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Meprobamate (Equanil°): watered-down half-measures are not enough

The risk-benefit balance of meprobamate is unfavourable. Withdrawing it definitively from the market would be the best way of protecting patients.

Meprobamate is a psychotropic drug with hypnotic and sedative properties. The risk-benefit balance of meprobamate is unfavourable for all its therapeutic indications. Its efficacy remains unproven, especially in the case of alcohol withdrawal. It exposes the patient to sometimes severe adverse effects: neuropsychological, digestive, cardiovascular and haematological disorders, hypersensitivity, withdrawal syndrome. It causes a number of drug interactions.

Meprobamate poisoning can be fatal, especially due to the risk of cardio-circulatory failure. Meprobamate is the fifth most frequent drug used in cases of intentional overdose in France.

This last fact has led the French Health Products Safety Agency (Afssaps) to reduce the number of tablets contained in a packet of Equanil° (the packet of Mepronizine still contained 30 tablets as at January 2010).

Given meprobamate's unfavourable risk-benefit balance and the risk of it being abused, drugs containing this substance should be withdrawn from the market.

The health authorities have once again opted for a watered-down half-measure.

© Prescrire March 2010

Source: "Équanil° Moins de comprimés par boîte, mais demi-mesure trop timorée" Rev Prescrire 2010; 30 (316): 112.