Is Death Just Another Ignorable Drug Side Effect?

Would you stay on an airplane if the flight attendant announced that the captain had discovered a few problems with the landing gear and that there was a small chance the plane might not land safely? My guess is that a lot of people would opt to get off before takeoff. Why, then, do so many people ignore drug commercials that list death as a potential drug side effect? Your odds of being in an airplane crash are far less. According to Forbes (Feb. 26, 2025) the “Airline Crash Rate Is Just Seven Per 41 Million Flights, Report Says.” Your odds of suffering a serious adverse drug reaction could be as high as 20% (1 in 5) with some powerful medications.

In the AVERROES clinical trial for the anticoagulant apixaban (Eliquis) there were some interesting stats (New England Journal of Medicine, March 3, 2011).

The study compared Eliquis to aspirin for the treatment of atrial fibrillation (AFib):

“The rates of death were 3.5% per year in the apixaban group and 4.4% per year in the aspirin group. There were 44 cases of major bleeding (1.4% per year) in the apixaban group and 39 (1.2% per year) in the aspirin group; there were 11 cases of intracranial bleeding with apixaban and 13 with aspirin.”

A later study, ARTESIA, also published in the New England Journal of Medicine (Jan. 11, 2024) reported that while the anticoagulant lowered the risk for blood clot formation and strokes, it contributed to major bleeding events.

According to the report:

“The risk of major bleeding was 1.71% per patient-year with apixaban and 0.94% per patient-year with aspirin…Fatal bleeding occurred in 5 patients with apixaban and 8 patients with aspirin.”

Would you take a medicine that listed death as a possible side effect? Lots of people do.

Does Anyone Pay Attention to Drug Side Effect Warnings?

If you watch anything on TV or on an electronic device, you almost assuredly have seen drug commercials. Virtually all these ads come with a long list of scary side effects. It’s hard to believe that people would badger their doctors for medications that could cause life-threatening complications.

The pharmaceutical industry clearly thinks the strategy works. It spent over $5 billion in 2024 on television commercials and streaming video ads. So, if you think you have been seeing a lot of messages encouraging you to “ask your doctor” about a brand name drug, you are right.

The FDA requires such ads to contain drug side effect information. Many of these pharma commercials start with a serious health problem. Then we learn about the benefits of the drug in question. After that, an announcer reads a long list of potential problems as quickly as possible. Usually, the spot ends with people having a good time.

Botox Commercial:

For example, the injectable medicine Botox (onabotulinumtoxinA) is being promoted to prevent chronic migraines. One commercial begins with the question:

“Ever feel like a spectator in your own life…?”

Then the voice over quotes a survey:

“…91% of users wish they talked to their doctor and started sooner.”

Next comes the intimidating part:

“Botox effects may spread hours to weeks after injection, causing serious symptoms. Alert your doctor right away as trouble swallowing, speaking, breathing, eye problems, or muscle weakness can be signs of a life-threatening condition. Those with these conditions before injection are at highest risk. Side effects may include allergic reactions like rash, breathing problems, dizziness, neck and injection site pain, and headache. Don’t receive Botox if there’s a skin infection. Tell your doctor your medical history, muscle or nerve conditions like ALS, myasthenia gravis or Lambert-Eaton syndrome and medicines like botulinum toxins which may increase the risk of serious side effects.”

Perhaps people just don’t listen. Or maybe they figure that these problems will not affect them.

Here is an old Celebrex commercial with drug side effect information.

(This was probably before the generic celecoxib became widely available):

“All prescription NSAIDs like Celebrex, ibuprofen, naproxen and meloxicam have the same cardiovascular warning. They all may increase the chance of heart attack or stroke which can lead to death. This chance increases if you have heart disease or risk factors such as high blood pressure or when NSAIDs are taken for long periods. NSAIDs, including Celebrex, increase the chance of serious skin or allergic reactions or stomach and intestine problems such as bleeding and ulcers which can occur without warning and may cause death. Patients also taking aspirin and the elderly are at increased risk for stomach bleeding and ulcers. Do not take Celebrex if you’ve had an asthma attack, hives or other allergies to aspirin, NSAIDs or sulfonamides. Get help right away if you have swelling of the face or throat or trouble breathing. Tell your doctor your medical history…and find an arthritis treatment for you.”

Millions of Americans swallow prescription and over the counter NSAIDs daily for aches and pains. Many folks with arthritis also have high blood pressure. Because arthritis is a chronic condition, people frequently take NSAIDs “for long periods.” Have you been warned that if you have “heart disease or risk factors such as high blood pressure,” you could be increasing your chance for a heart attack or stroke which can lead to death?

How much of a chance? That’s not clear, but I guarantee you that it is a lot higher than dying in an airplane crash.

Vraylar Commercial:

I have seen quite a few commercials for Vraylar (cariprazine) lately. It is an “atypical antipsychotic” being promoted as an add-on for the treatment of depression.

The onscreen message states that Vraylar is:

“For adults with major depressive disorder (MDD) taking an antidepressant and still experiencing unresolved depression symptoms.”

A woman is seen riding her bicycle and smiling while the announcer states:

“Vraylar is not approved for elderly patients with dementia-related psychosis due to increased risk of death or stroke. Report changes in behavior or suicidal thoughts to your doctor. Antidepressants can increase these in children and young adults. Report fever, stiff muscles, or confusion, which may be life-threatening or uncontrolled muscle movements, which may be permanent. High blood sugar, which can lead to coma or death, weight gain, and high cholesterol may occur. Difficulty moving, tremors, slow or uncontrolled body movements, restlessness and feeling like you need to move, nausea, constipation, insomnia, dizziness, increased appetite, and fatigue are common. Side effects may not appear for several weeks. Visit Vraylar.com to see additional side effects.”

Although drug side effect information may seem daunting, it does not appear to slow sales. Pharmaceutical companies do not throw money away, so these commercials must be working.

They also impact prescribers. This is a surprisingly affordable way to communicate directly with doctors and other primary care providers.

Humira (adalimumab) Commercial:

OK, I know you are getting tired of drug commercials. But here is one medication (Humira) that earned a ton of money.

An article in the New York Times (Jan. 28, 2023) reported:

“Next week, the curtain is expected to come down on a monopoly that has generated $114 billion in revenue for AbbVie just since the end of 2016.”

Since its debut in 2002, Humira may have earned nearly $200 billion. This medication is prescribed for rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn’s disease, ulcerative colitis, hidradenitis suppurativa and uveitis.

As often occurs on drug commercials, we see people smiling and having fun. Do viewers pay attention to the scary drug side effect data?

“Humira can lower your ability to fight infections. Serious and sometimes fatal infections including tuberculosis and cancers including lymphoma have happened, as have blood, liver and nervous system problems, serious allergic reactions and new or worsening heart failure. Tell your doctor if you have been to areas where certain fungal infections are common and if you’ve had TB, hepatitis B, are prone to infections or have flu-like symptoms or sores. Don’t start Humira if you have an infection.”

NOT Just Television!

If you read drug ads in popular magazines, you might end up wondering who would ever beg a doctor for a prescription.

Abilify for Depression:

Abilify is a case in point. This drug was originally approved to treat schizophrenia but has been advertised aggressively for bipolar disorder (manic-depressive illness). One ad promotes the drug for managing mood swings and implies that Abilify might help you “feel more like yourself.”

That sounds appealing, but read on and you learn that elderly dementia patients who take Abilify are at increased risk of death “when compared to patients who are treated with a placebo (sugar pill).”

Not elderly, you say? Another side effect is rare but potentially fatal.

Neuroleptic malignant syndrome is characterized by:

“very high fever, rigid muscles, shaking, confusion, sweating, or increased heart rate and blood pressure.”

Abilify can also cause headache, anxiety, insomnia, nausea, vomiting, constipation, dizziness, restlessness, high blood sugar, seizures, uncontrollable facial movements and suicidal thoughts.

Chantix to Stop Smoking:

Speaking of suicidal thoughts, a widely advertised stop-smoking medicine also came with such a warning. Chantix commercials featured a tortoise and a hare with the slogan, “It’s all about getting there.” There is a brief mention of side effects including “nausea, trouble sleeping, changes in dreaming, constipation, gas and vomiting.”

You might be willing to risk such side effects; they all sound like a small price to pay for help quitting smoking. But read the official prescribing information and you will discover that Chantix has been linked to nausea, diarrhea, headache, changes in the sense of taste, abnormal dreams, abdominal pain, pain, dizziness, anxiety, irritability and depression.

Does Chantix Trigger Depression and Suicidal Thoughts?

Most people find such a list of side effects overwhelming and tend to stop reading before they reach the end.

Such symptoms may seem abstract until someone like Pam shares her story:

“I started taking Chantix three and a half weeks ago. At first I felt great and stopped smoking after the first five days. The vivid, crazy dreams were even kind of fun, but now I am so depressed I can barely get up in the morning… All I want to do is sleep and cry. I thought about killing myself yesterday… The nausea, stomach pain and constipation are so bad it’s been a chore to function. I have never suffered from depression in my life, so I was kind of blind-sided by all this.

“I didn’t associate any of this with Chantix. My mother mentioned that there were some horrible side effects associated with Chantix that she just heard about on the news today.”

Having read similar posts on our Web site, Pam feels relieved to know she is not alone.

The point here is not that Chantix is a bad drug. Smoking puts health at risk, and helping people quit is valuable. But we have received an incredible number of drug side effect reports at this and other links on our website. When you’re watching television commercials, listen carefully to the side effect part of upbeat drug ads.

What Should You Do?

All medications have risks. Even rare side effects do happen. Whether the medicine is Botox, Celebrex, Vraylar, Abilify, Chantix, Humira or any other prescribed medication, take a few minutes to read the small print. Never start or stop any medicine without first discussing the pros and cons with the prescriber!

You might discover that a medication you take to relieve arthritis pain could cause a life-threatening bleeding ulcer or even lead to a heart attack. Without meaning to, your doctor might prescribe a drug that could trigger a potentially fatal heart rhythm disruption.

Being well informed about risks and drug side effects could save your life. Be sure to check with the prescriber and the pharmacist about possible serious adverse reactions. Don’t stop there, however. Track down the official prescribing information online at DailyMed. Read it and ask your healthcare provider for help understanding it if you find something alarming.

In our book, Top Screwups, we have outlined the crucial questions you should always ask your physician and pharmacist before starting a new medicine.

If you think this article has value, please share it with friends and family. These days a medication Google search often brings up ads from the manufacturer at the top of the page. For example, when I put “Vraylar side effects” into a search, this is the page that shows up at the tip-top. The headline:

“VRAYLAR can help your patients go from
getting through to breaking through”

Thank you for helping us spread the word about drug side effect information.