The Medical Letter - 2008
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January 14, 2008 (Issue 1277)
- A Diclofenac Patch (Flector) for Pain
Diclofenac epolamine patch 1.3% (Flector Patch - Alpharma), a topical formulation of the nonsteroidal anti-inflammatory drug (NSAID) diclofenac, has been approved by the FDA for topical... - Two New Drugs for HIV Infection
Raltegravir (Isentress - Merck), the first in a new class of oral HIV drugs called HIV-1 integrase strand transfer inhibitors (InSTI), has received accelerated FDA approval for use in... - In Brief: Cetirizine OTC
Cetirizine (Zyrtec, and others) and cetirizine/pseudoephedrine (Zyrtec-D) are becoming available without a prescription this month for treatment of allergic rhinitis and urticaria...
January 28, 2008 (Issue 1278)
- Doripenem (Doribax) - A New Parenteral Carbapenem
Doripenem (Doribax - Ortho-McNeil Janssen), an intravenous (IV) carbapenem antibiotic with a spectrum of activity similar to that of imipenem and meropenem, has been approved by the FDA for... - Ixabepilone (Ixempra) for Breast Cancer
Ixabepilone (ix ab ep' i lone; Ixempra - Bristol-Myers Squibb), a semisynthetic epothilone analog, has been approved by the FDA for treatment of advanced breast cancer. It is indicated for... - In Brief: Zetia and Vytorin: The ENHANCE Study
An unpublished 2-year randomized study (ENHANCE) on the effect of adding ezetimibe 10 mg to simvastatin 80 mg in 720 patients with heterozygous familial hypercholesterolemia has been in the news...
February 11, 2008 (Issue 1279)
- Budesonide/Formoterol (Symbicort) for Asthma
A combination of the corticosteroid budesonide and the long-acting beta2-agonist formoterol (Symbicort - AstraZeneca) has become available in a metered dose inhaler for long-term... - Ophthalmic Azithromycin (AzaSite)
The FDA has approved azithromycin 1% ophthalmic solution (AzaSite - Inspire) for treatment of bacterial conjunctivitis in patients > 1 year old. It is formulated, according to the... - In Brief: Herbal Warning
The FDA recently advised health care professionals and consumers not to use a number of dietary supplements found to contain the phosphodiesterase-5 inhibitor sildenafil (Viagra) or an analog...
February 25, 2008 (Issue 1280)
- Retapamulin (Altabax) - A New Topical Antibiotic
Retapamulin (re-tap'-a-mue'-lin; Altabax - Glaxo SmithKline) is a topical antibiotic recently approved by the FDA for treatment of bullous and non-bullous impetigo due to Streptococcus... - Veregen: A Botanical for Treatment of Genital Warts
The FDA has approved the marketing of sinecatechins (Veregen - Bradley/Medigene), a botanical drug product, for treatment of external genital and perianal warts. Sinecatechins is a water... - In Brief: Sevelamer-Based Phosphate Binders
Sevelamer carbonate (Renvela – Genzyme), a buffered form of the anion-exchange resin sevelamer hydrochloride (Renagel – Genzyme),1 has been approved by the FDA for use in patients...
March 10, 2008 (Issue 1281)
- Nebivolol (Bystolic) for Hypertension
Nebivolol (Bystolic - Forest) is a new beta-blocker that has been approved by the FDA for treatment of hypertension. It has been marketed in Europe since 1999 for treatment of hypertension... - Gluten-Free Drugs for Celiac Disease Patients
Celiac disease is a chronic autoimmune disorder caused by a genetic intolerance to gluten that occurs in about 1% of the population. The main form of treatment is a lifelong gluten-free diet.
March 24, 2008 (Issue 1282)
- A Rivastigmine Patch for Dementia
Cholinesterase inhibitors are now used routinely in patients with dementia. Rivastigmine transdermal system (Exelon Patch - Novartis), a patch formulation of the cholinesterase inhibitor... - Palatal Implants for Snoring and Obstructive Sleep Apnea
Treatment options for snoring and obstructive sleep apnea (OSA) now include, in addition to lifestyle remedies such as weight loss and avoidance of alcohol in the evening, mechanical devices,... - In Brief: Influenza Developments
Recent reports (D Kaye.Clin Infect Dis April 1, 2008;46:iii) indicate that 2 of the 3 components of this year's influenza vaccine (Med Lett Drugs Ther 2007;49:81), the influenza B and A/H3N2...
April 7, 2008 (Issue 1283)
- Simcor: A Niacin/Simvastatin Combination
The FDA has approved the marketing of a second fixed-dose combination of extended-release niacin (Niaspan) with a generic statin. Niaspan/simvastatin (Simcor - Abbott) is approved for... - Nilotinib (Tasigna) for CML
Nilotinib (Tasigna - Novartis), a tyrosine kinase inhibitor, has been approved by the FDA for treatment of Philadelphia chromosome-positive (Ph+) chronic or accelerated phase chronic... - Tadalafil (Cialis) Once a Day for Erectile Dysfunction
The phosphodiesterase type 5 (PDE5) inhibitor tadalafil (Cialis - Lilly) is now being promoted for once daily treatment of erectile dysfunction. Tadalafil differs from sildenafil... - In Brief: Meningococcal Prophylaxis
The CDC recently reported that fluoroquinoloneresistant strains of Neisseria meningitidis have been detected for the first time in the US in an area around the border of North Dakota and...
April 21, 2008 (Issue 1284)
- Which Statin?
Advertisements for atorvastatin (Lipitor), the market leader facing generic competition, have been in the news recently in the US. Lovastatin, pravastatin and simvastatin are all available... - Diclofenac Gel For Osteoarthritis
The nonsteroidal anti-inflammatory drug (NSAID) diclofenac, has been approved by the FDA in a 1% topical gel formulation (Voltaren Gel - Endo) for treatment of osteoarthritis (OA). A 3%... - In Brief: Genetic Test for Carbamazepine-Induced Stevens-Johnson Syndrome
Genetic Test for Carbamazepine-Induced Stevens-Johnson Syndrome Carbamazepine (Tegretol, Carbatrol, Equetro, and others), which is now used to treat not only epilepsy but also trigeminal...
May 5, 2008 (Issue 1285)
- Ciclesonide (Omnaris) for Allergic Rhinitis
Ciclesonide (Omnaris - Sepracor/Nycomed), a once daily corticosteroid nasal spray, is now available for treatment of seasonal allergic rhinitis (SAR) in adults and children ≥6 years old... - Natalizumab (Tysabri) for Crohn's Disease
Natalizumab (Tysabri - Elan and Biogen) is a monoclonal antibody approved for induction and maintenance treatment of moderate to severe Crohn's disease (CD) refractory to conventional... - In Brief: A New Indication for Colesevelam (Welchol)
Colesevelam (Welchol - Daiichi Sankyo - Med Lett Drugs Ther 2000; 42:102), a bile-acid sequestrant used to lower LDL cholesterol, has been approved by the FDA as an adjunct to diet and...
May 19, 2008 (Issue 1286)
- Desvenlafaxine for Depression
The FDA has approved the marketing of desvenlafaxine (Pristiq - Wyeth), the main active metabolite of venlafaxine (Effexor, and others - Wyeth), for treatment of major depressive... - Pharmacogenetic-Based Dosing of Warfarin
Warfarin sodium (Coumadin, and others) and other coumarin anticoagulants prevent thrombosis, but patient response is highly variable and overanticoagulation can lead to hemorrhage. Genotyping... - In Brief: IV Artesunate for Severe Malaria
The drug of choice for patients who require parenteral treatment for malaria is IV artesunate, which is available now from the CDC Malaria Branch (M-F, 8 AM-4:30 PM eastern time, 770-488-7788 or,...
June 2, 2008 (Issue 1287)
- Spinal Decompression Machines
Spinal decompression machines offer a motorized form of mechanical traction. These devices, which are widely advertised to the public as a noninvasive alternative to surgery, are claimed to relieve... - Bevacizumab (Avastin) for Metastatic Breast Cancer
Bevacizumab (Avastin - Genentech) is a recombinant humanized monoclonal antibody that binds to vascular endothelial growth factor and prevents it from binding to receptors on endothelial... - Sapropterin (Kuvan) for Phenylketonuria
Sapropterin (Kuvan - BioMarin) has been approved by the FDA to reduce phenylalanine plasma concentrations in patients with phenylketonuria (PKU). PKU is a rare genetic disorder (it occurs in... - In Brief: Measles Outbreak
The US Centers for Disease Control and Prevention (CDC) has reported that measles outbreaks have occurred in New York City, California and Arizona in 2008, and additional cases have been confirmed... - Correction: Natalizumab (Tysabri) for Crohn's Disease
The May 5, 2008 article (Med Lett Drugs Ther 2008; 50:34) on the approval of natalizumab (Tysabri) for treatment of Crohn's disease in the "Adverse Effects" section on page 35 included the...
June 16, 2008 (Issue 1288)
- A Fixed-Dose Combination of Sumatriptan and Naproxen for Migraine
The FDA has approved an oral, fixed-dose combination (Treximet - GlaxoSmithKline) of the selective serotonin receptor agonist ("triptan") sumatriptan (Imitrex) and the nonsteroidal... - Vitamins for Cataract Prevention
Cataracts are the leading cause of blindness worldwide because cataract surgery is not available to most people in developing countries. - Etravirine (Intelence) for HIV Infection
Etravirine (Intelence - Tibotec), a new non-nucleoside reverse transcriptase inhibitor (NNRTI), has received fast-track FDA approval for use in combination therapy in treatment-experienced... - Addendum: Warfarin-Acetaminophen Interaction
A reader expressed disappointment that our recent listing of “Some Warfarin Drug Interactions”1 did not include acetaminophen. Perhaps it should have. Acetaminophen can increase the...
June 30, 2008 (Issue 1289)
- Finasteride for Prevention of Prostate Cancer
Patients are asking physicians about an article on the front page of the June 15th New York Times, in which some prostate cancer experts were quoted as suggesting that men 55 and older might be well... - Extended-Release Fluvoxamine (Luvox CR)
Fluvoxamine maleate, a selective serotonin reuptake inhibitor (SSRI) that has been available for many years in an immediate-release formulation (Luvox, and others) for treatment of... - Olopatadine (Patanase) Nasal Spray
Olopatadine 0.6% nasal spray (Patanase - Alcon) has been approved by the FDA for treatment of seasonal allergic rhinitis in patients ≥ 12 years old. An H1-antihistamine with mast-cell... - In Brief: Intensive Glucose Lowering in Type 2 Diabetes
The goal for drug therapy of type 2 diabetes is achieving and maintaining a near-normal glycated hemoglobin (HbA1C) concentration without inducing hypoglycemia; the target has generally...
July 14, 2008 (Issue 1290)
- Varenicline (Chantix) Warnings: Risk Versus Benefit
The nicotine receptor partial agonist varenicline (Chantix - Pfizer) appears to be the most effective drug available to treat tobacco dependence, but the FDA has added a warning to the... - Lubiprostone (Amitiza) for Irritable Bowel Syndrome with Constipation
Lubiprostone (Amitiza), which was previously approved for treatment of chronic idiopathic constipation in adults, has now also been approved in a lower dose for use in women with irritable... - Wellbutrin Versus Generic Bupropion
Bupropion (Wellbutrin - GlaxoSmithKline, and others) is a norepinephrine and dopamine reuptake inhibitor that has been a useful antidepressant because, unlike some other antidepressants, it... - The EarCheck Middle Ear Monitor for Detection of Middle Ear Effusion in Children
The EarCheck Middle Ear Monitor (Innovia Medical) is a device marketed to consumers for home detection of middle-ear effusion (MEE) in children.
July 28, 2008 (Issue 1291)
- Duloxetine (Cymbalta) for Fibromyalgia
Duloxetine (Cymbalta - Lilly) is the second drug to be approved by the FDA for treatment of fibromyalgia. Pregabalin (Lyrica), which is also approved for treatment of neuropathic pain... - Drugs for Travelers' Diarrhea
The most common cause of travelers' diarrhea, usually a self-limited illness without fever lasting several days, is infection with noninvasive enterotoxigenic (ETEC) or enteroaggregative (EAEC)... - ECGs Before Stimulants in Children
The American Heart Association (AHA) recently published a statement saying that it would be reasonable to obtain an electrocardiogram (ECG) in children being evaluated for stimulant drug therapy for... - A Reminder: Meningococcal Vaccine
The U.S. Advisory Committee on Immunization Practices has recommended administration of the quadrivalent conjugated polysaccharide meningococcal vaccine (Menactra – Sanofi Pasteur) to all...
August 11, 2008 (Issue 1292)
- Antiplatelet Therapy for Patients with Stents
The antiplatelet agents aspirin and clopidogrel (Plavix, and others) are used in most patients undergoing percutaneous coronary intervention (PCI) to prevent stent thrombosis and to reduce... - Methylnaltrexone (Relistor) for Opioid-Induced Constipation
The FDA has approved subcutaneous injection of methylnaltrexone (Relistor - Wyeth/Progenics), a selective mu-opioid receptor antagonist, for treatment of opioid-induced constipation in... - Correction: The EarCheck Middle Ear Monitor
The article in the July 14th issue contained an error in the last sentence of the last paragraph beginning on page 55. The instrument's reading is determined not by the degree of protrusion of the...
August 25, 2008 (Issue 1293)
- Aliskiren/Hydrochlorothiazide (Tekturna HCT) for Hypertension
Aliskiren (Tekturna - Novartis), the first direct renin inhibitor for treatment of hypertension, has been approved for use in a fixed-dose combination with the diuretic hydrochlorothiazide... - A New Rotavirus Vaccine
Rotarix, an oral live-attenuated rotavirus vaccine, has been approved by the FDA for prevention of rotavirus gastroenteritis in infants and children. Rota-Shield was withdrawn from the... - Ezetimibe Revisited
In recent months, both the lay media and some medical experts have raised concerns about the effectiveness and safety of ezetimibe, a widely used drug that prevents absorption of cholesterol from... - Zingo for Local Analgesia in Children
The FDA has approved the marketing of a new device for delivering lidocaine to the skin of children undergoing a venipuncture or intravenous (IV) line placement. Zingo (Anesiva) is a powder...
September 8, 2008 (Issue 1294)
- Monthly Risedronate (Actonel) for Postmenopausal Osteoporosis
The bisphosphonate risedronate (Actonel - Procter & Gamble) was recently approved by the FDA in a 150- mg once-monthly oral tablet for prevention and treatment of postmenopausal osteoporosis.... - Sunscreens: An Update
Superseded by The Medical Letter "Sunscreens" - Issue 1553, August 13, 2018Sunscreens are an important component of photoprotection. A new definition of their effectiveness has been proposed,... - In Brief: Exenatide (Byetta) and Pancreatitis
The FDA has issued an update (August 18, 2008; www.fda.gov) on occurrences of acute pancreatitis in patients with diabetes taking exenatide (Byetta – Amylin/Lilly). The latest update,...
September 22, 2008 (Issue 1295)
- Clevidipine (Cleviprex) for IV Treatment of Severe Hypertension
Clevidipine (Cleviprex - The Medicines Company), a dihydropyridine calcium channel blocker (CCB), has been approved by the FDA for intravenous (IV) use in lowering high blood pressure. It is... - Ciclesonide (Alvesco) - A New Inhaled Corticosteroid for Asthma
The FDA has approved the marketing of the corticosteroid ciclesonide (Alvesco - Sepracor) in a hydrofluoroalkane (HFA) metered-dose inhaler formulation for maintenance treatment of asthma in...
October 6, 2008 (Issue 1296)
- Influenza Vaccine 2008-2009
Superseded by The Medical Letter "Influenza Vaccine for 2019-2020" - Issue 1583, October 21, 2019Annual immunization against influenza A and B is the most effective method of preventing... - Dutasteride (Avodart) with Tamsulosin (Flomax) for Benign Prostatic Hyperplasia
The FDA has approved the use of the 5α-reductase inhibitor dutasteride (Avodart - GlaxoSmithKline) together with the alpha1-blocker tamsulosin (Flomax - Boehringer...
October 20, 2008 (Issue 1297)
- Certolizumab (Cimzia) for Crohn's Disease
The FDA has approved the marketing of certolizumab pegol (Cimzia - UCB), a tumor necrosis factor (TNF) blocker, for treatment of moderate to severe Crohn's disease refractory to conventional... - Drug Interactions with Simvastatin
A recent letter to the editor of the Annals of Internal Medicine documented a single case of myopathy apparently due to an interaction between simvastatin (Zocor, and others) and green tea.... - In Brief: Melamine
Melamine present in infant formula and other milk products has been associated with widespread illness and some deaths among infants in China. It was also identified in pet food sold in North...
November 3, 2008 (Issue 1298)
- Prostate Cancer Screening
The US Preventive Services Task Force (USPSTF) has recently concluded that available evidence is insufficient to assess the balance between potential benefits and harms of using the... - Prevention of Venous Thromboembolism in Orthopedic Surgery
Major orthopedic surgery creates a prothrombotic state by causing tissue injury during the operation and requiring relative immobilization during recovery. Without thromboprophylaxis, 40-60% of... - In Brief: New Propellants for Albuterol Metered-Dose Inhalers
Inhaled drugs for asthma are available in the US mainly in pressurized metered-dose inhalers (MDIs), which require a propellant, and dry powder inhalers, which do not. The chlorofluorocarbon (CFC)...
November 17, 2008 (Issue 1299)
- Advertisements for TNF Inhibitors
Some tumor necrosis factor (TNF) inhibitors are being promoted on the internet directly to the public for use in psoriasis (www.yahoo.com). - Safety of SSRIs in Pregnancy
Depression occurs in up to 20% of pregnant women, and the use of selective serotonin reuptake inhibitors (SSRIs) in these women has been increasing. Maternal depression has itself been associated... - Bendamustine (Treanda) for CLL and NHL
Bendamustine HCl (Treanda - Cephalon), an unusual DNA-alkylating agent that has been used in Europe for many years to treat lymphoma, has now been approved by the FDA for treatment of chronic...
December 1, 2008 (Issue 1300)
- Alvimopan (Entereg) for Postoperative Ileus
The FDA has approved the marketing of alvimopan (Entereg - Adolor/GlaxoSmithKline), a selective muopioid receptor antagonist, for oral treatment of postoperative ileus after bowel resection.... - CT Colonography (Virtual Colonoscopy) Revisited
Options in screening for colon cancer include fecal occult blood tests, flexible sigmoidoscopy, colonoscopy, computed tomography (CT) colonography and fecal DNA tests. Since the last Medical... - Low-Voltage Electronic Diagnostic Devices
Health care professionals may be asked about lowvoltage electronic devices now being used to diagnose and/or treat a number of health problems. Most are galvanometers that measure skin resistance to... - In Brief: Fluoroquinolones and Tendon Injuries
The FDA has added a boxed warning to fluoroquinolone package inserts about tendon injuries that may occur as a result of their use. Tendinitis or tendon rupture may occur rarely with systemic use of... - Correction: Bendamustine (Treanda) for CLL and NHL
(Med Lett Drugs Ther 2008; 50:91) In the Clinical Studies section, the complete response rate with chlorambucil for CLL was 2% (not 24%).
December 15, 2008 (Issue 1301)
- CRP and Statins for Primary Prevention of Coronary Artery Disease
Modestly elevated C-reactive protein (CRP) concentrations have been associated with an increased risk of coronary heart disease. The recently published and heavily publicized results of the JUPITER... - Antiviral Drugs for Influenza
Superseded by The Medical Letter "Antiviral Drugs for Treatment and Prophylaxis of Seasonal Influenza" - Issue 1563, January 14, 2019Antiviral drugs are an important adjunct to influenza... - Drugs That May Cause Psychiatric Symptoms
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment could also be due to the underlying... - A Granisetron Patch (Sancuso)
The treatment of choice to prevent emesis due to highand moderate-risk emetogenic drugs used in cancer chemotherapy is aprepitant plus a serotonin receptor antagonist plus dexamethasone. Four... - Correction: CT Colonography
(Med Lett Drugs Ther 2008; 50:94) In table 1, "Invasive" should be "less" and "more" rather than "no" and "yes" for CT colonography and colonoscopy, respectively. - 2008 Annual Index (Online Only)
View the 2008 Annual Index