or the drug could be harmful with no apparent adverse reactions and the bad effects appear after chronic use?
Adverse effects are associated with almost all drugs some are early and some are late onset .actually there is nothing like that as bad profile. When drugs are developed they are tried on animal and after FDA approval post marketing surveillance is obtained from a large number of countries regarding any noted side effects. Drugs are selected according to the tolerability of the patient if not suitable they are replaced by alternative drugs,.A same drug can show different status regarding side effects from patient to patient.
"Bad" - or maybe better "unfavorable" - profile of a drug is a consequence of everything that may disturb predictably effective and safe treatment. Beside adverse effects, I would add route of administration, kinetics and mode of absorption, metabolism by CYPs, transport by OATs, P-gp, etc., being too lipophilic or too hydrophilic, drug interactions with other drugs or food, etc., therapeutic index, safety for special population (e.g. babies, eldery, pregnant women, hepatic, kidney insufficiency pts.), and many many others. In general, the usefulness of a drug is not only a function of adverse effects (risks) only, but mainly the balance of both benefits and risks.
Drug side-effects, or adverse drug reactions, are a major healthcare concern. Serious drug side-effects are estimated to be the fourth leading cause of death in US as per literature. Adverse effects are required by law to be reported in many countries.
If a drug has no "side/adverse effect"...it has no "effect" too.
Looking into the high mortality rate due to adverse effect profile of the drugs, a judgement can be made on benefit:risk ratio.
An adverse effect does not make a drug profile bad. The drug therapeutic potential can be judged by drug benefit-risk assesment. The drug profile can be ajudged as bad when the concern of adverse effect is not worth taking a risk. However, some adverse effects can be treated by concomitant medication.
No adverse effects are not enough to present bad profile of the drugs. Idiosyncriatic reactions and role of genetics, metabolism in short pharmacokinetics and dynamics both are important.
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