Older Medications May Be Better Than Fancy New Ones

Older Medications May Be Better Than Fancy New Ones

New drugs are the ones you hear about most. Drug companies can charge more for brand-new drugs before generics horn in on the territory, so it pays to advertise them and to fund studies that get doctors thinking about how great they are. Older drugs don't get as much press.

Photo by psyberartist

But doctors and scientists have had more time to get to know the older drugs. If there's a long-term risk or a subtle side effect, it might not be obvious at first. So even if a new drug is the one on the tips of prescribers' tongues, an older drug is sometimes a more solid choice.

In Australia, advertisements for all therapeutic goods (including medicine and medical devices) is controlled by the Therapeutic Goods Administration and only non-prescription medicines - over the counter and non-prescription complementary medicines - can be advertised to consumers. Prescription medicines can only be advertised to health professionals.

That's one of the "golden rules of drug therapy" from clinical pharmacologist Andrew Herxheimer, who died at age 90 earlier this year. Medical journal The BMJ remembered him with a blog post that included his nine rules intended to assist patients. Here are the first three:

  1. Think what you could do instead of using a medicine.
  2. Unless you have a special reason, avoid new medicines. Stick to those about which a lot is known from many sources and which have been used for over 10 years; bad news about a drug often takes years to emerge.
  3. Before deciding to use a medicine be clear whether it is to relieve a symptom, to cure a disease, to remedy some deficiency, or to prevent something. It doesn't make any sense at all to prevent something in the future if it's going to cause you some problem now.

For the rest, and more information on their author, visit the link below.

Andrew Herxheimer and His Golden Rules of Drug Therapy [The BMJ via Vox]


Comments

    One of my pet hates. Drug companies usually slightly tweak an existing drug, and re-register. the drug is basically the same, but it allows them to charge a premium for it..
    See Omeprazole vs Esomeprazole (Nexium) as an example.

    One of my pet hates. Drug companies usually slightly tweak an existing drug, and re-register. the drug is basically the same, but it allows them to charge a premium for it..
    See Omeprazole vs Esomeprazole (Nexium) as an example.

    For #2, not necessarily. This sounds empirically true. But drugs undergo extensive testing and screening prior to release. So, while it's possible for a new drug to be withdrawn, this only applies to a very small minority.

    Conversely, just because a drug has been on the market for years, doesn't automatically mean it's safe. For example, aprotinin was used for decades (to prevent bleeding). It was only fairly recently that it was implicated in increased risk of strokes, and lost its license.

    Even more confusingly, some drugs are approved in one jurisdiction but not others. For example, droperidol which is licensed here but not in the UK (where it was withdrawn due to safety concerns).

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