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Prescrire bilan. Towards better patient care: drugs to avoid

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Ulipristal can cause serious liver lesions that require Liver transplant. When the treatment is considered desirable to postpone surgery or wait for menopause, there are other less risky options available: insertion of an intrauterine device (IUD) of levonorgestrel is the first option despite its limitations; an alternative in some cases is an oral progestogen, but the benefit-benefit balance of the duration of treatment over a few months is uncertain.

Prescrire bilan. Towards better patient care: drugs to avoid

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Tibolone has androgenic, oestrogenic and progestogenic properties and carries a risk of cardiovascular disorders, breast cancer and ovarian cancer.

Choosing Wisely®

North American Spine Society

Red flags include, but are not limited to: trauma history, unintentional weight loss, immunosuppression, history of cancer, intravenous drug use, steroid use, fracture, infection, deformity, osteoporosis or osteopenia, progressive paresthesias or weakness involving the pelvis and lower extremities, urinary retention, saddle anesthesia, age > 50, focal neurologic deficit, and progression of symptoms.

Prescrire bilan. Towards better patient care: drugs to avoid

The risks of thrombosis and hormone-dependent cancers have not been adequately evaluated.

Choosing Wisely®

American Society for Apheresis

Clinical circumstances may indicate baseline laboratory coagulation parameters be measured. For most indications, therapeutic plasma exchange (TPE) can be performed on an intermittent schedule using clotting factor deficient replacement fluid without the need for repeated routine monitoring of the patient’s hemostasis status. Of note, daily TPE significantly reduces clotting factors; therefore, coagulation testing may be warranted.