Prescrire 2026: 108 Medications to Avoid – Risks & Alternatives

The “2026 Report” identifies 106 drugs (89 of which are marketed in France) with an unfavorable benefit-risk balance across all clinical situations outlined in their approved labeling. Identifying medications that pose greater risks than advantages is crucial for informed medical decision-making and patient safety.

These medications fall into several categories:

• Drugs with demonstrated efficacy but carrying risks that outweigh the benefits.
• Older medications whose use is now outdated due to the availability of newer drugs with a more favorable benefit-risk profile.
• Recently approved drugs with a less favorable benefit-risk balance compared to older alternatives.
• Drugs whose efficacy is no better than a placebo, yet still carry the potential for serious adverse effects.

Changes from the 2025 Report

The 2026 report reflects several changes compared to the 2025 report.

• Four drugs have been added to the list: andexanet alfa (Ondexxya), chondroitin (Chondrosulf or other), fezolinetant (Veoza), and gefapixant (Lyfnua).
• Two drugs have been removed: obeticholic acid (formerly Ocaliva) due to its market withdrawal, and piracetam (Nootropyl or other) as data suggests a possible, though uncertain, clinical benefit in a rare condition (cortical myoclonies).

2026 List of 106 “Drugs Providing More Harm Than Benefit”

The risks associated with these medications and preferable alternatives are detailed in a PDF document: Pour mieux soigner : des médicaments à écarter – Bilan 2026.

(To check if a specific medication is on this list, use the CTRL+F keys [simultaneously] to activate the search function. Use the active molecule name rather than the brand name.)

Oncology – Transplantation – Hematology

• Defibrotide (Defitelio), an antithrombotic authorized for severe hepatic veno-occlusive disease related to hematopoietic stem cell transplantation.

Antitumorals

• Mifamurtide (Mepact), not marketed in France
• Nintedanib (Vargatef), not marketed in France
• Panobinostat (Farydak)
• Roxadustat (Evrenzo)
• Trabectedine (Yondelis)
• Vandetanib (Caprelsa)
• Vinflunine (Javlor)

Cardiology

• Aliskiren (Rasilez, not marketed in France), an antihypertensive renin inhibitor.
• Andexanet alfa (Ondexxya, not marketed in France)
• Bezafibrate (Befizal), a cholesterol-lowering agent.
• Ciprofibrate (Lipanor or other, not marketed in France), a cholesterol-lowering agent.
• Dronedarone (Multaq), an antiarrhythmic.
• Fenofibrate (Lipanthyl or other), a cholesterol-lowering agent.
• Ivabradine (Procoralan), an inhibitor of the cardiac If current.
• Nicorandil (Ikorel, Adancor or other), a vasodilator.
• Olmesartan (Alteis, Olmetec; and associated with hydrochlorothiazide in Alteisduo, Coolmetec; and associated with amlodipine in Axeler, Sevikar), an antihypertensive from the angiotensin II receptor blocker (ARB) class.
• Ranolazine (Ranexa, not marketed in France), an anti-anginal medication.
• Trimethazidine (Vastarel or other), a substance with uncertain properties used for angina.
• Vernakalant (Brinavess, not marketed in France), an injectable antiarrhythmic.

Dermatology – Allergology

• Finasteride 1mg (Finasteride Arrow Lab or other), a 5-alpha reductase inhibitor for male pattern baldness.
• Mequitazine (Primalan), an antihistamine H1 with “sedative” and “anticholinergic” properties for allergies.
• Pimecrolimus topical (Elidel, not marketed in France), an immunosuppressant for atopic dermatitis.
• Promethazine injectable (Phénergan), an antihistamine H1 for severe urticaria.
• Peanut proteins (Palforzia), desensitization for peanut allergy.
• Tacrolimus topical (Protopic or other), an immunosuppressant for atopic dermatitis.

Diabetology – Nutrition

Diabetes

Weight Loss

“As of late 2024, no medication allows for sustainable weight loss without risk. The focus should be on modifications to physical activity and diet, with psychological support if needed.”

Pain – Rheumatology

Certain Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

• The coxibs:

  • Celecoxib (Celebrex or other)
  • Etoricoxib (Arcoxia or other)
  • Parecoxib (Dynastat)
• Aceclofenac (Cartrex or other) oral
• Diclofenac (Voltarène or other) oral
• Ketoprofen gel (Ketum gel or other)
• Meloxicam (Mobic or other) systemic
• Piroxicam (Feldene or other) systemic
• Tenoxicam (Tilcotil) systemic

See what side effects are associated with these NSAIDs: 18 Pain and Rheumatology Drugs More Dangerous Than Useful (Risks and Alternatives – Prescrire).

Also see, according to Prescrire: First-Choice Drugs for Moderate Nociceptive Pain (2017) and Which Drugs to Choose for Pain (2015).

Osteoarthritis

• Chondroitin (Chondrosulf or other)
• Diacerein (Art 50 or other)
• Glucosamine (Flexea or other)

See: Drugs for Osteoarthritis: Little or No Efficacy and Side Effects (Prescrire, 2015)

Muscle Relaxants

• Mephenesin oral (Décontractyl) and mephenesin-based ointment (Décontractyl balm), not marketed in France
• Methocarbamol (Lumirelax)
• Thiocolchicoside (Miorel or other)

Osteoporosis

Various

• Capsaicin patches (Qutenza), for neuropathic pain
• Colchicine + opium powder + thiemonium association (Colchimax)
• Quinine (Hexaquine, Okimus), for cramps

See: 18 Pain and Rheumatology Drugs More Dangerous Than Useful According to Prescrire (Risks and Alternatives)

Gastroenterology

• • Diosmectite (Smecta or other)
  • Hydrotalcite (Rennieliquo)
  • Beidellitic montmorillonite alias monmectite (Bedelix, or in association in Gelox)
  • Kaolin (in association in Gastropax)
• Domperidone (Motilium, Peridys, Oroperidys and generics), a neuroleptic, for gastroesophageal reflux.
• Droperidol (Droleptan or other), a neuroleptic, for gastroesophageal reflux.
• Metopimazine (Vogalène, Vogalib), a neuroleptic.
• Prucalopride (Resolor), related to neuroleptics, for chronic constipation.
• Opium tincture (Dropizal), for severe diarrhea.
• Glyceryl trinitrate 0.4% ointment (Rectogesic), a nitrated derivative authorized for anal fissures.

Gynecology – Endocrinology

• Fezolinetant (Veoza)
• Tibolone (Livial), a synthetic steroid for hormone replacement therapy in menopause.

Infectiology

• Moxifloxacin (Izilox or other), an antibiotic.

Neurology

Alzheimer’s Disease

• Donepezil (Aricept or other)
• Galantamine (Reminyl or other)
• Rivastigmine (Exelon or other)
• Memantine (Ebixa or other)

See: Alzheimer’s Drugs to Avoid According to Prescrire (2015).

Multiple Sclerosis

See: Multiple Sclerosis: Drug That Should Not Have Been Authorized, the One to Prefer, Those to Avoid (Prescrire, 2018).

Various

• Fenfluramine (Fintepla), an amphetamine authorized as an adjunct to antiepileptic treatment.
• Flunarizine (Sibelium), not marketed in France, a neuroleptic, for migraine.
• Ginkgo biloba (Tanakan or other), cognitive impairment in the elderly.
• Naftidrofuryl (Naftilux), a “vasodilator” authorized for intermittent claudication.
• Oxetorone (Nocertone), a neuroleptic, for migraine.
• Tolcapone (Tasmar), antiparkinsonian.

Pulmonology, ENT

Cough

• Ambroxol (Muxol or other), a mucolytic.
• Bromhexine (Bisolvon), a mucolytic.
• Gefapixant (Lyfnua)
• Oxomemazine (Toplexil or other), a sedative and anticholinergic H1 antihistamine from the phenothiazine group with neuroleptic properties.
• Pentoxyverine (Vicks pectoral syrup 0.15%; Clarix dry cough pentoxyverine 0.15%), a centrally acting antitussive.

Sore Throat

See: Which Drug for Sore Throat? – Prescrire

Various

• Epinephrine, a sympathomimetic vasoconstrictor.
• Naphazoline, a sympathomimetic vasoconstrictor nasal decongestant.
• Oxymetazoline, a sympathomimetic vasoconstrictor nasal decongestant.
• Phenylephrine, a sympathomimetic vasoconstrictor nasal decongestant.
• Pseudoephedrine (Actifed Rhume, Dolirhume, Humex Rhume, Rhinadvil Rhume), a sympathomimetic vasoconstrictor nasal decongestant.
• Tuaminoheptane, a sympathomimetic vasoconstrictor nasal decongestant.
• Xylometazoline, a rhinopharyngeal decongestant not marketed in France.
• Mannitol inhaled (Bronchitol), a mucolytic, not marketed in France.
• Nintedanib (Ofev)
• Roflumilast (Daxas), an anti-inflammatory, chronic obstructive pulmonary disease, not marketed in France.

Psychiatry, Addiction

Antidepressants

See what side effects are associated with these antidepressants: Eight Antidepressants to Avoid According to Prescrire.

Antidepressants: Some Warnings from Prescrire

Other Psychotropics

• Dapoxetine (Priligy)
• Etifoxine (Stresam), anxiety.

Smoking Cessation

Urology

• Pentosan polysulfate oral (Elmiron), painful bladder syndrome.

In a PDF document, Prescrire details the reasons for the negative assessment of each of these drugs and preferable alternatives.

For more information on medications, see the links below.

Psychomédia with source: Prescrire.
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