Smecta, Vogalène, Maxilase... Prescrire magazine publishes its list of drugs “more dangerous than useful”

Voltarène, Smecta, Vogalene, Actifed cold, Toplexil... The Prescrire medical journal has published, as it has every year for the past twelve years, its list of medications “more dangerous than useful”. Among the drugs authorized in France and in the European Union which were analyzed by the journal between 2010 and 2023, 105 - including 88 marketed in France - have a benefit-risk balance which remains "unfavorable in all clinical situations in which they are allowed". Medications which are however over the counter in pharmacies.

According to Prescrire, the “clinical effectiveness” of these drugs “has not been demonstrated”. Worse, they have side effects that can be serious. The review therefore recommends turning to other options in cases where “drug treatment” seems “desirable”.

Among the remedies to avoid, the magazine cites oral Diclofenac, also called Voltarene, a real success in pharmacy. The treatment exposes, according to Prescrire, “to an increase in cardiovascular adverse effects (including myocardial infarction, heart failure) and deaths of cardiovascular origin compared to other equally effective non-steroidal anti-inflammatories”. Another treatment not recommended, although regularly prescribed in cases of intestinal disorders: Smecta. The natural presence of lead in the drug is in question. “Lead has neurological, hematological, renal and cardiovascular toxic effects, and reprotoxic effects, most of which increase with the exposure dose,” writes Prescrire. The drug Vogalene (or metopimazine), used for vomiting or nausea, is also mentioned in the list of drugs to avoid because of its serious side effects (heart rhythm disturbances, strokes and sudden deaths).

Concerning treatments against the common cold, a disease particularly present in winter, the review therefore advises against decongestants because they expose you to cardiovascular problems which can be “serious or even fatal”. This includes medications such as Actifed cold, Nurofen and Rhinadvil. Finally, cough syrups are not left out. The review thus considers that Toplexil (or oxomemazine) or even Maxilase (or alpha-amylase) are more “dangerous than useful”. Maxilase is in fact judged “to have no demonstrated effectiveness beyond that of a placebo”.