Table 1.

The OncPal deprescribing guideline.

Class of medication	Medication	Situations of limited benefit
Aspirin	Aspirin	Primary prevention
Lipid lowering medications	Statins Fibrates Ezetimibe	All indications
Blood pressure lowering medications	ACE inhibitors Sartans Beta blockers Calcium channel blockers Thiazide Diuretics	Mild to moderate hypertension Secondary prevention of cardiovascular events Management of stable coronary artery disease
Anti-ulcer medications	Proton pump inhibitors H2 antagonists	All indications unless recent history of gastrointestinal bleeding, peptic ulcer, gastritis, GORD, or the concomitant use of NSAIDs and steroids
Oral hypoglycaemics	Metformin Sulfonylureas Thiazolidinediones DPP-4 inhibitors GLP-1 analogues Acarbose	Mild hyperglycaemia (prevention of diabetic complications)
Osteoporosis medications	Bisphosphonates Raloxifene Strontium Denosumab	All indications except hypercalcaemia
Vitamins	n/a	All except treatment of low serum concentrations
Minerals	n/a	All except treatment of low serum concentrations
Complementary therapies	n/a	All indications

Adapted with permission from Lindsay J, Dooley M, Martin J et al. The development and evaluation of an oncological palliative care deprescribing guideline: the ‘OncPal deprescribing guideline’. Support Care Cancer 2015;23:71–8.
ACE = angiotensin-converting enzyme; DPP-4 = dipeptidyl peptidase-4; GLP-1 = glucagon-like peptide-1; GORD = gastro-oesophageal reflux disease; NSAIDs = nonsteroidal anti-inflammatory drugs; n/a = not applicable.