Worst Pills, Best Pills

An expert, independent second opinion on more than 1,800 prescription drugs, over-the-counter medications, and supplements

methotrexate (JYLAMVO, OTREXUP, RASUVO, REDITREX, TREXALL, XATMEP)


DISEASE AND DRUG FAMILY INFORMATION

Search results below include Disease and Drug Family Information where your selected drug is a secondary subject of discussion.

Vitamins and Minerals
One promotional strategy of supplement suppliers is to make people worry about whether they are getting enough nutrients. But do most people really need to take vitamins and minerals to supplement their diets? Or are they a waste of money? Are there better alternatives to taking supplements to ensure adequate nutrition? This section will attempt to answer these questions and help you sort through the fact and fiction surrounding nutritional supplements.

DRUG AND DIETARY SUPPLEMENT PROFILES

A comprehensive review of the safety and effectiveness of this drug. If the drug is not a Do Not Use product, information on adverse effects, drug interactions and how to use the medication are included.
Search results below include Drug and Dietary Supplement Profiles where your selected drug is a secondary subject of discussion.

baricitinib (OLUMIANT)
  • We list this drug as Do Not Use because it has unique risks of serious harm — in particular, an increased risk of life-threatening blood clots — without offering any unique benefits over other disease-modifying antirheumatic drugs.
leflunomide (ARAVA)
  • We list this drug as a Do Not Use drug because it may be less effective than other drugs and causes liver damage and high blood pressure.

WORST PILLS, BEST PILLS NEWSLETTER ARTICLES

Search results below include Worst Pills, Best Pills Newsletter Articles where your selected drug is a secondary subject of discussion.

Review of the Tumor Necrosis Factor Blocker Adalimumab (HUMIRA)
August 2024
The tumor necrosis factor blocker adalimumab (HUMIRA and biosimilars) is used to treat rheumatoid arthritis and various autoimmune diseases. It is one of the best-selling drugs in the United States. Learn about the efficacy of adalimumab, its serious adverse effects and why Public Citizen’s Health Research Group has classified this biologic drug as Limited Use.
Recommendation Reaffirmed for Folic Acid Supplementation to Prevent Birth Defects
February 2024
In 2023, the U.S. Preventive Services Task Force reaffirmed its recommendation that all persons who are planning to or could become pregnant take a daily supplement containing 400 to 800 micrograms of folic acid starting at least one month before conception and continuing through the end of the first trimester of pregnancy. Learn about the evidence supporting this recommendation.
Long-Term Risks with the Use of Proton Pump Inhibitors
February 2024
Proton pump inhibitors (PPIs) reduce the amount of stomach acid. They are available by prescription and over the counter, and their use has increased in recent years. Although PPIs are generally safe for short-term use, they have serious long-term risks.
Nonalcoholic Fatty Liver Disease: A Disease that Is Difficult to Treat
December 2023
Learn about nonalcoholic fatty liver disease (NAFLD), a condition in which excess fat accumulates in the liver, and the form of this disease known as nonalcoholic steatohepatitits (NASH), which is associated with inflammation of the liver and in some instances can lead to fibrosis, cirrhosis and liver failure. At present, there are no medications that have been approved by the FDA to treat either condition.
Tofacitinib (XELJANZ, XELJANZ ER) for Rheumatoid Arthritis Increases Risk of Infections
February 2023
A recently published study confirmed that tofacitinib (XELJANZ, XELJANZ ER) increases the risk of severe and other infections compared to treatment with the tumor necrosis factor blocker drugs that demonstrate similar effectiveness for treating rheumatoid arthritis.
Cannabidiol Treatment Is Ineffective for Arthritic Pain
March 2022
Despite the suggestion that cannabidiol may have pain-relieving or anti-inflammatory effects, the totality of the evidence thus far has led international experts to conclude that this substance should not be recommended for pain management. Results of a recently published clinical trial reinforce that conclusion by showing that cannabidiol is ineffective as a treatment for arthritis pain.
FDA Limits Approved Uses of Tofacitinib (XELJANZ, XELJANZ XR) Because of Serious Adverse Effects
January 2022
Learn why the FDA has limited the approved uses and strengthened the product labeling warnings for the oral drug tofacitinib (XELJANZ, XELJANZ XR), which is approved for treatment of rheumatoid arthritis and certain other inflammatory diseases.
New FDA Warning About Heart, Cancer Risks for Tofacitinib (XELJANZ)
July 2021
In this article, we discuss an important new warning issued by the FDA about preliminary results from a safety clinical trial that showed increased risks of serious heart-related adverse effects and cancer in rheumatoid arthritis patients taking the oral drug tofacitinib.
Protecting Yourself from Life-Threatening Pharmacist Errors
April 2020
In his editor’s column, Dr. Michael Carome discusses findings of a recent exposé published in The New York Times that highlighted how overworked pharmacists at major national pharmacy chains — such as CVS, Rite Aid and Walgreens — have endangered patients by making potentially fatal errors when filling and dispensing prescriptions.
Review of the Popular Stomach-Acid Suppressant Proton Pump Inhibitor Drugs
July 2019
Learn why the widely used proton pump inhibitors should be reserved for certain patients with stomach-acid disorders and only taken at the lowest possible dose for the shortest possible duration needed.
Patients Infrequently Screened Before Immunosuppressive Specialty Drug Therapy, Study Finds
July 2019
More and more patients are being treated with an expanding array of potent immunosuppressive drugs that require special screening and monitoring to minimize the risk of serious harm. But new research reveals that too many patients receiving these drugs are not undergoing the appropriate screening and monitoring tests.
FDA Warns of Life-Threatening Blood Clots with Use of High-Dose Tofacitinib
June 2019
In this article, we discuss preliminary data from an ongoing clinical trial that prompted the FDA to issue a new warning about potentially fatal blood clots caused by tofacitinib, an oral drug used to treat rheumatoid arthritis and other inflammatory diseases.
Baricitinib (OLUMIANT): The Wrong Choice for Rheumatoid Arthritis
December 2018
Baricitinib is the most recent drug approved by the FDA for treatment of patients with rheumatoid arthritis. Read our assessment of this dangerous drug.
Tofacitinib (XELJANZ): The Wrong Choice for Rheumatoid Arthritis
October 2017
Tofacitinib is one of the newer medications approved by the FDA for treatment of rheumatoid arthritis. Learn why we have designated this drug as Do Not Use.
New Biologic Drugs for Rheumatoid Arthritis: Which Are Safe?
March 2016
Patients with rheumatoid arthritis have a wide array of medication choices for reducing joint pain and inflammation and slowing the progression of joint damage. The most potent such drugs are a group of medications known as disease-modifying anti-rheumatic drugs (DMARDs). Learn about the serious risks posed by these drugs and when they should be used.
New Warnings on Common Heartburn Drugs: Too Little — and, for Some, Too Late
February 2015
After a more than three-year delay and a Public Citizen lawsuit filed against the FDA, the agency finally responded to our petition for stronger label warnings on a class of medications, known as proton pump inhibitors, commonly used to treat heartburn. This article discusses the new warnings that the FDA has required in response to our petition.
Drug Mix-Ups
June 2011
This article lists 355 drugs with names that are often confused with similar-sounding drug names. Find out what you can do to prevent getting the wrong drug.
Black Box Warning for ENBREL (etanercept)
June 2008
Etanercept, an effective disease-modifying anti-rheumatic drug (DMARD), now joins adalimubab (HUMIRA) and inflixamib (REMICADE) to be the third of the arthritis disease-modifying drugs (see discussion on the following page about disease-modifying drugs) to receive a black box warning concerning infections, calling for TB testing and, if positive, TB treatment before starting these drugs. For some people, the potential benefit of etanercept outweighs the risk of infections, including the very small risk of TB infection. The article also discusses a fourth DMARD and the precautions we advise for its use.
Lung Inflammation (Pneumonitis) with the Arthritis Drug Leflunomide (ARAVA)
June 2006
There is increasing evidence that the arthritis drug leflunomide (ARAVA), taken alone or in combination with another drug, methotrexate, can case serious lung inflammation called pneumonitis. If you are taking leflunomide, either alone or in combination with methotrexate, and you experience difficulty breathing, a dry cough, and dizziness, you should contact your physician immediately.
New Warnings About Fatal Liver Toxicity And Infections For The Arthritis Drug Leflunomide (ARAVA)
January 2004
The maker of the arthritis drug leflunomide (ARAVA), Aventis Pharmaceuticals of Bridgewater, NJ, notified health professionals in October 2003 that new safety warnings concerning life-threatening liver toxicity and infections have been required on the professional product labeling or package insert for the drug.
Two New Warnings! Tuberculosis and Heart Failure with Infliximab (REMICADE)
December 2001
Two new warnings about increased risk of tuberculosis and heart failure were issued for the arthritis drug infliximab (REMICADE) on October 23, 2001. Infliximab is approved by the Food and Drug Administration (FDA) for use in combination with methotrexate (RHEUMATREX), also an arthritis drug, for treating moderately to severely active rheumatoid arthritis in patients who have had an inadequate response to methotrexate alone.

ADDITIONAL INFORMATION FROM PUBLIC CITIZEN

Search results below include Additional Information from Public Citizen where your selected drug is a secondary subject of discussion.

Letter to FDA addressing Dr. Gary Firestein's comments concerning HRG's petition to remove ARAVA from the market (HRG Publication #1644)
It is discouraging that we have a so-called expert in the field of rheumatology who, apparently, has not thoroughly read either our petition or the original label for leflunomide, yet feels free to attack our petition. We tried in our petition to present as much information as was available, to analyze it rigorously, and to provide references so that our statements could be checked; unfortunately, Dr. Firestein failed to do this.