Drugs to be avoided II

Gastro-intestinal drugs


This article is an adaptation of ‘Towards better patient care: drugs to avoid in 2018’, published in our French sister journal Prescrire International, 2018; 27 (192): 107.1-107.9.
  • In view of its unproven efficacy and its potentially serious risks, domperidon should not be prescribed. Nevertheless, domperidon is still given the status of drug of first choice in a number of guidelines. 
  • Droperidol is effective against postoperative nausea and vomiting, but as long as it remains insufficiently proven that this drug is safe at lower dosages, it should not be prescribed for patients with a prolonged QT-interval. Checking cardiac function is warranted not only at high dosages but also at lower ones.
  • Prucalopride has limited efficacy for chronic constipation, and its side-effects are insufficiently known. Fortunately, this drug to be avoided has not found its way onto the market.
  • Only if a new drug offers proven added value and its side-effects are acceptable and well-defined, can its prescription by medical practitioners be justified.
  • Reassessment of drugs that are already on the market is currently insufficient. Current practice often lacks adequately designed and implemented post-marketing studies into their efficacy and side-effects.

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Authors

  • mw drs M.A.E. Nieuwhof