Worst Pills, Best Pills

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

phenytoin (DILANTIN, PHENYTEK)


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.
Antipsychotic Drugs: Dangerously Overused
Antipsychotic drugs, also called neuroleptic drugs or major tranquilizers, are properly and successfully used to treat serious psychotic mental disorders, the most common of which is schizophrenia. In younger adults, an alarming number of those with schizophrenia who could and often have previously benefited from antipsychotic drugs are not receiving them. They are seen, among other places, on the streets and in homeless shelters. In older adults, the problem is not underuse but, rather, gross overuse by people who are not psychotic.
Depression: When are Drugs Called For And Which Ones Should You Use?
Ironically, one of the kinds of depression that should not be treated with drugs is depression caused by other kinds of drugs. If someone is depressed and the depression started after beginning a new drug, it may well be drug-caused. Commonly used drugs known to cause depression include the following:

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.

dexmethylphenidate (FOCALIN, FOCALIN XR)
  • We list this drug as a Do Not Use drug because it has no advantage over similar drugs with longer safety records.
zaleplon (SONATA)
  • We list this drug as a Do Not Use drug because it is less effective than related drugs and can cause addiction.

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.

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.
High-Dose Biotin Supplements Can Cause Inaccurate Laboratory Test Results
February 2021
Dietary supplements that contain more than the recommended daily intake of biotin, also known as vitamin B7, can significantly interfere with many important clinical laboratory blood tests (including those for heart disease and thyroid problems), falsely altering their results. Incorrect test results can lead to misdiagnosis and inappropriate treatment of health conditions, which may have serious or even deadly consequences.
Review of Lamotrigine (LAMICTAL)
October 2018
For certain types of epilepsy, lamotrigine is an appropriate treatment for preventing seizures. Learn about the common and serious adverse effects that can occur while taking this drug and how to take this drug safely.
Do Not Use Fentanyl for Non-Cancer Pain
February 2018
Fentanyl is a dangerous synthetic opioid that has been involved in an increasing number of overdose deaths in the U.S. Learn why this drug should be used only by cancer patients with breakthrough cancer-related pain.
Drugs That Cause Weight Gain
December 2017
Weight gain is an adverse event associated with many widely used medications and may lead to significant overweight and obesity, especially in susceptible individuals. Find out which drugs have this adverse effect.
St. John’s Wort: No ‘Wonder Remedy’ for Depression
February 2016
St. John’s wort, an over-the-counter herbal supplement, has been around for centuries, and many patients have been using it in recent years to self-medicate for depression. In this article, we explain why St. John’s wort should not be used to treat this disease.
Weight-Loss Supplements Illegally Spiked with Prescription Drugs
May 2009
The article lists 72 weight loss dietary supplements that have recently been found to have been spiked with one of nine different prescription drugs, often at dangerously high concentrations. If you have used any products containing these ingredients, you should stop taking them and consult your health care professional immediately.
Watch out for Interactions Between Drugs for Erectile Dysfunction and Other Medications
January 2009
The article lists 56 drugs that can interact with the three drugs for erectile dysfunction (ED): sildenafil (VIAGRA), tadalafil (CIALIS) and vardenafil (LEVITRA). Eight of the drugs are either nitrates such as nitroglycerin or a certain group of high blood pressure drugs.In combination with ED drugs, these drugs can cause a dangerous fall in blood pressure that could lead to a heart attack or stroke. Thirty-two other drugs can inhibit the enzyme that helps the body to eliminate the ED drugs, resulting in abnormally high blood levels of the drugs and a potentially harmful "overdose" even though you are actually taking the recommended amount. The other 16 drugs speed up the metabolism of the ED drugs, thereby lowering the blood levels and reducing the effectiveness of the ED drugs.
New Evidence of Suicidal Thinking and Behavior In Patients Using Anti-Epileptic Drugs
November 2008
Among patients taking antiepileptic drugs for epilepsy, the risk of suicidal thinking and behavior was 3.5 times greater compared to placebo. These drugs are also used to treat pain and as mood stabilizers in people with manic-depressive disorders. Pay attention to common warning signs that may indicate an increased risk of suicide, including: talking or thinking about hurting oneself or ending one’s life; withdrawal from family and friends; worsening depression; increased preoccupation with death and dying; giving away prized possessions. Do not make any medication regimen changes without consulting your provider. Unsupervised sudden changes in prescription drugs can have dangerous adverse effects
29 Medications That May Cause Adverse Interactions with Thyroid Drugs
September 2008
Thyroid medications are among the most widely-prescribed drugs in the U.S. In this article, we review 29 different medications that can have harmful interactions with thyroid medicines such as levothyroxine (Synthroid). There are four major kinds of interaction problems that can occur: • Certain medications can decrease the absorption of levothyroxine resulting in lower levels in the blood. • Other medications can increase the rate at which the body gets rid of levothyroxine, also resulting in lower thyroid levels in the blood. • Other medications can cause changes of levothyroxine binding in blood, decreasing the body's ability to use levothyroxine. • Levothyroxine can affect the safety or effectiveness of other medications by raising or lowering the levels of these other drugs in the blood, causing them to be either infective (lower levels) or dangerous (higher levels).
Dangers of Mixing Alcohol with Certain Medications or Diseases
August 2008
The article discusses 273 drugs that can have harmful interactions with alcohol. Also reviewed are several ways in which these harmful interactions can occur: 1/ Medications Can Increase Alcohol Blood Levels 2/ Additive effects of medications and alcohol. One of the best- known drug-alcohol interactions is when alcohol, a depressant, is taken with other sedative medications, and excessive sedation or depression of respiration can occur 3/Alcohol can increase the blood levels of some medications leading to toxicity of these drugs. 4/ Alcohol also can reduce blood levels of some medications causing them to be less effective. Although some of the interactions between alcohol and medications mainly occur in people who drink heavily (three or more drinks on one occasion), many of these interactions may occur with much lower amounts of alcohol use, such as one to two drinks on an occasion. We strongly urge you to tell your physicians and other health care providers how much alcohol you are drinking so they can effectively assess the risks and advise you about the safe use of alcohol and medications.
Calcium Channel Blocker Drug Interactions
May 2008
This article lists more than 60 prescription drugs that can interact with calcium channel blocking drugs such as amlodipine (NORVASC),diltiazem (CARDIZEM, DILACOR XR TIAZAC)or nifedipine (PROCARDIA)to either cause toxicity or to lessen the effectiveness of the calcium channel blocking drugs. Included in the lists are a number of drugs that we list in Worst Pills, Best Pills as DO NOT USE or LIMITED USE drugs. The article also explains the different kinds of toxicity that can ensue from these interactions.
SSRIs Can Have Dangerous Interactions With Other Drugs
January 2008
More than 70 million prescriptions a year are filled for these popular antidepressants, including Prozac, Paxil, Zoloft, Luvox, Celexa and Lexapro. This article gives details about more than 60 other widely prescribed prescription drugs that can have harmful interactions if used with these antidepressants. The two different kinds of interactions are also discussed.
Drug Interactions: Warfarin (COUMADIN)
December 2007
This article explains how to understand the International Normalized Ratio (INR), a test applied to a sample of a patient’s blood to determine how “thin” it is when you are using the blood thinner COUMADIN (warfarin). In addition, the article lists more than 50 drugs or dietary supplements that can interact harmfully with COUMADIN to cause the blood to be too thin (abnormal bleeding) or not thin enough which could result in lessening the effect of COUMADIN in stopping blood clot formation.
Adverse Drug Reactions Cause 1.4 Million Emergency Room Visits in 2004 and 2005
January 2007
An estimated 701,547 patients were treated for adverse drug reactions in emergency rooms each year in 2004 and 2005, totaling 1.4 million visits to the emergency room. Of these, an estimated 117,318 patients were hospitalized each year. According to the study. 18 drugs were each, either independently or in combination with other drugs, implicated in one percent or more of the estimated adverse drug events. These drugs are listed in the table that accompanies this article along with the annual estimates of adverse drug events.
Over-The-Counter Omeprazole (PRILOSEC OTC) — There Are Better Choices For Heartburn
October 2003
You should try the non-pharmacologic interventions listed in the box below before trying antacids, histamine-2 blockers, or, as a last resort, proton pump inhibitors. If you classify yourself as a person with frequent heartburn, that is heartburn more than two days per week, and the interventions recommended above have failed, you should be under the care of a physician

ADDITIONAL INFORMATION FROM PUBLIC CITIZEN

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

Statement before the National Academy of Sciences on the Framework for Evaluating the Safety of Dietary Supplements (HRG Publication #1594)
Since at the heart of this problem is the irrational legal distinction that has been made between those pharmacologically active chemicals which are regulated as prescription or over-the-counter drugs and those which others call dietary supplements which I call drug supplements, eventually the same standards for safety and effectiveness must be adopted.
Letter to the FDA concerning the United Kingdom's Committee on Safety of Medicine's recent warning about potentially serious drug interactions between St. John's Wort and a large number of other drugs. (HRG Publication #1513)
British physicians and patients are now being forcefully warned, for many more drugs than American physicians or patients, about potentially serious, clinically important drug interactions between the unregulated herbal St. John's Wort (Hypericum perforatum) and a large number of prescription drugs.