The Medical Letter - 2009
Year:    Publication:      2009 Annual Index: U.S. English | Canadian English
January 12, 2009 (Issue 1303)  
  • Long-Acting Beta-2 Agonists in Asthma
    Continued use of a long-acting beta-2 agonist for treatment of asthma may cause down-regulation of the beta-2 receptor with loss of the bronchoprotective effect from rescue therapy with a...
  • PPI Interactions with Clopidogrel
    Clopidogrel (Plavix), which prevents arterial thrombosis by inhibiting platelet activation, is commonly prescribed (usually with aspirin) for months after acute coronary syndromes and stent...
  • Silodosin (Rapaflo) for Benign Prostatic Hyperplasia
    Silodosin (Rapaflo - Watson Pharmaceuticals), an alpha1a-adrenoreceptor selective antagonist, has been approved by the FDA for treatment of benign prostatic hyperplasia (BPH). Some...
  • 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. In the conclusion, CT colonography...
January 26, 2009 (Issue 1304)  
  • More Resistance to Oseltamivir (Tamiflu)
    Since publication of our recent article on antiviral drugs for influenza, increased levels of resistance to oseltamivir (Tamiflu) have been detected in influenza A H1N1 strains.
  • Implantable Cardioverter Defibrillators
    Implantable cardioverter defibrillators (ICDs) are widely used in patients at risk for sudden cardiac death (SCD) because these devices have been highly successful in terminating life-threatening...
  • Tetrabenazine (Xenazine) for Huntington's Chorea
    Tetrabenazine (Xenazine - Ovation Pharmaceuticals), an old drug first synthesized 50 years ago for treatment of schizophrenia, was recently approved by the FDA for the treatment of chorea...
  • The Medical Letter - 50th Anniversary
    The Medical Letter was founded in 1959 by Arthur Kallet, an engineer, and Dr. Harold Aaron, an internist. In 1932, Kallet had written the book 100,000,000 Guinea Pigs, a best-seller that was...
February 9, 2009 (Issue 1305)  
February 23, 2009 (Issue 1306)  
  • PPI Interactions with Clopidogrel Revisted
    Current guidelines recommend use of a proton pump inhibitor (PPI) to decrease the risk of gastrointestinal bleeding in patients taking clopidogrel (Plavix) with aspirin. A recent issue of The...
  • Conjugated Estrogens (Premarin) Vaginal Cream
    An old conjugated estrogens vaginal cream (Premarin Vaginal Cream - Wyeth) has been newly approved by the FDA specifically for treatment of moderate to severe dyspareunia due to vulvar and...
  • Screening for Oral Cancer
    The incidence of oral cancer appears to be increasing, especially in younger patients. Risk factors include use of tobacco and alcohol, and exposure to human papillomavirus. ViziLite Plus...
  • In Brief: Cardiac Risks of Antipsychotic Drugs
    A recently published retrospective cohort study in patients 30-74 years old has led to headlines in the media warning that use of atypical antipsychotic drugs doubles patients’ risk of sudden...
March 9, 2009 (Issue 1307)  
March 23, 2009 (Issue 1308)  
  • Dexlansoprazole (Kapidex) for GERD and Erosive Esophagitis
    The FDA has approved the proton-pump inhibitor (PPI) dexlansoprazole (Kapidex - Takeda), a delayed release formulation of the R-enantiomer of lansoprazole (Prevacid - Takeda), for...
  • Focalin XR for ADHD
    Short-acting methylphenidate (MPH) is effective for treatment of attention-deficit/hyperactivity disorder (ADHD), but its 3-5 hour duration of action usually requires mid-day dosing in school, which...
  • In Brief: Different Diets
    A recent article in the New England Journal of Medicine confirms something that others, including The Medical Letter (Treat Guidel Med Lett 2008; 6:23), have been saying for years: no particular...
April 6, 2009 (Issue 1309)  
  • Vancomycin Dosing and Monitoring
    Consensus recommendations for dosing and therapeutic monitoring of intravenous (IV) vancomycin (Vancocin, and others) were recently published. IV vancomycin has been used for decades as an...
  • Deep Brain Stimulation for Parkinson's Disease
    Deep brain stimulation (DBS) is increasingly used to treat advanced Parkinson's disease (PD), but few controlled clinical trials have been published. New evidence from a large controlled study has...
  • Valproic Acid Delayed Release (Stavzor)
    The FDA has approved a delayed-release capsule formulation of valproic acid (VPA; Stavzor - Noven Therapeutics) for all of the indications for which divalproex sodium (Depakote, and...
April 20, 2009 (Issue 1310)  
  • Azelastine (Astepro) Nasal Spray for Allergic Rhinitis
    A new formulation of the H1-antihistamine azelastine hydrochloride 0.1% nasal spray (Astepro - Meda) has been approved by the FDA for treatment of seasonal allergic rhinitis (SAR) in patients...
  • Adapalene-Benzoyl Peroxide (Epiduo) for Acne
    Epiduo gel (Galderma), a fixed-dose combination of adapalene 0.1% (Differin), a synthetic retinoid analog, and benzoyl peroxide (BPO) 2.5%, an oxidizing agent, has been approved by the...
  • Correction: Vancomycin Dosing and Monitoring
    (Med Lett Drugs Ther 2009; 51:25) In the paragraph on dosing, the second-to-last sentence should have said that the new recommendations suggest considering use of an alternative antibiotic when the...
May 4, 2009 (Issue 1311)  
  • Fenofibric Acid (Trilipix)
    The FDA has approved the marketing of fenofibric acid (Trilipix - Abbott) to reduce triglycerides and increase HDL-C in patients with mixed dyslipidemia on optimal doses of a HMG-CoA...
  • Fesoterodine (Toviaz) for Overactive Bladder
    The FDA has approved the marketing of fesoterodine (Toviaz - Pfizer), a muscarinic receptor antagonist, for treatment of overactive bladder. It is the sixth antimuscarinic drug approved for...
  • Drugs for MRSA with Reduced Susceptibility to Vancomycin
    The recent Medical Letter article on vancomycin dosing and monitoring briefly mentioned use of an alternative antibiotic for treatment of methicillin-resistant Staphylococcus aureus...
May 18, 2009 (Issue 1312)  
  • Febuxostat (Uloric) for Chronic Treatment of Gout
    Febuxostat (Uloric - Takeda), a xanthine oxidase inhibitor, has been approved by the FDA for chronic management of hyperuricemia in patients with gout. It is the first drug marketed for...
  • Encapsulated Mesalamine Granules (Apriso) for Ulcerative Colitis
    Apriso (Salix) is a new formulation of mesalamine (5-aminosalicylic acid; 5-ASA) approved by the FDA for maintenance of remission in mild to moderate ulcerative colitis (UC). Mesalamine is a locally...
  • Colon Cleansing
    Web sites and blogs are advising patients that periodic "cleansing" of the colon is necessary to rid the body of toxins.
  • In Brief: Plan B for 17-Year Olds
    The FDA has announced that it will lower the age for over-the-counter access to the emergency contraceptive Plan B1 from 18 to 17 years old. In a randomized, controlled trial, the two...
June 1, 2009 (Issue 1313)  
June 15, 2009 (Issue 1314)  
  • In Brief: Tamoxifen and SSRI Interactions
    Use of a selective serotonin reuptake inhibitor (SSRI) is common in women taking tamoxifen (Nolvadex, and others) for breast cancer, both to treat depression and to decrease hot flashes....
  • Milnacipran (Savella) for Fibromyalgia
    Milnacipran (Savella - Forest), an oral selective serotonin and norepinephrine reuptake inhibitor (SNRI), is the third drug approved by the FDA for management of fibromyalgia. The 2 others...
  • Exforge HCT
    Most patients with hypertension require more than one drug to control their blood pressure. Exforge HCT (Novartis) is a new 3-drug fixed-dose combination tablet approved by the FDA for...
  • Pneumococcal Vaccination of Adults: Polysaccharide or Conjugate?
    A 23-valent polysaccharide vaccine (PPSV23; Pneumovax 23 - Merck) is the only pneumococcal vaccine approved for use in adults. It has reduced the risk of invasive pneumococcal disease...
June 29, 2009 (Issue 1315)  
July 13, 2009 (Issue 1316)  
  • Acetaminophen Safety - Deja Vu
    Concerns have surfaced again at the FDA and in the media about the safety of acetaminophen and the multiplicity of products on the market in the US that contain various amounts of it.
  • Golimumab (Simponi) for Inflammatory Arthritis
    Golimumab (Simponi - Centocor), a fully humanized anti-tumor necrosis factor (TNF)-a antibody, has been approved by the FDA for the treatment of: (1) moderate to severe active rheumatoid...
July 27, 2009 (Issue 1317)  
August 10, 2009 (Issue 1318)  
  • Tapentadol (Nucynta) - A New Analgesic
    The FDA has approved tapentadol hydrochloride (Nucynta - Ortho-McNeil Janssen) for oral treatment of moderate to severe acute pain in patients ≥18 years old. It has been classified as a Schedule...
  • Tablet Splitting
    Superseded by The Medical Letter "Tablet Splitting" - Issue 1396, August 6, 2012Readers have asked us to update our 2004 article on tablet splitting. Breaking drug tablets in half is a common...
  • In Brief: Heat and Transdermal Fentanyl
    Transdermal fentanyl (Duragesic, and others) offers a convenient delivery system for patients with chronic pain1 but it has some drawbacks. One is that exposing the patch to heat, either...
August 24, 2009 (Issue 1319)  
  • Safety of Smoking Cessation Drugs
    The most effective drugs available for treatment of tobacco dependence are bupropion (Zyban, and others and varenicline (Chantix). The FDA recently ordered the manufacturers of both to...
  • A New Japanese Encephalitis Vaccine (Ixiaro)
    The FDA has approved a new Japanese encephalitis vaccine (Ixiaro - Intercell/Novartis). It will replace JEVax (Sanofi Pasteur), which has had tolerability and safety problems and is no...
  • Insulin Glargine (Lantus) and Cancer Risk
    Several large European observational studies published on-line this summer have raised questions about whether use of insulin glargine increases the risk of cancer.
  • Corrections
    Benzyl Alcohol Lotion for Head Lice (Med Lett Drugs Ther 2009; 51:57) In Table 1, the price for lindane 1% shampoo should be $136.86 (not $3.00). When a Statin...
September 7, 2009 (Issue 1320)  
  • Prasugrel (Effient) vs. Clopidogrel (Plavix)
    The FDA has approved prasugrel (Effient - Lilly/Daiichi Sankyo), an oral antiplatelet drug, for use with aspirin to reduce the rate of thrombotic cardiovascular events in patients with acute...
  • Calcitriol (Vectical) for Mild to Moderate Plaque Psoriasis
    The FDA has approved calcitriol ointment (Vectical - Galderma), a vitamin D analog, for topical treatment of mild-to-moderate plaque psoriasis in adults ≥18 years old. Ointments are...
  • Red Yeast Rice
    Red yeast rice is a food product that has been used in Chinese cooking and medicine for centuries. It is available in the US in a capsule formulation and is often used by patients who want a...
  • Addendum: Why Not Ertapenem for Surgical Prophylaxis?
    Some readers have asked why the June 2009 issue of Treatment Guidelines (Antimicrobial Prophylaxis for Surgery) did not recommend use of ertapenem (Invanz) for prevention of infection after...
September 21, 2009 (Issue 1321)  
  • Seasonal Trivalent Influenza Vaccine for 2009-2010
    Superseded by The Medical Letter "Influenza Vaccine for 2017-2018" - Issue 1531, October 9, 2017Two separate influenza vaccines will be available this season: the usual seasonal trivalent...
  • Resveratrol
    Resveratrol is a phytochemical found in the skin of red grapes and in many other plants, including berries, plums and peanuts. As a constituent of red wine, it has been associated with...
  • Artemether-Lumefantrine (Coartem) for Treatment of Malaria
    The FDA has approved artemether-lumefantrine (Coartem - Novartis) for oral treatment of uncomplicated Plasmodium falciparum malaria. It is not approved for prophylaxis....
October 5, 2009 (Issue 1322)  
  • H1N1 Vaccine for Prevention of Pandemic Influenza
    The FDA has licensed 4 new monovalent vaccines for prevention of respiratory illness caused by a new influenza A H1N1 virus that appears to be derived from a swine strain. The 5th vaccine should be...
  • Dronedarone (Multaq) for Atrial Fibrillation
    Dronedarone (Multaq - Sanofi-Aventis) has been approved by the FDA for oral treatment of atrial fibrillation and flutter. Amiodarone (Cordarone, and others) is the most effective drug for...
October 19, 2009 (Issue 1323)  
  • Generic Drugs Revisited
    The equivalence of generic drugs to their brand-name precursors continues to be controversial. The last Medical Letter review of this subject (2002) concluded that well-documented therapeutic...
  • Degarelix (Firmagon) for Prostate Cancer
    The FDA has approved degarelix (Firmagon - Ferring), a synthetic decapeptide gonadotropin-releasing hormone (GnRH) receptor antagonist, for rapid medical castration of men with advanced...
  • Recombinant Human Antithrombin (ATryn)
    The FDA has approved the use of recombinant human antithrombin (rhAT; ATryn - Lundbeck) in patients with inherited antithrombin (AT) deficiency to prevent thrombosis during or after surgery...
November 2, 2009 (Issue 1324)  
November 16, 2009 (Issue 1325)  
  • Antiviral Drugs for Influenza
    Superseded by The Medical Letter "Antiviral Drugs for Seasonal Influenza 2016-2017" - Issue 1511, January 2, 2017Currently circulating influenza virus is almost universally pandemic 2009...
November 30, 2009 (Issue 1326)  
  • Colchicine and Other Drugs for Gout
    Until the recent introduction of febuxostat (Uloric), no new drugs had been marketed for treatment of gout in the past 40 years. Colchicine, which has been available for decades as an...
  • Aliskiren/Valsartan (Valturna) for Hypertension
    The FDA has approved the use of aliskiren (Tekturna), a direct renin inhibitor, with valsartan (Diovan), an angiotensin-receptor blocker (ARB), in a fixed-dose combination as...
  • Tolvaptan (Samsca) for Hyponatremia
    The FDA has approved the marketing of tolvaptan (Samsca - Otsuka), an oral vasopressin receptor antagonist, for treatment of hypervolemic or euvolemic hyponatremia due to congestive heart...
December 14, 2009 (Issue 1327)  
  • Screening Mammography for Women 40-49 Years Old
    Conflicting recommendations on when to screen for breast cancer are problematic for healthcare providers. The recent recommendation by the US Preventive Services Task Force (USPSTF) against routine...
  • Rapid-Acting Insulin Analogues
    Three rapid-acting insulin analogs are currently available: insulin lispro, insulin aspart and insulin glulisine. 1-3 All three are approved for use in both type 1 and type 2 diabetes, either by...
  • Bone Morphogenetic Protein (Infuse Bone Graft)
    Harvesting of autogenous bone, most commonly from the iliac crest, for use as the interbody graft in spinal fusion procedures has been standard practice, but is associated with a high rate of...
  • Drugs Past Their Expiration Date
    Superseded by The Medical Letter "Drugs Past Their Expiration Date" - Issue 1483, December 7, 2015Healthcare providers are often asked if patients can use drugs after their expiration date....
  • Ophthalmic Besifloxacin (Besivance)
    The FDA has approved the fluoroquinolone besifloxacin 0.6% ophthalmic suspension (Besivance - Bausch & Lomb) for treatment of bacterial conjunctivitis caused by susceptible bacteria....
  • Mercury in Fish
    Recent news articles about mercury in fish may lead some patients to seek more information from their healthcare providers. For most Americans, seafood is the major source of exposure to mercury....