Table 2 “Drugs to avoid” marketed in Australia but not listed on the PBS
From: “Drugs to avoid” to improve quality use of medicines: how is Australia faring?
Therapeutic area | “Drugs to avoid” marketed but not listed on PBS | Reasons for avoiding |
|---|---|---|
Cardiology | Bezafibrate | No proven efficacy in the prevention of cardiovascular events, cutaneous, haematological and renal adverse effects |
Ranolazine | Gastrointestinal and neuropsychiatric disorders, palpitations, bradycardia, hypotension, QT prolongation and peripheral oedema | |
Endocrinology | Conjugated oestrogens + bazedoxifene | Risks of thrombosis and hormone-dependent cancers have not been adequately evaluated |
Tibolone | Risk of cardiovascular disorders, breast cancer and ovarian cancer | |
Gynaecology | Ulipristal | Serious liver injury |
Gastroenterology | Droperidol | Ventricular arrhythmias and sudden death |
Glyceryl trinitrate ointment | No proven efficacy for chronic anal fissure, headache that can be severe | |
Prucalopride | Adverse effect profile is poorly documented, particularly with respect to cardiovascular disorders, depression and suicidal ideation and teratogenicity | |
Infections | Moxifloxacin | Toxic epidermal necrolysis and fulminant hepatitis and has also been linked to an increased risk of cardiac disorders |
Oncology | Nintedanib | Indicated for non-small cell lung cancer serious adverse effects including venous thromboembolism, bleeding, hypertension, gastrointestinal perforations and impaired wound healing |
Panobinostat | Many, often serious and life-threatening adverse effects | |
Vandetanib | Serious adverse effects (diarrhoea, pneumonia, hypertension) occur in about one-third of patients. There is also a risk of interstitial lung disease, torsades de pointes and sudden death | |
Vinflunine | High risk of haematological adverse effects (including aplastic anaemia), and a risk of serious infections and cardiovascular disorders (torsades de pointes, myocardial infarction, ischaemic heart disease) | |
Pain | Etoricoxib | Excess of cardiovascular events (including myocardial infarction and thrombosis) and skin reactions |
Glucosamine | Allergic reactions (angioedema, acute interstitial nephritis) and hepatitis | |
Parecoxib | Excess of cardiovascular events (including myocardial infarction and thrombosis) and skin reactions | |
Psychiatry | Agomelatine | No proven efficacy, hepatitis and pancreatitis, suicide and aggression, as well as serious skin disorders including Stevens–Johnson syndrome |
Dapoxetine | Aggressive outbursts, serotonin syndrome, and syncope | |
Milnacipran | Cardiac disorders (hypertension, tachycardia, arrhythmias, QT prolongation) | |
Respiratory medicines | Bromhexine | Risk of anaphylactic reactions and severe, sometimes fatal cutaneous reactions such as erythema multiforme, Stevens–Johnson syndrome and toxic epidermal necrolysis |
Phenylephrine | Serious and even life-threatening cardiovascular disorders, including hypertensive crisis, stroke and arrhythmias, as well as ischaemic colitis | |
Weight loss | Bupropion + naltrexone | Neuropsychiatric disorders (including aggressiveness, depression and suicidal ideation), potentially severe allergic reactions (including angioedema and Stevens–Johnson syndrome), addiction, and congenital heart defects in children exposed to the drug in utero |