A black box warning is a consumer warnings with a black border placed on labels calling out the product’s serious health risks—like the one that appears on tobacco packaging. It is the most severe type of warning by the Food and Drug Administration (FDA).
Black Box warnings are not something to take lightly. For the FDA to warn about a drug means it’s pretty bad (the last stop before a recall notice)! I believe the black box warnings are a result of the many lawsuits that are being won by injured patients and demanding them to warn others.
“To be forewarned is to be forearmed.” ~old proverb
8 common drugs in various categories:
1. Pradaxa (Blood Clots)
Patients who stop taking Pradaxa without continuing some anticoagulation protocol increase the risk of stroke. In older patients, there’s a significant trend toward internal bleeding. Its mechanism of action involves blocking “thrombin” which causes blood to clot. See more here: https://www.consumersafety.org/drugs/pradaxa/
Why a Black Box warning?
- After only the first two years on the market, the anticoagulant drug Pradaxa had been linked to more than 500 deaths. That number is now in the thousands. (source)
2. Adderall (ADHD)
Adderall is a stimulant, amphetamine drug used to treat ADHD, but is also frequently used recreationally by college students and others to lose weight, stay awake and study longer, recreationally to get high. The risk of serious Adderall side effects typically outweighs the potential benefits of the drug.
Why a Black Box warning?
- The FDA announced they have received 51 reports of sudden death in children and adults who took Adderall.
- On college campuses nationwide, Adderall and other ADHD medications are quickly becoming drugs of choice as popular study aids. It seems caffeine just does not cut it anymore for late night cram sessions. (Source)
- Increased risk of sudden death and cardiovascular events (Source)

(Source)
3. Xanax (Anxiety)
Xanax is a benzodiazepine drug. It’s also used to manage phobic behaviors and specific conditions like social anxiety. Prescription rates in the last 18 years have risen only 67%, but the number of Xanax related deaths per year has multiplied sixfold.
Why a Black Box warning?
- Taking Xanax along with opioid painkillers or cough medicines containing opioids may cause can cause extreme sleepiness, slowed breathing, coma, and death
- Highly addictive
- Minimum dosage is recommended and should be monitored (Source)
And in 2015 alone, 9,000 deaths were due to a sham Xanax pill.
4. Cipro (Bacterial Infection)
Ciprofloxacin is in a class of antibiotics called “fluoroquinolones” and includes Levaquin and Avalox used to treat bacterial infections of all different types like chronic bronchitis, infectious diarrhea, urinary tract infections (UTIs) and more.
Why a Black Box warning?
- Vastly increased risk of tendonitis and tendon rupture (incl. Achilles tendon)
- Events of acute liver damage
- Common nervous system damage and neurotoxicity. Reports found in over 300 studies (Source)
Amy’s story: Cipro, Levaquin, Avalox: Fluoroquinolone Antibiotics That Will Ruin You!!
Avelox (see Cipro above)
Have you suffered a tendon rupture or tendonitis while taking Avelox? In the same class as Cipro and Levaquin. Avelox tendon ruptures can be very severe, and lead to life-long disability.
5. Synthroid (Levothyroxine) (for Hypothyroidism)
Synthroid (levothyroxine) is the number one brand-name drug in terms of number of prescriptions written by physicians – over 23 million scrips/month. It is usually given for Hashimoto’s, an autoimmune disease, and when thyroid cancer lowers the circulating thyroxin in the body. But we also see subsequent development of dementia of the Alzheimer type with Thyroid medication use.
Why a Black Box warning?
- Consumers may be at increased risk for a variety of ailments when taken for weight loss – often prescribed but not effective for weight loss/obesity
- High doses may cause toxicity especially when used in combo (see below)
6. Vicodin (Pain relief)
Vicodin is a synthetic drug formed by combining acetaminophen (the active ingredient in Tylenol) and hydrocodone, which is an extremely powerful opioid. It’s commonly prescribed for pain relief after surgery, and even after less serious surgery like wisdom teeth removal.
Why a Black Box warning?
- Highly addictive
- According to data from 2011, opioid painkillers like Vicodin caused more deaths than illicit drugs
- Increased risk of respiratory depression
- Risk of fatalities from accidental consumption (especially in unaccompanied minors)
- Risk to baby if taken during pregnancy
- Significantly increased risk of liver damage/failure
7. Zoloft (Depression)
The FDA insists all generic drugs sold in the U.S. are “identical” to their brand name counterparts. Many disagree. Controversy surrounds generic sertraline (Zoloft). This antidepressant is taken by millions of people. The reports make you wonder how good a job the FDA is doing at monitoring foreign-made pharmaceuticals. (source)
Why a Black Box warning?
- Increased risk of suicide in children, adolescents, young adults
- High risk of major depressive or other psychiatric disorders (mania, hallucinations)
- Resulted in numerous Birth defect lawsuits – do not take when pregnant!
8 Million US Kids Taking Psychiatric Drugs: Parents Not Told the Deadly Documented Risks
8. Celebrex (NSAID)
Prescription Celebrex should be used exactly as prescribed at the lowest dose possible and for the shortest time needed. (Source)
Why a Black box Warning?
- potentially fatal cardiovascular thrombotic events, incl. heart attack, heart failure and stroke
- risk may occur early in treatment and may increase with duration of use
- high risk of life-threatening allergic reactions and kidney problems
In addition, medical practitioners downplay the dangers of NSAIDs, as do the pharmaceutical companies that make these popular OTC drugs. Research reveals (pg. 309-310) that NSAIDs (and CELEBREX) have been shown to:
- Accelerate the progression of osteoarthritis
- Increase risk of joint replacement
- Inhibit the cells that form cartilage
- Inhibit collagen synthesis
- Inhibit substances that act as a lubricant and shock absorbe
The Black Box Warning – the unknown, unconsented agreement
Whether you knew it or not – by opening a black box labeled bottle or package you have accepted that these black-box warnings of serious and fatal side effects can occur. Proceed at your own risk or that of your loved one.
Sadly, it’s very unlikely most patients will read a black box warning. Most patients rely on their doctor or pharmacist for advice; so an increased warning on a drug’s label may in reality make little difference.
Research For Yourself:
- Use the FDA Access Data site to research the drugs you currently take.
- Use the Pubmed resource to search through clinical trials.
- Search ConsumerSafety.org
Never stop taking a medication without speaking with your doctor first.
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Thanks for reading!

Siena says
I fully agree. For the FDA to place such warnings is because the product Is known to cause serious health issues! Wow…
Elise says
This is why it is so important to read every label. Know exactly what you are taking.
Trish says
Thanks for sharing… I was wondering if you knew that you have ads showing on your blog for prescription drugs?
Barbara says
Wow! Did not know about the synthroid risks. My hubby has taken this for years. Thank you so much for this article. Love your blog!
Jacqueline says
I felt bad writing this, Barbara, bc it is pretty difficult for many on pharmaceuticals and there aren’t always alternatives once you are on them…but I kept reminding myself it was helpful to others (to look for alternatives) and not meant to scare people! I am glad it has been helpful! Blessings! J
Barbara says
Oh, you shouldn’t feel bad at all, Jacqueline- you are doing us a great service providing this info! I actually have done a lot of research on many prescriptions due to my husband’s serious health problems, but this one slipped through the cracks. I really appreciate this article, as well as so many of the other things you post. My son and his wife are homeschooling their children and they are very adamant about restricting technology. I forward many of your posts to them as affirmations of their feelings on this issue. You are a blessing!!