in any medication that is prescribed (or with-held) there should be a serious consideration of the potential risks vs. the expected benefits.

this is of course stastitical, as no one has a "crystal ball" that can tell which patient will respond how. and hopefully we will have better abilities to predict response or lack of, and potential risks much better in the future, but we still don't have those tools, in most medical situations.

there is no medication in the world without potential side effects. once you interfere with a certain biological system, you are always interfering with processes that you don't want to interfere with. some times this may be advantageous, and lead to the discovery of a novel treatment approach, but many times not.

therefore every treatment decission (even tylenol) should idealy be based on a joined decission of physician and patient based on a reasonable understanding of the risk benefit ratio involved in this treatment, and proper follow up to asses possible expected or unexpected side-effects, and the timely discontinuation of this treatment if those side-effects alter the risk/benefit ratio. (obviously long-term side effects are harder to asses, but should be taken into consideration).

every medication, including widely used antibiotics comes with a very long list of potential side-effects, and this should not lead to fear of using it, if it is clearly indicated.

as you well know from the Vioxx story, if a certain medication has an unaccaptable side effect profile for its indication, then it is removed from the shelves immadiately.

alice