Side effect reporting is very conservative. At least in the US, the big list of side effects isn’t the things we’re pretty sure that the medicine caused, or even things that seemed to be more common among people who took the medicine than people who didn’t.
If more than a trivial number of people taking the medicine report headaches, or nausea, or diarrhea, then those get reported as side effects. And those conditions are common enough to get reported for almost any medicine whether or not the medicine causes them.
The trials do report comparative rates of various conditions for treatment and control groups, so physicians can see which conditions the medicine might actually be causing (or at least associated with) and what they might actually want to be careful about. But the big list of side effects in a drug ad goes beyond those conditions.
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