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The Medical Letter on Drugs and Therapeutics • September 21, 2020 (Issue 1607)
Annual vaccination against influenza A and B viruses is recommended for everyone ≥6 months old without a contraindication. Vaccination of all eligible persons can reduce the prevalence of influenza illness and symptoms that might be confused with those of COVID-19. Available vaccines and recommendations for specific patient populations for the 2020-2021 season are listed in Tables 2 and 3. Lower...
The Medical Letter on Drugs and Therapeutics • September 21, 2020 (Issue 1607)
The FDA has removed a boxed warning from the labeling of products containing the sodium-glucose co-transporter 2 (SGLT2) inhibitor canagliflozin (Invokana, Invokamet, Invokamet XR) that described an increased risk of lower limb amputation associated with use of the drug. Package inserts for canagliflozin products still contain a standard warning about a risk of lower limb...
The Medical Letter on Drugs and Therapeutics • June 1, 2020 (Issue 1599)
The FDA has required new warnings in the labels of gabapentin (Neurontin, and others) and pregabalin (Lyrica, Lyrica CR, and generics) about the risk of life-threatening or fatal respiratory depression in patients with respiratory risk factors. Respiratory risk factors include chronic obstructive pulmonary disease (COPD) and concurrent use of opioids or other CNS depressants...
The Medical Letter on Drugs and Therapeutics • June 1, 2020 (Issue 1599)
The FDA has approved Trijardy XR (Boehringer Ingelheim/Lilly), a fixed-dose combination of the sodium-glucose cotransporter 2 (SGLT2) inhibitor empagliflozin, the dipeptidyl peptidase-4 (DPP-4) inhibitor linagliptin, and extended-release metformin, for oral treatment of type 2 diabetes in adults. Empagliflozin and linagliptin have been available in a fixed-dose combination as Glyxambi...
The Medical Letter on Drugs and Therapeutics • May 4, 2020 (Issue 1597)
The FDA is requiring stronger warnings in the labeling of the leukotriene receptor antagonist montelukast (Singulair, and generics) about the risk of suicidal behavior and other serious neuropsychiatric events associated with its use.
The Medical Letter on Drugs and Therapeutics • April 6, 2020 (Issue 1595)
The severity and rapid spread of COVID-19 (caused by SARS-CoV-2) have raised questions about the use of some drugs in patients with the disease and whether currently available drugs could be effective in treating it. Definitive answers are lacking, but some recommendations can be made. For additional information on specific drugs, see our table Some Drugs Being Considered for Treatment of COVID-...
The Medical Letter on Drugs and Therapeutics • April 6, 2020 (Issue 1595)
View the Table: Treatments Considered for COVID-19
The Medical Letter on Drugs and Therapeutics • April 6, 2020 (Issue 1919)
The severity and rapid spread of COVID-19 (caused by SARS-CoV-2) have raised questions about the use of some drugs in patients with the disease and whether currently available drugs could be effective in treating it. Definitive answers are lacking, but some recommendations can be made. For additional information on specific drugs, see our table Some Drugs Being Considered for Treatment of COVID-...
The Medical Letter on Drugs and Therapeutics • March 23, 2020 (Issue 1594)
In our article on Slynd (Med Lett Drugs Ther 2020; 62:18), the drospirenone-only oral contraceptive, we mentioned that drospirenone has antiandrogenic activity that could improve acne and antimineralocorticoid activity that could cause hyperkalemia. We should have added that concurrent use of drospirenone with other drugs that increase potassium levels, such as the anti-androgen...
The Medical Letter on Drugs and Therapeutics • March 9, 2020 (Issue 1593)
We reviewed brolucizumab (Beovu – Novartis) for treatment of neovascular (wet) age-related macular degeneration in our February 10 issue. On February 23, the American Society of Retina Specialists reported that 14 patients who received the drug have developed retinal vasculitis, a potentially vision-threatening complication.
The Medical Letter on Drugs and Therapeutics • March 9, 2020 (Issue 1593)
Opioids delay gastric emptying and the absorption of many oral drugs, including the P2Y12 inhibitors clopidogrel (Plavix, and generics), prasugrel (Effient, and generics), and ticagrelor (Brilinta), which are commonly used for initial treatment of acute coronary syndrome (ACS). An article in our February 25, 2019 issue reviewed studies showing that coadministration...
The Medical Letter on Drugs and Therapeutics • January 27, 2020 (Issue 1590)
The FDA has approved tafamidis, an oral transthyretin stabilizer, in 2 different formulations (see Table 1) for treatment of adults with transthyretin-mediated amyloid cardiomyopathy (ATTR-CM). Tafamidis is the first drug to be approved in the US for this indication. Patisiran (Onpattro), a transthyretin-directed small interfering RNA, and inotersen (...
The Medical Letter on Drugs and Therapeutics • January 13, 2020 (Issue 1589)
Influenza is generally a self-limited illness, but pneumonia, respiratory failure, and death can occur. FDA-approved antiviral drugs for influenza are listed in Table 2. The neuraminidase inhibitors oseltamivir (Tamiflu, and generics), which is taken orally, and zanamivir (Relenza), which is inhaled, are approved for prophylaxis and treatment of acute uncomplicated influenza. The IV...
The Medical Letter on Drugs and Therapeutics • January 13, 2020 (Issue 1589)
View the Expanded Table: Antiviral Drugs for Influenza
The Medical Letter on Drugs and Therapeutics • November 18, 2019 (Issue 1585)
The FDA has approved a new formulation of glucagon (Gvoke – Xeris) for subcutaneous treatment of severe hypoglycemia in patients ≥2 years old with diabetes. Conscious patients with symptoms of hypoglycemia can take oral glucose. Glucagon is usually administered by a caregiver to an unresponsive patient. The new formulation is available in a single-use prefilled syringe (Gvoke PFS)...
The Medical Letter on Drugs and Therapeutics • September 23, 2019 (Issue 1581)
Lefamulin (Xenleta – Nabriva), a semisynthetic pleuromutilin antibiotic, has been approved by the FDA for IV and oral treatment of community-acquired bacterial pneumonia (CABP) in adults. It is the first systemic pleuromutilin antibiotic to be approved in the US; retapamulin (Altabax), a 1% topical ointment for treatment of impetigo, was approved in 2007.
The Medical Letter on Drugs and Therapeutics • September 23, 2019 (Issue 1581)
The lipid-lowering drug rosuvastatin is now available in a sprinkle capsule formulation (Ezallor Sprinkle – Sun Pharma). Rosuvastatin tablets (Crestor, and generics) have been available since 2003.1,2

The new formulation is being marketed specifically for residents of long-term care facilities who have difficulty swallowing. ...
The Medical Letter on Drugs and Therapeutics • September 23, 2019 (Issue 1581)
View the Expanded Table: Statins
The Medical Letter on Drugs and Therapeutics • September 9, 2019 (Issue 1580)
Treatment of atrial fibrillation includes anticoagulation, rate control, and rhythm control. US guidelines were recently updated.
The Medical Letter on Drugs and Therapeutics • August 26, 2019 (Issue 1579)
Use of insect repellents is strongly recommended by the Centers for Disease Control and Prevention (CDC) and the Environmental Protection Agency (EPA) to prevent infections transmitted by mosquitoes and ticks. Insect repellents applied to exposed skin should be used in conjunction with other preventive measures such as wearing pants and long-sleeved shirts, and avoiding outdoor activities during...