The blacklist of drugs to avoid in 2025

Every year, the medical journal Prescrire updates its review of medications to avoid. For this 13^e edition, six new drugs have been added to the 2025 blacklist because the adverse effects to which they expose are either disproportionate to their low effectiveness, or because other less dangerous options exist.

Among the main developments between the 2024 report and the 2025 report, Prescrire notes:

• the return of fenfluramine (Fintepla) among the drugs to be excluded. Authorized in severe forms of epilepsy in children, it had been removed from the list of drugs to be excluded in 2024 in order to assess its benefit-risk balance in a new indication: Lennox-Gastaut syndrome. Analysis of clinical evaluation data showed that, in this situation too, the benefit-risk balance of fenfluramine is unfavorable;
• the addition to the balance sheet of reboxetine (not marketed in France). It is an inhibitor of the reuptake of noradrenaline and, more weakly, of serotonin which seems less effective than other antidepressants although it exposes people to atropinic side effects, sexual disorders, loss of appetite;
• the addition of Phloroglucinol, indicated in the treatment of spasmodic pain of the intestine, bile ducts, bladder and uterus. Its main adverse effects are allergic reactions, including rare Lyell syndromes, and a poorly understood teratogenic risk. Its symptomatic effectiveness on recurrent benign intestinal disorders is uncertain.

In total, the black list established by Prescrire 2024 contains 106 drugs not recommended, of which 88 are marketed in France.

Oncology Transplants – Hematology

Defibrotide (Defitelio), mifamurtide (Mepact – not marketed in France), nintedanib (Vargatef° – not marketed in France), panobinostat (Farydak), roxadustat (Evrenzo°), trabectedin (Yondelis), vandetanib (Caprelsa), vinflunine (Javlor).

Cardiology

Aliskiren (Raziren – not marketed in France), bezafibrate (Befizal), dronedarone (Multaq), ivabradine (Procoralan or other), nicorandil (Ikorel or other), olmesartan (Alteis, Olmetec; and associated with hydrochlorothiazide in Alteisduo, Coolmetec and associated with amlodipine in Axeler, Sevikar), ranolazine (Ranexa – not marketed in France), trimetazidine (Vastarel or other), vernakalant (Brinavess – not marketed in France).

Dermatology-allergology

Finasteride 1 mg (Propecia or other), mequitazine (Primalan), pimecrolimus (Elidel – not marketed in France), Palforzia peanut seed powder, Phloroglucinol, injectable promethazine (Phenergan).

Diabetology-Nutrition

For diabetes, we find:

Weight loss

• the bupropione + naltrexone combination (Mysimba° – not marketed in France);
• orlistat (Xenical° or other).

Pain – Rheumatology

Nonsteroidal anti-inflammatory drugs (NSAIDs) have a common side effect profile, but some pose fewer risks than others. When paracetamol is not sufficient, the least risky options are ibuprofen and naproxen (Naprosyne° or other), provided you control the dosage and avoid taking it continuously.

Certain nonsteroidal anti-inflammatory drugs :

Aceclofenac (Cartrex or other), diclofenac (Voltarene or other), celecoxib (Celebrex or other), etoricoxib (Arcoxia or other) and parecoxib (Dynastat), ketoprofen gel (Ketum gel or other) , the meloxicam (Mobic or other), the piroxicam (Feldène or other) and tenoxicam (Tilcotil).

Osteoarthritis

Diacerein (Art 50 or other), glucosamine (Flexea or other)

“Muscle relaxant” medications

Oral mephenesin (Décontractyl° – not marketed in France), methocarbamol (Lumirelax°), thiocolchicoside (Miorel° or other).

Osteoporosis

Denosumab dosed at 60 mg (Prolia), romosozumab (Evenity – not marketed in France).

Divers

Capsaicin in patches (Qutenza°), the combination of colchicine + opium powder + tiemonium in the specialty Colchimax, quinine

Gastroenterology

Obeticholic acid (Ocaliva), diosmectite (Smecta or other), hydrotalcite (Rennieliquo), beidellitic montmorillonite aka monmectite (Bedelix, and in combination in Gelox) and kaolin (in combination in Gastropax), domperidone ( Motilium or other), droperidol (Droleptan or other) and metopimazine (Vogalene, Vogalib), prucalopride (Resolor), tincture of opium (Dropizal°), glyceryl trinitrate ointment 0.4% (Rectogésic).

Gynecology – Endocrinology

Tibolone (Livial° or other)

Infectiology

Moxifloxacin (Izilox or other)

Neurology

Alzheimer's disease

Donepezil (Aricept or other), galantamine (Reminyl or other), rivastigmine (Exelon or other), memantine (Ebixa or other)

Multiple sclerosis

alemtuzumab (Lemtrada – not marketed in France), natalizumab (Tysabri), teriflunomide (Aubagio)

Divers

Fenfluramine (Fintepla°), flunarizine (Sibelium) and oxétorone (Nocertone), Ginkgo biloba, naftidrofuryl (Naftilux or others), piracétams (Nootropyl or others), tolcapone (Tasmar)

Pneumology – ENT

Antitussifs

Ambroxol (Muxol or other), bromhexine (Bisolvon), oxomemazine (Toplexil or other), pentoxyverine (Clarix dry cough pentoxyverine 0.15%).

Sore throat

Alpha-amylase (Maxilase° or other)

Divers

Various other medications used in pulmonary or ENT disorders should be avoided.

Oral or nasal decongestants (ephedrine, naphazoline, oxymetazoline, pseudoephedrine, tuaminoheptane; phenylephrine and xylometazoline (not marketed in France), inhaled mannitol (Bronchitol° – not marketed in France), nintedanib (Ofev°), roflumilast (Daxas° – not marketed in France)

Inhaled mannitol (Bronchitol – not marketed in France), roflumilast (Daxas – not marketed in France).

Psychiatry – Addictions

Depression medications

Agomelatine (Valdoxan or other), citalopram (Seropram or other) and escitalopram (Seroplex or other), duloxetine (Cymbalta or other), milnacipran (Milnacipran Arrow or other) and venlafaxine (Effexor LP or other ), esketamine nasal spray solution (Spravato), tianeptine (Stablon or other)

Other psychotropic drugs

The dapoxetine (Priligy), the etifoxine (Stresam)

Smoking cessation

Bupropione (Zyban)

urologists

Oral polysulfate pentosans (Elmiro