Safe Drug List

by Neil Bauman, Ph.D.

A man wrote,

How about publishing a list of drugs that are safe to use?” [This was in relation to my article on drugs that are associated with tinnitus “New List of Drugs, Herbs and Chemicals Associated with Tinnitus Released.]

You are not the only person to ask me this. It sounds like a great idea at first thought—so, here it is. You’ll notice it is a mighty short list!

Drugs That Are Safe to Use

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Here are five reasons why I don’t publish a list of “safe” drugs.

1. All drugs have adverse side effects according to the FDA. Here is a quote from my book, “Ototoxic Drugs Exposed”. (1) “All drugs have side effects. This is no secret. The United States Food and Drug Administration (FDA) is the government’s watchdog on the drug industry. The FDA warns, ‘When it comes to using medicine, there is no such thing as a completely safe drug. All medicines have risks.’ (2) Notice this, ‘No drug is perfectly safe. Every single drug that affects our bodies will have some side effects.’ (3)” Thus there is no completely safe drug—which means no drug makes the “safe” list! As I said, it’s a mighty short list.

2. Not all side effects are known when a drug is released for use by the public. In fact, just under half of the drugs released to the public still had serious side effects that had not been found in all the testing that goes on before a drug is approved by the FDA and released to the public. This means that about 51% of the drugs released to the public had serious side effects that were only discovered after all the studies had been completed. (4) This makes you the guinea pig.

Notice that most of the drugs released to the public still had serious side effects that were missed. Who knows how many “minor” side effects were missed? Obviously it has to be much higher than the 51% of the major side effects missed. (And unfortunately, ototoxic side effects seem to be relegated to the “minor” category.)

Therefore, you can’t say a drug is “safe” for your ears until years or decades after it has been used by the general public. For example, it took 11 years after Vicodin came on the market before it was found to be ototoxic. It took more than two decades after Erythromycin was released to the public before doctors realized that it was ototoxic. And it took over a century of use (117 years to be exact) before doctors discovered that Acetaminophen was ototoxic. So how long do you have to wait before you declare any given drug to be “safe” and thus eligible for the “safe list”?

3. People vary in their sensitivity to drugs. Therefore, a drug that apparently does not produce any side effects in one person may produce a host of serious side effects in someone that is sensitive to that drug. With this in mind, how do we decide whether a given drug is safe or not?

4. Often side effects are related to dosage—the higher the dose, the more chance you have of getting a side effect, and of that side effect being more severe. Thus, we’d have to know whether a drug had a “safe” level and what that “safe” level was. Here it gets complicated because that “safe” level likely varies considerably with each person (see No. 3 above).

5. Some drugs appear to be safe when taken alone, but when taken in combination with other drugs, the synergistic effect produces unwanted side effects. Since few drug combinations are studied, such resulting side effects are unknown. Thus, we can’t say that a given combination of drugs is always “safe”.

Based on the above, there is no way a person could honestly declare a drug to be truly safe and thus place it on the safe list, and have this list accurate. Therefore, all we can do is compile lists of drugs that have proven themselves to cause certain specific side effects such as tinnitus.

The best I can do, if you ask me about a given drug, is to tell you what I think the risk is. It may be small, but there are no guarantees that it won’t cause you grief. Thus, you needs to do your own “due diligence” before taking any drugs if you wish to avoid (as much as is humanly possible) unwanted ototoxic (and other) side effects.
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(1) Bauman, Neil. 2010. Ototoxic Drugs Exposed, 3rd Ed. pp. 71-73.

(2) Be an active member of your health care team. 2001. U.S. Food and Drug Administration. Center for Drug Evaluation and Research.

(3) Questions about CDER. 2001. U.S. Food and Drug Administration. Center for Drug Evaluation and Research.

(4) Waltermire, Richard, R. Ph., MS. 1998. Direct-to-customer advertising of RX drugs can be harmful to your health. From Drug benefit trends. p. 1.