2026 Warning: Prescrire Identifies 108 Drugs Deemed More Harmful Than Beneficial

106 drugs Deemed “More Dangerous Than Useful” in Latest Prescribe Review

Published December 4, 2025

For the 14th year running, Prescribe magazine has released it’s annual list of medications with unfavorable risk-benefit profiles, urging their discontinuation in favor of better treatment options.The December 2025 issue details 106 drugs – 89 of which are marketed in France – that the publication deems “more dangerous than useful.”

This critical assessment, according to Prescribe, “aims to help choose quality care, not to harm patients and to avoid putting them at disproportionate risk.”

The “2026 Review” identifies medications falling into several categories: those with proven effectiveness but carrying disproportionate risks; older drugs superseded by newer, safer alternatives; recent drugs with a less favorable benefit-risk balance than established treatments; and drugs demonstrating efficacy no better than a placebo while posing serious adverse effects.

Specifically, the list includes drugs that:

* Expose patients to risks outweighing their benefits.
* Have become outdated due to the availability of superior medications.
* Offer less favorable outcomes compared to older drugs.
* Lack demonstrable efficacy beyond a placebo effect, yet carry the potential for severe side effects.

This year’s review marks a change from the 2025 assessment, with specific updates detailed in a comparison to the previous list available here.

How dose Prescrire define “net clinical benefit” when assessing medications?

Understanding the Prescrire Assessment

Prescrire, an independent French pharmaceutical review institution, regularly assesses the benefit-risk balance of medications. Their upcoming 2026 report is generating important concern,identifying 108 drugs were the risks demonstrably outweigh the benefits. This isn’t a blanket condemnation of these medications, but a critical evaluation based on rigorous scientific data. Understanding why these drugs are flagged is crucial for both healthcare professionals and patients. This assessment focuses on the net clinical benefit – does the drug offer a genuine, substantial enhancement in health outcomes considering its potential adverse effects?

Categories of Drugs Flagged by Prescrire

The 108 drugs span a wide range of therapeutic areas.While the full list isn’t yet publicly available (as of December 4, 2025), preliminary reports indicate the following categories are heavily represented:

* Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Chronic use of certain NSAIDs continues to be linked to cardiovascular risks, gastrointestinal bleeding, and kidney damage. The benefit for mild to moderate pain may not justify these risks in many cases.

* Antidepressants: Specifically, some older generation antidepressants and those with significant side effect profiles are under scrutiny. Concerns include lack of demonstrated superiority over placebo for mild to moderate depression, and potential for withdrawal symptoms.

* Antipsychotics: The report highlights risks associated with long-term antipsychotic use,including metabolic syndrome,weight gain,and extrapyramidal symptoms. The benefit-risk ratio is especially concerning for off-label use in elderly patients with dementia.

* Proton Pump Inhibitors (PPIs): Prolonged PPI use has been associated with increased risk of Clostridium difficile infection, pneumonia, and nutrient deficiencies. The report emphasizes the importance of using PPIs only when medically necessary and for the shortest duration possible.

* Certain Antibiotics: The rise of antibiotic resistance is a major public health concern. Prescrire’s assessment likely flags antibiotics frequently used inappropriately or where alternative treatments exist.

* musculoskeletal Drugs: Some muscle relaxants and pain medications used for chronic musculoskeletal conditions are being re-evaluated due to limited long-term efficacy and potential for dependence.

The Benefit-Risk Ratio: A Deeper Dive

prescrire employs a unique methodology for evaluating drugs. They don’t simply look at whether a drug works; they assess whether it works better than existing treatments,or even better than no treatment,considering the potential for harm.This is frequently enough visualized as a benefit-risk ratio.

Here’s a breakdown of their rating system:

1. Great Benefit: Drugs offering a significant and demonstrable improvement in health outcomes with minimal risks.
2. Moderate Benefit: Drugs with a clear benefit, but with some potential risks that need to be carefully managed.
3. Limited Benefit: Drugs where the benefit is small or uncertain, and the risks are significant.
4. No Benefit: Drugs where the risks outweigh any potential benefit.

The 108 drugs identified in the 2026 report largely fall into the “limited Benefit” and “No Benefit” categories.

Implications for patients: What You Need to Know

If you are currently taking a medication that may be on Prescrire’s list, do not stop taking it without consulting your doctor. Abruptly discontinuing medication can be dangerous. instead:

* Schedule an Appointment: Discuss the Prescrire report with your physician. Ask them to review your medication list and assess the benefit-risk ratio for your specific situation.

* Explore Alternatives: If appropriate, ask about alternative treatments, including non-pharmacological options like physical therapy, lifestyle changes, or psychological therapies.

* Understand Your Risks: Be fully informed about the potential side effects of your medications and what to do if you experience them.

* Medication Review: Regularly review all your medications with your doctor, including over-the-counter drugs and supplements. Polypharmacy (taking multiple medications) increases the risk of adverse drug interactions.

The Role of Healthcare Professionals

The Prescrire report serves as a crucial reminder for healthcare professionals to practice evidence-based medicine and prioritize patient safety. Key considerations include:

* Deprescribing: Actively reviewing and discontinuing medications that are no longer necessary or where the risks outweigh the benefits.

* Shared Decision-Making: Engaging patients in informed discussions about their treatment options, including the potential benefits and risks of each medication.

* Staying Updated: Keeping abreast of the latest research and guidelines regarding drug safety and efficacy.

* Pharmacovigilance: Reporting adverse drug reactions to regulatory authorities.

Real-World Example: Vioxx and the Importance of Post-Market Surveillance

The case of Vioxx (rofecoxib), a painkiller withdrawn from the market in 2004, serves as a stark reminder of the importance of rigorous post-market surveillance. Initially approved, subsequent studies revealed a significantly increased risk of cardiovascular events. Prescrire’s ongoing assessments contribute to