This is a series of small tidbits that I have realised over a period of time and I thought it a good idea to circulate to our medical community. Most perspectives will be unequivocal and a lot of you will not agree so be it my opinions will remain unchanged, for most part, unless someone comes up with a compelling argument. After all, I do believe that I am open-minded. We have to be cautious about blindly adopting guidelines even Indian ones. For our patients, safety and tolerability are both equally important.
For regulators who approve drugs and academic researchers who formulate guidelines, only safety is usually considered. A drug may be safe, even "long-term safe" but the patient may not be able to tolerate it. A simple side-effect such as "epigastric burning" or nausea or excessive flatulence can lead to poor compliance or a change of doctor by the patient. So, even if a…
