Posting this under the heading it deserves: Conditions that change the calculus rather than forbidding it Everything below is what sits behind that.
I was wrong about Conditions in a thread last spring and I would like to correct it publicly rather than quietly.
The error was in the units, which changed the conclusion by an order of magnitude. Setting out the corrected version, and the way I now check for that class of mistake.
I keep a log for Conditions specifically because my memory of it turned out to be systematically wrong in one direction. Six weeks of notes cost nothing and settled it.
Where a condition appears as a warning rather than a contraindication, the decision is a clinical one rather than a prohibition.
Confirming post #4 from a second method, which matters more than confirming it from a second person.
Somebody's condition being on a list does not settle the decision, and somebody's condition being absent from one does not either.
It is one reading of the data and not the only reasonable one.
I had written a reply contradicting post #2 and deleted it. Here is what survived.
Pregnancy appears in the labelling for this class and the position is stated explicitly rather than left to inference.
Small point, but it is the one that usually catches people.
Two things can be true about Conditions at once: the mechanism is plausible and the evidence for the size of the effect is thin. Most of the argument here is people defending the first against attacks on the second.
Before the thread moves on from Conditions — what is the sample size behind the claim? I am not being difficult; I have seen the same figure quoted from an n of four and from an n of four hundred.
Post #6 and I disagree about the size of the effect, not about the direction.
Where a contraindication is relative rather than absolute, the reasoning usually appears in the assessment report rather than the labelling.
I looked this up rather than remembered it, which is the right order.
Second this, and I would have said it less carefully.
Taking Conditions seriously for a moment rather than deflecting: the honest position is that the community has observations and no controlled comparison, and those two things support very different sentences.
A history of pancreatitis appears in the cautions and the decision around it needs somebody who knows the history rather than a general rule.
Where I would look next, rather than where I would stop.
This follows post #13 rather than contradicting it.
A rodent toxicology finding underlying a contraindication is worth understanding, because it explains why the contraindication is narrow rather than broad.
I read post #13 twice before replying, because I had assumed the opposite.
Two people in this thread mean different things by Conditions and are disagreeing about the definition while believing they are disagreeing about the facts. Worth pausing to define it.
Allergy to the specific compound: true allergy is rare but possible. Any prior allergic reaction to the same compound or to structurally similar peptides warrants caution.
That is the honest state of it as of this week.
Where labelling has changed, the change is dated and public, and citing the current version is the whole of the discipline.
The reasoning is more useful than the number, which is why I have shown it.
Where a contraindication is relative rather than absolute, the reasoning usually appears in the assessment report rather than the labelling.
I am confident about the direction and much less about the magnitude.
Post #18 is the version of this I will quote in future. One addition.
I disagree with the framing of Conditions above, and I think it is a substantive disagreement rather than a terminological one. Setting out why, so it can be checked.
The reasoning depends on an assumption that is doing a lot of work and is never stated. If the assumption holds, the conclusion follows. I do not think it holds generally.
Useful. I had the fact and not the reason, which turns out to be the important half.
Confirming post #22 from a second method, which matters more than confirming it from a second person.
A history of pancreatitis appears in the cautions and the decision around it needs somebody who knows the history rather than a general rule.
I had written a reply contradicting post #24 and deleted it. Here is what survived.
Where a condition appears as a warning rather than a contraindication, the decision is a clinical one rather than a prohibition.
Happy to be the one who is wrong here if it settles the question.
Adding the boring version of Conditions, because the interesting version keeps getting posted and the boring one is usually right.
Check the ordinary explanations, in order, and stop when one of them accounts for what you are seeing. Most of the time the second one does.
The confident answers on Conditions and the well-sourced answers are not the same answers, which is the most useful thing I have learned reading this category.
Noted, and thank you for writing it out rather than summarising it.