What are some commonly used drugs that have been banned?

Commonly Used Drugs That Have Been Banned

Several previously marketed medications have been withdrawn from use due to severe safety concerns, most notably thalidomide for its catastrophic teratogenic effects, and terfenadine for life-threatening cardiac arrhythmias.

Historical Drug Bans

Thalidomide - The Paradigm Case

Thalidomide was banned worldwide in the early 1960s after causing severe birth defects in over 10,000 children, making it the most infamous example of a drug withdrawal in medical history 1, 2.

• Originally marketed as a sedative and antiemetic for morning sickness in pregnant women in the late 1950s and early 1960s 1, 2
• Caused severe limb malformations (phocomelia) and other congenital anomalies when taken during pregnancy 2
• The tragedy led to fundamental changes in drug regulation and toxicity testing protocols worldwide 2

Important caveat: Thalidomide has been reintroduced under strict controls for specific indications including erythema nodosum leprosum (a leprosy complication) and multiple myeloma 3, 1, 4. However, it requires mandatory registration programs, pregnancy testing, and contraception requirements due to its extreme teratogenicity 3, 1.

Terfenadine - Cardiac Toxicity

Terfenadine, a once-popular antihistamine, was withdrawn from the market due to potentially fatal cardiac arrhythmias 5.

• Caused QT prolongation and torsades de pointes, particularly when combined with certain medications 6
• The drug label for its replacement (fexofenadine/Allegra-D) specifically references terfenadine's removal 5
• Dangerous interactions occurred with CYP3A inhibitors like ketoconazole and macrolide antibiotics 6

Drugs Banned in Competitive Sports

Performance-Enhancing Substances

All systemic decongestants except topical preparations are banned by the International Olympic Committee and US Olympic Committee 6.

• Pseudoephedrine and phenylephrine (systemic forms) are prohibited in competitive athletics 6
• Only topical (nasal or ophthalmologic) phenylephrine and imidazole preparations (oxymetazoline, tetrahydrozoline) are permitted 6
• Athletes must verify medication status through WADA (World Anti-Doping Agency) or the USOC hotline (1-800-233-0393) before competition 6

Herbal Supplements

Ma Huang (ephedra) is banned due to cardiovascular risks and performance-enhancing effects 6.

• Guidelines recommend complete avoidance of ephedra-containing products 6
• Associated with elevated blood pressure and stimulant effects 6

Drugs Contraindicated Due to Dangerous Interactions

With Protease Inhibitors (Hepatitis C Treatment)

Several medications are absolutely contraindicated when using protease inhibitors like telaprevir and boceprevir 6:

• Cardiac medications: Class I and III antiarrhythmics (amiodarone, flecainide, propafenone, quinidine, bepridil) due to risk of torsades de pointes 6
• Ergot derivatives: Dihydroergotamine and ergotamine can cause serious toxicity 6
• Benzodiazepines: Oral midazolam is contraindicated 6
• Other agents: Cisapride, sildenafil (for pulmonary hypertension), simvastatin, and lovastatin 6
• Antimicrobials: Rifampicin and ketoconazole are contraindicated 6
• Herbal products: St. John's wort must be avoided 6

Contemporary Restrictions

Short-Term Use Only Medications

Four sympathomimetic amines are FDA-approved only for short-term use (12 weeks maximum) 6:

• Phentermine, diethylpropion, benzphetamine, and phendimetrazine 6
• Should be avoided in patients with coronary artery disease, uncontrolled hypertension, glaucoma, and substance use disorder history 6
• Extended use beyond 12 weeks requires consultation with local laws and state medical boards 6

Recreational Drugs

All recreational drugs including "bath salts" (MDPV), cocaine, and methamphetamine should be discontinued 6.

• These substances cause severe blood pressure elevation and cardiovascular complications 6
• Guidelines recommend complete avoidance 6

Key Clinical Pitfall

The thalidomide case demonstrates that even with reintroduction under strict controls, birth defects continue to occur in countries with less stringent oversight—33 cases were reported in Brazil where thalidomide is available for leprosy treatment 1. This underscores that regulatory frameworks alone cannot completely prevent harm when teratogenic drugs remain available.