Some prescription-drug warnings are so critical that they're displayed in black-bordered boxes on package inserts. 2004 and 2005 were big years for such "black box" warnings: The Food and Drug Administration required that serious step for over 90 medications, including all antidepressants and prescription nonsteroidal anti-inflammatory painkillers.

It's important for consumers to be aware of the potential dangers and side effects of any medications they are taking. In one study, doctors ignored a black-box warning in two-thirds of patients who were given the drug. In another study, they failed more than half the time to heed cautions to monitor patients. If you're taking any of the other top-selling "black box" drugs listed below, don't stop taking it on your own, but do discuss options with your physician.

FDA Black Box Warnings
Drug name	Used for	Increases risk for?
Adalimumab (Humira) and infliximab (Remicade)	Rheumatoid arthritis	Tuberculosis. Test and treat for tuberculosis before starting either drug.
Antidepressants (all), including tricyclics such as amitriptyline (Elavil) and bupropion (Wellbutrin), as well as SSRIs such as citalopram (Celexa) and paroxetine (Paxil).	Depression	Suicidal thinking and behavior in children and adolescents. Anyone considering use of an antidepressant in a child or adolescent must balance this risk with the clinical need. Anyone started on therapy should be closely observed for worsening depression, suicidal thoughts or actions, and unusual changes in behavior.
Estrogens, including pills (Premarin, Femhrt) and patches (Estraderm, Combipatch)	Menopausal symptoms and prevention of osteoporosis.	Endometrial cancer, heart attack, stroke, invasive breast cancer, pulmonary emboli, deep vein thrombosis and dementia in postmenopausal women. Should be prescribed at the lowest effective dose for the shortest time.
Fentanyl (Duragesic)	Moderate to severe chronic pain	Life-threatening breathing problems. Use only in patients who can tolerate opioid drugs.
Fluticasone/Salmeterol (Advair Diskus)	Asthma	Asthma-related deaths. Risk may be greater in African Americans compared with Caucasians.
Levothyroxine (Synthroid)	Hypothyroidism and pituitary suppression in people with goiters	Serious or life-threatening toxicity. Not for obesity or weight loss.
Medroxyprogesterone injections (Depo-Provera)	Contraception	Severe bone loss, with prolonged use. Use for longer than two years only if other forms of contraceptive are unacceptable.
Methylphenidate (Concerta)	Attention deficit hyperactivity disorder	Addiction, psychotic behavior and, during withdrawal, severe depression.
Nonsteroidal anti-inflammatories (NSAIDs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and celecoxib (Celebrex)	Arthritis and chronic pain.	Heart attack, stroke, and gastrointestinal bleeding. Applies only to prescription-strength products.
Progesterone (Prometrium)	Hormone replacement therapy	Dementia, heart attack, stroke, breast cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women.
Oxycodone (OxyContin)	Moderate to severe pain	Drug abuse and fatal reaction. Use with caution in people who've never used an opiod; don't crush, break, or chew.
Pimecrolimus (Elidel) and tacrolimus (Protopic)	Eczema	Skin cancer and lymphoma. Use only if other treatments fail.
Promethazine (Phenergan)	Allergies and cough.	Depressed and interrupted breathing, especially in children under two years old. Don't use in children under that age, and use with caution in all others.
Tamoxifen (Nolvadex)	Breast cancer	Stroke, pulmonary embolism, and uterine cancer. Benefits clearly outweigh risks in women with history of breast cancer, but possibly not others.