cough: sedative effects, anaphylactic reactions or heart problems
Oxomemazine (Toplexil or other): its action against dry or wet coughs would be “nothing” compared to its strong sedative effects. Photo illustration Original Frank/Pixabay
It is a syrup intended to relieve wet or dry coughs, often prescribed, particularly for cases of bronchitis. According to the balance sheet of Prescribe, oxomemazine (Toplexil or other) would expose one to “disproportionate adverse effects”, that is to say a strong sedative effect.
Basically, drinking a herbal tea made from lemon, ginger and honey would be just as effective, minus the falling asleep, which is dangerous in certain circumstances.
Other products affected? Ambroxol (Muxol or other) and Bromhexine (Bisolvon) dedicated to thinning mucus which “have no demonstrated clinical effectiveness beyond that of a placebo”. And which would expose some to anaphylactic reactions or serious skin reactions.
Finally, we find the pentoxyvérine (Pentoxyvérine Clarix 0,15%)a centrally acting cough suppressant which may cause heart problems and serious allergic reactions.
Against intestinal disorders: natural lead pollution in medicated clays
Photo illustration MabelAmber/Pixabay
These are small sachets that are very often found in travel kits to fight, among other things, against tourists. Inside, medicated clays which, according to Prescribeshould be excluded because of their natural lead pollution.
Are concerned the diosmectite (Smecta or other), l’hydrotalcite (Rennieliquo), monmectite (Bedelix, and in combination with Gelox) and the kaolin (in combination in Gastropax).
On the one hand, in the case of diarrhea, clays would modify the appearance of the stools without really acting on water loss and the risk of dehydration.
On the other, the natural presence of lead, which has neurological, hematological, renal and cardiovascular toxic effects. A negative benefit-risk balance which invites us to dismiss them.
Against nausea: cardiovascular problems
They are prescribed for nausea and vomiting. Yes, but droperidol (Droleptan or other) and metopimazine (Vogalene, Vogalib or other) would expose you to heart rhythm disorders, strokes and sudden deaths. “Effects disproportionate to the symptoms treated and their low effectiveness”, according to Prescribe.
Used against gastric reflux, domperidone (Domperidone Biogaran and others) is also included.
The particular case of Phloroglucinol (Spasfon)
Photo illustration Pixabay
The phloroglucinol ? That probably doesn't mean much to you… This is the generic form of a medication that many people know: Spasfon.
Although it is not included in the 2025 blacklist, Prescribe chose to give it a separate box.
Already scratched in 2023 by teacher-researcher Juliette Ferry-Danini in her book Pink pills: ignorance in medicinethis antispasmodic very popular with the French, but especially among French women against menstrual pain, is the subject of a certain circumspection.
“Its symptomatic effectiveness on recurrent benign intestinal disorders is uncertain. In other clinical situations, there is nothing to expect from phloroglucinol beyond the effectiveness of a placebo”, indicates the review, before focusing on the notable risks it poses to health.
Its main side effects concern allergic reactions, including “rare Lyell syndromes (ulcerative lesions affecting all mucous membranes, scales and a rash), and a poorly understood teratogenic risk*”.
This is why she advises avoiding it for women who are pregnant or who could become pregnant, and avoiding taking phloroglucinol for self-medication, which is unfortunately very commonplace in France.
*Teratogenic means “which can have an action on the embryo or fetus”.
To find the complete list of medications to avoid for better care in 2025, consult the latest issue of Prescribe.
What are the criteria?
In its classification, the journal Prescribe indicates that the drugs listed are:
-Medications with demonstrated effectiveness but which exposes people to disproportionate risks in relation to the benefits they bring.
-Medicines old ones whose use is outdated because other, more recent medications have a more favorable benefit-risk balance.
-Medicines recent ones whose benefit-risk balance turns out to be less favorable than that of older drugs.
-Medicines whose effectiveness is not proven beyond that of a placeboand which expose one to particularly serious adverse effects.
