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Prescrire bilan. Towards better patient care: drugs to avoid

Prescrire International

Injectable promethazine can cause thrombosis, skin necrosis and gangrene following extravasation or accidental injection into an artery. Injectable dexchlorpheniramine, which does not appear to carry these risks, is a better option.

Prescrire bilan. Towards better patient care: drugs to avoid

Prescrire International

Mequitazine carries a higher risk than other antihistamines of cardiac arrhythmias through QT prolongation in patients who are slow CYP2D6 metabolisers or when co-administered with drugs that inhibit CYP2D6. A “nonsedating” antihistamine without antimuscarinic activity, such as cetirizine or loratadine, is a better option in this situation.

Prescrire bilan. Towards better patient care: drugs to avoid

Prescrire International

Vernakalant has not been shown to reduce mortality or the incidence of thromboembolic or cardiovascular events. Its adverse effects include various arrhythmias. It is better to use amiodarone for pharmacological cardioversion.

Prescrire bilan. Towards better patient care: drugs to avoid

Trimetazidine can cause parkinsonism, hallucinations and thrombocytopenia. It is better to choose better-known treatments for angina: certain beta-blockers, or, as an alternative, calcium-channel blockers such as amlodipine and verapamil.

Prescrire bilan. Towards better patient care: drugs to avoid

Prescrire International

Ranolazine provokes adverse effects including: gastrointestinal disorders, neuropsychiatric disorders, palpitations, bradycardia, hypotension, QT prolongation and peripheral oedema.