2026: Which drugs should be avoided for better treatment?

For fourteen years, Prescrire has published an annual review of the drugs used in France and the European Union that should be avoided in all clinical situations. Let’s take stock of the drugs identified by health experts working for the monthly magazine Prescrire as drugs that pose more risks than benefits.

A hundred references to avoid

This list of medicines, updated every year by Prescrire, includes medicines that have been added or withdrawn after their marketing was stopped by a decision of the pharmaceutical company or health authorities. Some also no longer appear on the list as they are re-evaluated by Prescrire teams in light of new medical and scientific data.

For this year 2026, 108 drugs, 89 of which are marketed in Franceare classified as “more dangerous than useful” by Prescrire magazine.

These are commonly used medicines that can cause side effects for some and serious consequences for others, ranging from hospitalization to death.

Prescrire’s 2026 blacklist is available and viewable here lien, contains 108 non-recommended drugs, 89 of which are marketed in France. In fact, they have an unfavorable benefit-risk ratio in all clinical situations listed in the marketing authorization (MA).

We find in this blacklist, among others, 8 drugs in oncology, transplantation and hematology, 12 in cardiology, 5 in dermatology, 8 in nutrition and diabetes, 20 in rheumatology and pain, 9 in gastroenterology, 13 in neurology, 9 in pulmonology and 11 in psychiatry.

Additions to the list between the 2025 report and the 2026 report

Prescrire is adding four drugs to be excluded from the list this year. Their benefit-risk ratio is unbalanced: these drugs expose patients to side effects that are disproportionate to their effectiveness. This point may be due to a lack of proof of effectiveness or to uncertain or insufficient effectiveness compared to taking a placebo.

These four medications are:

• L’andexanet alfa (Ondexxya – not marketed in France), reserved for hospital use due to uncontrolled or life-threatening bleeding. Compared to usual treatment, this puts you at risk of serious thromboembolic accidents.
• chondroitin, indicated in the treatment of hips and knees. The molecule can cause side effects, some of which are serious, including hypersensitivity reactions (skin rash, urticaria, angioedema);
• Fezolintant indicated for menopause, treatment of hot flashes. It exposes you to hepatotoxicity, digestive and neuropsychological disorders, and various pains;
• Fapixant Indicated for chronic persistent cough, it can cause very common taste disorders, pneumonia and urolithiasis.

Removals from the blacklist between 2025 and 2026

Two drugs were removed from the blacklist this year: Obeticholic acid and piracetam.

Obeticholic acid (exOcaliva°), a bile acid derivative, is no longer approved for primary biliary cholangitis.

Knowledge!Primary biliary cholangitis is a chronic liver disease in which the immune system causes slow, progressive damage to the bile ducts. This disease mainly affects women between the ages of 40 and 60.

In fact, it does not improve the clinical situation of patients, either as monotherapy or in combination with ursodeoxycholic acid (Delursan° or others). It often worsens the main symptoms of the disease (itching and fatigue) and causes potentially serious, sometimes fatal, side effects on the liver.

Piracetam (Nootropyl° or another) is a “psychostimulant” approved for various pathologies such as dizziness, cognitive and neurosensory deficits in the elderly, dyslexia in children and myoclonus of cortical origin.

Knowledge!Myoclonus (short contractions of a muscle or group of muscles) of cortical origin is associated with lesions of the cerebral cortex or epilepsy. This type of myoclonus can seriously affect speaking and walking.

After re-analysis of the benefit-risk ratio in cortical myoclonus in 2025, it appears that piracetam has a possible but uncertain clinical benefit in this rare situation. And also because the rating only lists drugs that are more dangerous than useful in all indications listed in their marketing authorization, Piracetam has been removed from the list.

At the end of their document, the Prescrire editorial team specifies: “In addition to nurses’ active actions to exclude from their therapeutic spectrum these drugs that companies continue to market, health authorities must also take concrete measures to protect patients and encourage nurses and patients to switch to treatments with a favorable risk-benefit ratio. Until the end of 2025, there is no good reason for these drugs, which are more dangerous than useful, to remain approved and available on the market.”

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