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.
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.
> 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."
