Eight Drugs Doctors Wouldn't Take
Are These Drugs Dangerous?
If they won't use these medications, why should you?
With 3,480 pages of fine print, the Physicians' Desk Reference (a.k.a. PDR) is not a quick read. That's because it contains every iota of information on more than 4,000 prescription medications. Heck, the PDR is medication -- a humongous sleeping pill.
Doctors count on this compendium to help them make smart prescribing decisions -- in other words, to choose drugs that will solve their patients' medical problems without creating new ones. Unfortunately, it seems some doctors rarely pull the PDR off the shelf. Or if they do crack it open, they don't stay versed on emerging research that may suddenly make a once-trusted treatment one to avoid. Worst case: You swallow something that has no business being inside your body.
Dangerous Drugs
Courtesy of Men's Health
With 3,480 pages of fine print, the Physicians' Desk Reference (a.k.a. PDR) is not a quick read. That's because it contains every iota of information on more than 4,000 prescription medications. Doctors count on this compendium to help them make smart prescribing decisions -- in other words, to choose drugs that will solve their patients' medical problems without creating new ones. Unfortunately, it seems some doctors rarely pull the PDR off the shelf. Or if they do crack it open, they don't stay versed on emerging research that may suddenly make a once-trusted treatment one to avoid.
Of course, plenty of M.D.'s do know which prescription and over-the-counter drugs are duds, dangers, or both. So we asked them, "Which medications would you skip?" Their list is your second opinion. If you're on any of these meds, talk to your doctor.
Advair
It's asthma medicine . . . that could make your asthma deadly. Advair contains the long-acting beta-agonist (LABA) salmeterol. A 2006 analysis of 19 trials, published in the Annals of Internal Medicine, found that regular use of LABAs can increase the severity of an asthma attack. Because salmeterol is more widely prescribed than other LABAs, the danger is greater -- the researchers estimate that salmeterol may contribute to as many as 5,000 asthma-related deaths in the United States each year. In 2006, similarly disturbing findings from an earlier salmeterol study prompted the FDA to tag Advair with a "black box" warning -- the agency's highest caution level.
Avandia
Diabetes is destructive enough on its own, but if you try to control it with rosiglitazone -- better known by the brand name Avandia -- you could be headed for a heart attack. Last September, a Journal of the American Medical Association (JAMA) study found that people who took rosiglitazone for at least a year increased their risk of heart failure or a heart attack by 109 percent and 42 percent, respectively, compared with those who took other oral diabetes medications or a placebo. The reason? While there have been some reports that Avandia use may cause dangerous fluid retention or raise artery-clogging LDL cholesterol, no one is sure if these are the culprits. That's because the results of similar large studies have been mixed. So the FDA has asked GlaxoSmithKline, the maker of Avandia, to conduct a new long-term study assessing users' heart risks. There's only one problem: The study isn't expected to start until later this year.
Celebrex
Once nicknamed "super aspirin," Celebrex is now better known for its side effects than for its pain-relieving prowess. The drug has been linked to increased risks of stomach bleeding, kidney trouble, and liver damage. But according to a 2005 New England Journal of Medicine study, the biggest threat is to your heart: People taking 200 mg of Celebrex twice a day more than doubled their risk of dying of cardiovascular disease. Those on 400 mg twice a day more than tripled their risk, compared with people taking a placebo.
Ketek
This antibiotic, which has traditionally been prescribed for respiratory-tract infections, carries a higher risk of severe liver side effects than similar antibiotics do. "Ketek can cause heart-rhythm problems, can lead to liver disease, and could interact poorly with other medications you may be taking," says Dr. Rodgers. "Unfortunately, it's still available, and although many doctors are aware of the risks, some may still prescribe it without caution." In February 2007, the FDA limited the usage of Ketek to the treatment of pneumonia.
Prilosec and Nexium
Heartburn can be uncomfortable, but heart attacks can be fatal, which is why the FDA has investigated a suspected link between cardiac trouble and the acid-reflux remedies Prilosec and Nexium. In December 2007, the agency concluded that there was no "likely" connection. Translation: The scientific jury is still out. In the meantime, there are other reasons to be concerned. Because Prilosec and Nexium are proton-pump inhibitors, they are both incredibly effective at stopping acid production in the stomach -- perhaps too effective. A lack of acid may raise your risk of pneumonia, because the same stuff that makes your chest feel as if it's burning also kills incoming bacteria and viruses. You may also have an elevated risk of bone loss -- in the less acidic environment, certain forms of calcium may not be absorbed effectively during digestion. "The risk of a fracture has been estimated to be over 40 percent higher in patients who use these drugs long-term, and the risk clearly increases with duration of therapy," says Dr. Rodgers.
Visine Original
What possible harm to your peepers could come from these seemingly innocuous eyedrops? "Visine gets the red out, but it does so by shrinking blood vessels, just like Afrin shrinks the vessels in your nose," says Thomas Steinemann, M.D., a spokesman for the American Academy of Ophthalmology. Overuse of the active ingredient tetrahydrozoline can perpetuate the vessel dilating-and-constricting cycle and may cause even more redness.
Pseudoephedrine
Forget that this decongestant can be turned into methamphetamine. People with heart disease or hypertension should watch out for any legitimate drug that contains pseudoephedrine. See, pseudoephedrine doesn't just constrict the blood vessels in your nose and sinuses; it can also raise blood pressure and heart rate, setting the stage for vascular catastrophe. Over the years, pseudoephedrine has been linked to heart attacks and strokes. "Pseudoephedrine can also worsen symptoms of benign prostate disease and glaucoma," says Dr. Rodgers.
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Of course, plenty of M.D.'s do know which prescription and over-the-counter drugs are duds, dangers, or both. So we asked them, "Which medications would you skip?" Their list is your second opinion. If you're on any of these meds, talk to your doctor. Maybe he or she will finally open that big red book with all the dust on it.
Advair
It's asthma medicine . . . that could make your asthma deadly. Advair contains the long-acting beta-agonist (LABA) salmeterol. A 2006 analysis of 19 trials, published in the Annals of Internal Medicine, found that regular use of LABAs can increase the severity of an asthma attack. Because salmeterol is more widely prescribed than other LABAs, the danger is greater -- the researchers estimate that salmeterol may contribute to as many as 5,000 asthma-related deaths in the United States each year. In 2006, similarly disturbing findings from an earlier salmeterol study prompted the FDA to tag Advair with a "black box" warning -- the agency's highest caution level.
YOUR NEW STRATEGY: No matter what you may have heard, a LABA, such as the one in Advair, is not the only option, says Philip Rodgers, Pharm.D., a clinical associate professor at the University of North Carolina school of pharmacy. For instance, if you have mild asthma, an inhaled corticosteroid such as Flovent is often all you need. Still wheezing? "Patients can also consider an inhaled corticosteroid paired with a leukotriene modifier," says Dr. Rodgers. This combo won't create dangerous inflammation, and according to a Scottish review, it's as effective as a corticosteroid-and-LABA combo.
Avandia
Diabetes is destructive enough on its own, but if you try to control it with rosiglitazone -- better known by the brand name Avandia -- you could be headed for a heart attack. Last September, a Journal of the American Medical Association (JAMA) study found that people who took rosiglitazone for at least a year increased their risk of heart failure or a heart attack by 109 percent and 42 percent, respectively, compared with those who took other oral diabetes medications or a placebo.
The reason? While there have been some reports that Avandia use may cause dangerous fluid retention or raise artery-clogging LDL cholesterol, no one is sure if these are the culprits. That's because the results of similar large studies have been mixed. So the FDA has asked GlaxoSmithKline, the maker of Avandia, to conduct a new long-term study assessing users' heart risks. There's only one problem: The study isn't expected to start until later this year.
YOUR NEW STRATEGY: Stick with a proven performer. "I prefer metformin, an older, cheaper, more dependable medication," says Sonal Singh, M.D., the lead author of the JAMA study. "Avandia is now a last resort." Dr. Singh recommends that you talk to your doctor about cholesterol-lowering medicines, such as statins or the B vitamin niacin. Swallowing high doses (1,000 milligrams) of niacin daily may raise your HDL (good) cholesterol by as much as 24 percent, while at the same time lowering your LDL and triglyceride levels.
Next: Celebrex and Ketek
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Recent Comments
adoctorhmd1997 03:38:41 PM Jul 19 2008
I'm a doctor. I take Advair and Prilosec/omeprazole. My asthma's better than it's ever been--I think the key is educating patients on the signs of worsening of their asthma so they don't ignore it until they're too bad. As far as the Prilosec, I've lost over a hundred pounds and still have bad GERD, so I'll just keep taking it, thank you very much.
DFoster 12:33:32 AM Jul 18 2008
What a crock. Your medical "Advisors" are worse than the National Enquirer's. More current research has shown Avandia NOT to be associated with heart problems, pseudoephedrine (Sudafed) is the only effective decongestant ("PE" - phenylephrine is totally useless and is broken down by the liver on the first pass). Long acting bronchodilators like salmeterol, when combined with inhaled steroids reduce deaths from asthma and have now been proven innocent of the reputed harm. You need to research your literature!A physican of 25 years experience.
Krizaelle 09:39:29 PM Jul 17 2008
The side affects that come with many medicines are so bad one has to discontinue the garbage. What diseases have these wonderful experts cured lately. Overpaid arrogant ********!
Swimaholic84 09:22:00 PM Jul 17 2008
I'm in my last year of pharmacy school and yes, it is true that these drugs do contain those side effects/adverse reations, BUT when used in the right context by the right person and not abused ,the benefits FAR outweigh the risks for almost all of them! The side effects listed here are so rare that it is much more likely for certain disease states to kill you from not taking the medications than getting the side effect while taking them.
John1877 09:55:36 AM Jul 16 2008
Advair changed my life for the better!! Terrible article. I used to use my fast acting inhaler (albuterol) 4 times per day for my asthma in a reactive way after getting an asthma attack. Now I never have to use albuterol because Advair prevents me from ever getting an asthma attack in the first place. This article only tells part of the story, shame on Men's Health and this half-baked article
tonywohlers 03:00:45 AM Jul 06 2008
I am suprised Acetaminophen (aka Tylenol) is not on this list. I work in a transplant ward and a great percentage of liver failure is due to Tylenol overdose, whether it be intentional or not. I know people that have died because of tylenol...I have never heard of anyone dying from prilosec...I dont think anyone has. And the comment concerning doctors killing more people then all the street gangs of LA is ridiculous. Doctors SAVE people at a rate exponential to that of those they harm. Its like saying we should not drive because of all the people that die in car accidents.
gotzo12 10:36:21 PM Jul 05 2008
I am a pharmacist and this article is so misleading I am disgusted that mens health even wrote it. Celebrex has the same risk profile as the rest of the NSAIDS in that class. In matter of fact, all things being equal, Celebrex might be a better option than a comparable NSAID because of the less risk of stomach upset/ulcers. Worse, what does the article list as an allternative? ACUPUNCTURE! Are they kidding me? Acupuncture does not work for everyone especially if people need higher doses of NSAIDS for pain. Prilosec and nexium are wonder drugs for some people who have ulcers eating them from the inside out. Zantac and pepcid do not work as well as those drugs. The article should have made a point not to use these meds in mild cases of heartburn instead of broadly saying that they are bad drugs. PDR is a poor medical resource and personally if my doctor had to keep referring to a book for medical advice I would change doctors. Advair is overused but it is necessary for a lot of p
Dmcsmr 09:22:25 PM Jul 05 2008
I have worked for several doctors over the last 20 years and all of them have used an up to date PDR. It is widely respected and quite helpful, and was not ever gathering dust in corner.
MorrisLever 06:22:35 AM Jun 26 2008
I had a serious breathing problem for years my New Doctor treated me for asthma with singulair tabs. After afew weeks felt better and the next appointment I had I told him at 69year old I felt like joging He swich me to Advair I do not fell like jogging condition returning. Think you very much will make appointment with him to try and understand the logic.
Angelmtg1 02:40:30 AM Jun 26 2008
Dr.'s do not use a PDR and it for sure gathers dust. As for dr.'s killing more peiple than th gangs in La., perhaps this person should have some respect for a profession that has been subjected to rules for HMO's, DRG regualtions from hospitals and the government sticking theri nose where it doesn't belong. And be prepared its only going to get worse.
