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SafetyScorer

Safety scores

Medications

Each score rates a medicine as prescribed or as the label directs, using the official US label, UK NHS guidance and overdose data. Serious side effects count for 30%, the gap between a normal and a harmful dose for 20%, interactions and dependence for 15% each, and regulatory warnings and years of use for 10% each. A low score does not mean you should stop a medicine. It means the risks need more care, so talk to your doctor or pharmacist before changing anything.

All rated medications

  1. #1 of 65

    Loratadine

    Loratadine (Claritin, Clarityn) is a non-drowsy antihistamine sold over the counter for hay fever and hives. Serious side effects are very rare, it barely interacts with other drugs or alcohol, and single doses of 160 mg caused no harm in volunteers. Combination products with pseudoephedrine carry extra risks.

    Score 92, grade A

  2. #2 of 65

    Amoxicillin

    Amoxicillin is one of the safest medicines you can be prescribed. Diarrhoea and rash are common but mild; anaphylaxis is rare, and most people who think they are allergic to penicillin are not.

    Score 91, grade A

  3. #3 of 65

    Cetirizine

    Cetirizine (Zyrtec, Reactine, Piriteze) is one of the safer everyday medicines. Serious harm is rare, overdoses mostly cause sleepiness and interactions are few. It sedates more than some other non-drowsy antihistamines, and US labels now warn of rare, severe itching after stopping long-term use.

    Score 88, grade A

  4. #4 of 65

    Atorvastatin

    Atorvastatin (Lipitor) is one of the best-studied medicines in the world, and serious harm is rare. Large blinded trials show most muscle aches in people on statins are not caused by the drug. The main things to watch are interactions with certain antibiotics, antifungals and grapefruit juice.

    Score 87, grade A

  5. #5 of 65

    Rosuvastatin

    Rosuvastatin (Crestor) is a strong, well-studied statin with no boxed warning and no dependence. Serious muscle injury is rare. The catch is dose: the 40 mg tablet carries more muscle risk, and people of Asian descent, people with severe kidney disease and those on certain drugs need lower caps.

    Score 87, grade A

  6. #6 of 65

    Doxycycline

    Doxycycline (Vibramycin, Doryx, Oracea, generics) is a tetracycline antibiotic used since 1967 for infections, acne, tick-borne disease and malaria prevention. Serious harm is rare. The practical risks are sunburn, throat irritation, antacids or iron blocking it, and tooth staining in young children.

    Score 86, grade A

  7. #7 of 65

    Omeprazole

    Omeprazole (Prilosec, Losec) is one of the safest medicines on our list for short courses. Years of daily use carry some real but small risks, such as low magnesium and B12 and gut infections, and many of the scarier links in observational studies did not hold up in a large trial.

    Score 86, grade A

  8. #8 of 65

    Pantoprazole

    Pantoprazole (Protonix) is a proton pump inhibitor with no boxed warning, no dependence and a very wide overdose margin. A 3-year trial of 17,598 people found only slightly more gut infections. Years of daily use can lower magnesium and B12, and unlike omeprazole it does not clash with clopidogrel.

    Score 86, grade A

  9. #9 of 65

    Albuterol

    Albuterol (salbutamol; Ventolin, ProAir, Proventil) is one of the best-studied medicines there is, and at label doses serious side effects are rare. The real risk is overuse, which hides worsening asthma and is linked to severe attacks and deaths.

    Score 83, grade B

  10. #10 of 65

    Hydrochlorothiazide

    Hydrochlorothiazide (HCTZ) has treated high blood pressure since 1959 and serious harm is uncommon. The real risks are low sodium or potassium, especially in older people in the first weeks, a small rise in skin cancer with years of use, and a dangerous interaction with lithium.

    Score 83, grade B

  11. #11 of 65

    Ivermectin

    Ivermectin (Stromectol, Soolantra, Sklice) treats worm infections, head lice and rosacea, and single doses rarely cause more than mild dizziness or itching. Most recent harm came from large or repeated doses, often of animal products, taken for COVID-19, which large trials found it does not treat.

    Score 83, grade B

  12. #12 of 65

    Simvastatin

    Simvastatin (Zocor) has over 30 years of use and cut deaths by 30% in its landmark trial. At the usual 20 to 40 mg, serious muscle damage is rare, but the risk rises sharply at 80 mg, which the FDA restricted in 2011. More drugs cap its dose than for atorvastatin, including amlodipine and diltiazem.

    Score 83, grade B

  13. #13 of 65

    Amlodipine

    Amlodipine (Norvasc) is one of the most widely used blood pressure medicines and is well tolerated at prescribed doses. Ankle swelling is the usual complaint, especially at 10 mg and in women. The real danger is overdose, which can cause delayed, hard-to-treat shock.

    Score 82, grade B

  14. #14 of 65

    Finasteride

    Finasteride (Propecia for hair loss, Proscar for the prostate) has a very wide overdose margin and almost no interactions. Its risks are sexual side effects in a few percent of men, which some say persist after stopping, and depression and suicidal thoughts, now flagged in EU and UK packs.

    Score 81, grade B

  15. #15 of 65

    Losartan

    Losartan (Cozaar) is an ARB blood pressure medicine with side effect rates close to placebo and less cough and angioedema than ACE inhibitors. It has a boxed warning against use in pregnancy, and many generic lots were recalled in 2018–2020 for nitrosamine impurities, a risk the FDA called very low.

    Score 81, grade B

  16. #16 of 65

    Sildenafil

    Sildenafil (Viagra for erectile dysfunction, Revatio for pulmonary arterial hypertension) has 28 years of wide use and a wide overdose margin. Headache and flushing are common; vision or hearing loss and priapism are rare. It must never be combined with nitrates, and many illegal 'sexual enhancement' products hide it.

    Score 81, grade B

  17. #17 of 65

    Metformin

    Metformin (Glucophage) has been the first medicine for type 2 diabetes for decades because it works and serious harm is rare. Stomach upset is the usual problem. Its boxed warning on lactic acidosis is mainly a concern in severe kidney disease, serious illness and heavy drinking.

    Score 80, grade B

  18. #18 of 65

    Lisinopril

    Lisinopril (Zestril, Prinivil) is a well-tested ACE inhibitor for blood pressure and heart failure. Serious harm is uncommon, but it carries a boxed warning against use in pregnancy, can rarely cause dangerous swelling of the face and throat, and mixes badly with potassium supplements and some painkillers.

    Score 79, grade B

  19. #19 of 65

    Montelukast

    Montelukast (Singulair) is a once-a-day asthma and allergy tablet with a wide overdose margin and almost no drug interactions. Its serious issue is the mind, from nightmares and agitation to depression and, rarely, suicidal thoughts. That carries a US boxed warning, and for hay fever it is now second-line.

    Score 78, grade B

  20. #20 of 65

    Acetaminophen (paracetamol)

    At the doses on the box, acetaminophen (paracetamol, Tylenol) is one of the gentlest painkillers there is. The risk is the small gap to a liver-damaging dose, which people cross by accident when they combine products.

    Score 77, grade B

  21. #21 of 65

    Combined oral contraceptive pill

    Combined pills (estrogen plus a progestin, such as Yaz, Microgynon or generic levonorgestrel/ethinyl estradiol) are among the most studied medicines in the world. Serious harm is uncommon, but they raise the risk of blood clots, more with some progestins, and carry a boxed warning against use by smokers over 35.

    Score 77, grade B

  22. #22 of 65

    Estradiol

    Estradiol is the main estrogen in menopausal hormone therapy (tablets, patches, gels, vaginal products). For women under 60 or within 10 years of menopause, the extra risks of clots, stroke and breast cancer are small in absolute terms and grow with age and duration. The FDA began narrowing its boxed warning in 2025.

    Score 77, grade B

  23. #23 of 65

    Mifepristone

    Mifepristone (Mifeprex and generics) is used with misoprostol to end an early pregnancy, and as Korlym for Cushing's syndrome. Large trials report serious complications in under 0.5% of patients; heavy bleeding and rare severe infections are the main risks. It is sold in the US under a REMS that the FDA is reviewing.

    Score 76, grade B

  24. #24 of 65

    Ibuprofen

    For a few days at the dose on the pack, ibuprofen (Advil, Motrin, Nurofen) is a safe choice for most adults. The risks build with dose and time, mainly stomach bleeding, kidney strain and a small rise in heart attack and stroke.

    Score 74, grade B

  25. #25 of 65

    Metoprolol

    Metoprolol (Lopressor, Toprol-XL) is a long-established beta-blocker that cut deaths by a third in a large heart failure trial. Tiredness, dizziness and a slow pulse are common. The main risks are stopping it suddenly, use in asthma, interactions that slow the heart, and overdose.

    Score 74, grade B

  26. #26 of 65

    Levothyroxine

    Levothyroxine (Synthroid, Levoxyl, Euthyrox) replaces missing thyroid hormone and at the right dose causes very few side effects. The risks come from a wrong dose, through overtreatment, absorption interactions or product switches, and from misuse for weight loss, which carries a boxed warning.

    Score 73, grade B

  27. #27 of 65

    Naproxen

    Naproxen (Aleve, Naprosyn) is a safe short-term painkiller for most adults at the dose on the pack. Its heart risk looks lower than other NSAIDs in trials, but stomach bleeding, kidney strain and interactions build up with dose, age and time.

    Score 73, grade B

  28. #28 of 65

    Clopidogrel

    Clopidogrel (Plavix) is an antiplatelet medicine used after heart attacks, stents and strokes, with almost three decades of use. Bleeding is its main side effect, more so with aspirin. Its boxed warning is unusual. In people with two inactive copies of the CYP2C19 gene it may barely work, and omeprazole blunts it too.

    Score 72, grade B

  29. #29 of 65

    Semaglutide

    Semaglutide (Ozempic, Wegovy, Rybelsus) is effective for diabetes and weight loss, and a large trial found fewer heart attacks and strokes. Stomach side effects are very common, serious ones such as pancreatitis and gallbladder disease are uncommon, and its long-term record is still under ten years.

    Score 72, grade B

  30. #30 of 65

    Sertraline

    Sertraline (Zoloft, Lustral) is one of the most prescribed antidepressants and one of the better tolerated. Nausea and sexual side effects are common, under-25s need close watching early on, and it interacts with other serotonin drugs and blood thinners.

    Score 72, grade B

  31. #31 of 65

    Escitalopram

    Escitalopram (Lexapro, Cipralex) is among the better tolerated antidepressants and is not addictive. The catches are the class boxed warning for young people, discontinuation symptoms if stopped suddenly, and a small dose-related effect on the QT interval that limits the dose in older adults.

    Score 71, grade B

  32. #32 of 65

    Modafinil

    Modafinil (Provigil, Modiodal) is a wakefulness drug with a wide overdose margin and lower misuse potential than amphetamine-type stimulants. The main risks are rare but severe skin reactions, psychiatric effects, a possible risk of birth defects and an interaction that can make hormonal contraception fail.

    Score 71, grade B

  33. #33 of 65

    Aspirin

    Aspirin is two medicines in one. Low-dose aspirin after a heart attack or stroke has a clear benefit, while daily use by healthy older people mostly adds bleeding risk. At pain-relief doses it carries stomach bleeding and overdose risks, and children should not take it.

    Score 70, grade B

  34. #34 of 65

    Fluoxetine

    Fluoxetine (Prozac) is the original SSRI and still one of the most used. Its very long half-life makes stopping easier but interactions last for weeks after the last dose. Under-25s need close watching early on, and it is less forgiving in overdose than sertraline.

    Score 70, grade B

  35. #35 of 65

    Tirzepatide

    Tirzepatide (Mounjaro for type 2 diabetes, Zepbound for weight and sleep apnoea) works well, and stomach side effects are the usual price. Serious problems such as pancreatitis are uncommon, but the drug has only been sold since 2022, and fake pens and compounded copies add risks of their own.

    Score 70, grade B

  36. #36 of 65

    Propranolol

    Propranolol (Inderal, Inderal LA, generics) is a 1960s beta-blocker for blood pressure, angina, migraine, tremor and, in the UK, the physical symptoms of anxiety. Side effects are usually mild. The serious risks are asthma attacks, stopping suddenly and overdose, which can cause seizures and cardiac arrest.

    Score 69, grade C

  37. #37 of 65

    Testosterone

    In men with confirmed low testosterone, prescribed testosterone did not raise heart attacks or strokes in the 5,198-man TRAVERSE trial, and the FDA dropped its heart-risk warnings in 2025. It still raises blood pressure and red cell counts, gels can virilise children, and it is a widely misused Schedule III drug.

    Score 68, grade C

  38. #38 of 65

    Citalopram

    Citalopram (Celexa, Cipramil) is a widely used SSRI that is not addictive and suits many adults with depression. Its main catch is a dose-related effect on heart rhythm, which led regulators in 2011 to cap the dose at 40 mg (20 mg for older adults) and makes overdoses more dangerous than with sertraline.

    Score 67, grade C

  39. #39 of 65

    Isotretinoin

    Isotretinoin (Accutane, Absorica, Roaccutane) is the most effective treatment for severe acne. Dry skin and lips are near-universal and blood fats often rise. Its defining risk is severe birth defects, managed through the US iPLEDGE programme, and regulators also require checks for mood changes and sexual side effects.

    Score 67, grade C

  40. #40 of 65

    Trazodone

    Trazodone is a 1981 antidepressant now prescribed mostly at low doses for sleep, an unapproved use. It is not controlled and rarely misused, but drowsiness and dizziness are common, and the label warns of priapism, heart rhythm problems, serotonin syndrome and suicidal thoughts in young people.

    Score 67, grade C

  41. #41 of 65

    Gabapentin

    Gabapentin (Neurontin, Gralise, Horizant) treats nerve pain and seizures and is seldom harmful on its own at labelled doses. The main risks are drowsiness and dizziness, serious breathing problems when it is combined with opioids or other sedatives, misuse, and withdrawal if it is stopped suddenly.

    Score 66, grade C

  42. #42 of 65

    Metamizole (dipyrone)

    Metamizole (dipyrone; Novalgin, Nolotil, Analgin) treats severe pain and fever in much of Europe and Latin America. It is not an NSAID, but it can wipe out white blood cells without warning, which is why the US withdrew it in 1977 and the EU strengthened its warnings in 2024.

    Score 66, grade C

  43. #43 of 65

    Prednisone

    Prednisone is a cheap, powerful steroid for asthma flares, arthritis, allergies and many inflammatory diseases. An overdose is rarely the problem. The risks rise with dose and time, from infections, high blood sugar and mood changes to bone loss and cataracts, and stopping after long use must be gradual.

    Score 66, grade C

  44. #44 of 65

    Orforglipron

    Orforglipron (Foundayo) is Eli Lilly's once-a-day GLP-1 tablet for weight loss, approved in the US in April 2026. Its trial side effects look like those of semaglutide and tirzepatide, mostly nausea and vomiting, but it interacts with more drugs and has only months of real-world use.

    Score 65, grade C

  45. #45 of 65

    Apixaban

    Apixaban (Eliquis) is a blood thinner that needs no INR tests and caused less bleeding than warfarin in a trial of 18,201 people. Bleeding is still its main risk, a few drugs change its levels, and the US label has a boxed warning about stopping it early and about spinal procedures.

    Score 64, grade C

  46. #46 of 65

    Ciprofloxacin

    Ciprofloxacin (Cipro) treats serious bacterial infections well and most people only get mild stomach upset. But it carries a US boxed warning for rare tendon rupture, nerve damage and mental health effects that can be long-lasting, and it interacts with many common drugs and supplements.

    Score 64, grade C

  47. #47 of 65

    Diphenhydramine

    Diphenhydramine (Benadryl, ZzzQuil, Nytol) has been sold for 80 years and an occasional label dose is low-risk for most adults. The catches are strong drowsiness that impairs driving, confusion and falls in older people, a hidden presence in many night-time products, and seizures or heart problems in overdose.

    Score 64, grade C

  48. #48 of 65

    Rivaroxaban

    Rivaroxaban (Xarelto) is a once-a-day blood thinner with no INR tests. In its main trial it caused fewer brain and fatal bleeds than warfarin but more stomach and gut bleeding. The 15 mg and 20 mg tablets must be taken with food, and the US label carries a boxed warning on stopping early and spinal procedures.

    Score 61, grade C

  49. #49 of 65

    Bupropion

    Bupropion (Wellbutrin, Zyban) works differently from SSRIs and spares sex drive and weight. The trade-offs are a dose-related seizure risk, higher blood pressure, many interactions through the liver and an overdose profile much more dangerous than SSRIs, with seizures in about a third of cases.

    Score 60, grade C

  50. #50 of 65

    Insulin Glargine

    Insulin glargine (Lantus, Toujeo, Basaglar, Semglee) is a long-acting insulin with 25 years of use and no boxed warning. It is essential for people with type 1 diabetes. Its risk is low blood sugar, which can be severe, and the margin for dosing mistakes is narrow.

    Score 60, grade C

  51. #51 of 65

    Methylphenidate

    Methylphenidate (Ritalin, Concerta, Medikinet) has the longest record of any ADHD medicine and causes psychosis about half as often as amphetamine in large studies. It still carries a boxed warning on misuse and addiction, raises pulse and blood pressure, and can slow growth in children.

    Score 58, grade C

  52. #52 of 65

    Pregabalin

    Pregabalin (Lyrica, Alzain, Axalid) treats nerve pain, fibromyalgia and seizures, and in the UK anxiety. Dizziness and drowsiness affect many users, it is a controlled drug in the US and UK because of misuse, and combined with opioids, alcohol or other sedatives it can cause fatal breathing problems.

    Score 57, grade C

  53. #53 of 65

    Lisdexamfetamine

    Lisdexamfetamine (Vyvanse, Elvanse) is an effective once-daily treatment for ADHD and binge eating disorder. Its prodrug design smooths the effect and blunts some misuse, but it is still amphetamine in the body, carries the stimulant boxed warning on abuse and addiction, and raises pulse and blood pressure.

    Score 55, grade C

  54. #54 of 65

    Quetiapine

    Quetiapine (Seroquel) is an effective antipsychotic for schizophrenia and bipolar disorder, but it carries two boxed warnings and commonly causes sedation, weight gain and changes in blood sugar and lipids. Low doses are widely used off-label for sleep, where the evidence is thin and the same risks apply.

    Score 55, grade C

  55. #55 of 65

    Amphetamine

    Amphetamine (Adderall, Adderall XR) is an effective ADHD treatment and most people who take it as prescribed do well. The weak points are a high potential for misuse and addiction, small rises in heart rate and blood pressure, rare psychosis, and dangerous overdoses when tablets are taken in large amounts or snorted.

    Score 53, grade D

  56. #56 of 65

    Zolpidem

    Zolpidem (Ambien, Stilnoct) helps people fall asleep and leaves the body within hours. Its risks are rare but serious complex sleep behaviours such as sleep-driving, next-morning impairment, falls in older people, and dependence with long use. With alcohol or opioids it is far more dangerous.

    Score 53, grade D

  57. #57 of 65

    Lithium

    Lithium is the first-choice long-term treatment for bipolar disorder in NICE guidelines, with trial evidence of fewer suicides. Its catch is a narrow margin: toxic levels are close to useful ones, so it needs regular blood tests, kidney and thyroid checks, and care with dehydration and common painkillers.

    Score 51, grade D

  58. #58 of 65

    Warfarin

    Warfarin (Coumadin, Jantoven, Marevan) saves lives by preventing clots, but it is a high-risk medicine. The gap between too little and too much is small, many drugs and foods change its effect, and bleeding sends more older Americans to hospital than any other drug.

    Score 49, grade D

  59. #59 of 65

    Codeine

    Codeine (Tylenol with Codeine, co-codamol) is a weak opioid that works only once the liver turns it into morphine. That varies with the CYP2D6 gene, so it can be useless for some people and life-threatening for others. It is addictive, banned for children under 12 in the US and often combined with acetaminophen.

    Score 42, grade D

  60. #60 of 65

    Lorazepam

    Lorazepam (Ativan) works well for short bursts of severe anxiety and in hospitals for seizures. Alone, an overdose is seldom fatal. The serious risks are physical dependence, withdrawal that can include seizures, falls in older people, and fatal breathing problems when combined with opioids or alcohol.

    Score 41, grade D

  61. #61 of 65

    Alprazolam

    Alprazolam (Xanax) works quickly for anxiety and panic, and on its own an overdose is rarely fatal. The serious risks are dependence and withdrawal, sedation and falls, and deadly combinations with opioids or alcohol. Fake "Xanax" bars sold illegally often contain fentanyl.

    Score 40, grade D

  62. #62 of 65

    Tramadol

    Tramadol (Ultram, Ultracet, ConZip) is often seen as a mild painkiller, but it is an opioid with the same boxed warning as stronger ones, plus seizures, serotonin syndrome and low blood sodium or sugar. How much active drug a person makes depends on the CYP2D6 gene and other medicines they take.

    Score 34, grade F

  63. #63 of 65

    Hydrocodone

    Hydrocodone, mostly prescribed with acetaminophen (Vicodin, Norco and generics), relieves short-term pain but carries every risk of a strong opioid. Addiction can develop at prescribed doses, mixing it with alcohol or benzodiazepines can stop breathing, and the acetaminophen inside can damage the liver.

    Score 27, grade F

  64. #64 of 65

    Oxycodone

    Oxycodone (OxyContin, Percocet, Roxicodone, OxyNorm) controls severe pain well but carries the risks of every strong opioid. Addiction can develop even in people who take it as prescribed, and an overdose, or a mix with alcohol or benzodiazepines, can stop breathing.

    Score 26, grade F

  65. #65 of 65

    Fentanyl

    Prescription fentanyl, mainly patches and hospital injections, controls severe pain in people already used to strong opioids. A patch on an opioid-naive person, heat on the skin or a used patch found by a child can cause a fatal overdose. Illicit fentanyl is a separate problem.

    Score 22, grade F