[sambe]

The parent is not being flippant - don't be so dismissive. The dose makes the poison. All medications have long lists of side-effects. Most will have a small minority of users who have severe side-effects. We don't go around calling them all poisons.

[thatcat]

How do you know what% users have side effects or what doseage that occurs at or what causes this reaction in the subpopulation? You don't and just wave that off, that's why it's flippant.

[sambe]

Look, I don't know anything about this medication. But the grandparent responded to a pure anecdote, including the claim that it is "a poison". It seems an entirely appropriate response to caution against false taxonicity in this context. I don't see why the thread is so full of downvoting and accusations.

If someone wants to claim an approved medication is especially poisonous, the onus should be on them to provide evidence. Note that the great-great-grandparents 3 links are all individual case studies. One of them summarizes the situation: "overall, the frequency and severity of adverse events are rather low".

[thatcat]

That's fair enough. I would personally not risk nerve damage even if "frequency and severity are rather low" (1.5% reported in pubmed) unless necessary because the mechanism of action is still there and I don't have any information about why that happens sometimes. It would be great if our medication review could extend past trials and allow people to independently analyze the data in population studies so some causation could be investigated in those rare events when things go wrong.

[techrat]

Bear in mind, with a lot of different types of medications, they're required to report severe reactions found during trials and use... even if those reactions were very specific to that individual (genetic predisposition, for example)... Eg, Stevens Johnson Syndrome (a really severe skin reaction) which has no real general consistency on who reacts to what class or type of drugs.

If one person experiences it in a trial of a group of, say, 60... That becomes a risk of 1.6% in the side effects profile.

Real world cases would be much, much, much lower to the point to where doctors in the ER wouldn't even know what they're looking at when it happens. Sometimes it gets diagnosed as a 'drug eruption' or an allergy, when it's more an immune hypersensitivity response.

I know anecdotal isn't what people want around here, but I had a reaction to Sulfa that was later diagnosed as Stevens Johnson Syndrome. The doctor who prescribed it to me never personally saw a case of it herself until I came along. Even then, she sent me to a dermatologist first.

https://www.webmd.com/drugs/2/drug-5530/bactrim-ds-oral/deta...

However, It's commonly listed at the top of the side effects list for this drug.

https://en.wikipedia.org/wiki/Stevens%E2%80%93Johnson_syndro...

Actual incidence of the syndrome?

> SJS is a rare condition, with a reported incidence of around 2.6[10] to 6.1[26] cases per million people per year. In the United States, about 300 new diagnoses are made each year. The condition is more common in adults than in children.

Up to 6 cases per million per year across ALL drugs and not just the one I mentioned here.

Even common over the counter medications like Ibuprofen is known to cause SJS. The odds, however, are vanishingly small.

The risk exists, yes, but the perspective needed is that when you see percentages reported... that's not a "1.5% chance", that is "1.5% of those in a particular group experienced this side effect while 98.5% did not."

[techrat]

>How do you know what% users have side effects

This information is typically provided in the published drug facts for each medication.

https://pubmed.ncbi.nlm.nih.gov/2686432/

https://www.rxlist.com/cipro-drug.htm#dosage

Studies provide further info.

> or what doseage that occurs at or what causes this reaction in the subpopulation?

It's through trials they discover the incidence of side effects and appropriate dosages for maximum therapeutic benefit.

> You don't and just wave that off, that's why it's flippant.

Nobody is waving anything off when providing perspective.