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The Medical Letter on Drugs and Therapeutics • August 29, 2016 (Issue 1502)
A reader asked why our Cannabis and Cannabinoids article (Med Lett Drugs Ther 2016; 58:97) did not include our usual Dosage/Cost table. We have now posted one in the article as it appears online. You can access it here: www.medicalletter. org/TML-article-1500a.

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The Medical Letter on Drugs and Therapeutics • August 15, 2016 (Issue 1501)
The FDA has approved Epclusa (Gilead), a fixed-dose combination of sofosbuvir (Sovaldi) and velpatasvir, a new direct-acting antiviral agent, for oral treatment of chronic hepatitis C virus (HCV) infection. Epclusa is the first oral combination to be approved for treatment of all six major HCV genotypes.
The Medical Letter on Drugs and Therapeutics • July 18, 2016 (Issue 1499)
The FDA has approved subdermal implants of the partial opioid agonist buprenorphine (Probuphine – Titan) for maintenance treatment of opioid dependence in patients stabilized on low to moderate doses of transmucosal buprenorphine. Probuphine was designed to provide continuous low levels of buprenorphine for 6 months and to safeguard against illicit use of the drug.
The Medical Letter on Drugs and Therapeutics • July 4, 2016 (Issue 1498)
Use of insect repellents is strongly recommended by the CDC and the EPA to prevent Zika virus infection and other mosquito- and tickborne diseases. Mosquitoes can transmit chikungunya, dengue, West Nile, and yellow fever viruses, and malaria. Ticks can transmit Lyme disease and rickettsial diseases such as Rocky Mountain spotted fever.
The Medical Letter on Drugs and Therapeutics • July 4, 2016 (Issue 1498)
The FDA has approved the pyrimidine analog uridine triacetate (Vistogard – Wellstat Therapeutics) for emergency treatment of a fluorouracil (5-FU) or capecitabine (Xeloda, and generics) overdose or severe toxicity that occurs within 96 hours following administration of one of these drugs. Fluorouracil is a cytotoxic antimetabolite used to treat breast, colorectal, and other...
The Medical Letter on Drugs and Therapeutics • June 20, 2016 (Issue 1497)
A reader commenting on our Treatment of Lyme Disease article (Med Lett Drugs Ther 2016; 58:57) objected to a footnote in the table advising against use of doxycycline in children <8 years old. This warning has been included in the labeling of all tetracyclines since 1970 when it was recognized, after decades of use, that these drugs caused...
The Medical Letter on Drugs and Therapeutics • June 20, 2016 (Issue 1497)
The FDA has approved Xtampza ER (Collegium), a new extended-release, abuse-deterrent capsule formulation of oxycodone, for management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.
The Medical Letter on Drugs and Therapeutics • May 9, 2016 (Issue 1494)
Most cases of Lyme disease in the US occur between May and September in the Northeastern, Mid-Atlantic, and North Central states.
The Medical Letter on Drugs and Therapeutics • March 14, 2016 (Issue 1490)
Three coordinated double-blind, placebo-controlled clinical trials have evaluated the efficacy of one year of testosterone replacement therapy in improving sexual function, physical function, and vitality in a total of 790 men ≥65 years old with moderately low serum testosterone concentrations and symptoms suggesting hypoandrogenism. Sexual function improved modestly, and there appeared to be...
The Medical Letter on Drugs and Therapeutics • February 29, 2016 (Issue 1489)
Tobacco dependence remains the primary preventable cause of death in the United States. It is a chronic disorder that often requires pharmacologic therapy, but counseling may be equally effective and can add to the effectiveness of any treatment for this indication. Abrupt cessation of smoking appears to be as effective as gradual reduction.
The Medical Letter on Drugs and Therapeutics • February 15, 2016 (Issue 1488)
The FDA has approved Genvoya (Gilead), a fixed-dose combination of the integrase strand transfer inhibitor (INSTI) elvitegravir, the pharmacokinetic enhancer cobicistat, and the nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) emtricitabine and tenofovir alafenamide, for treatment of HIV-1 infection in patients ≥12 years old. This is the first approval for tenofovir...
The Medical Letter on Drugs and Therapeutics • January 4, 2016 (Issue 1485)
Harvoni, a once-daily fixed-dose combination of the direct-acting antiviral agents ledipasvir and sofosbuvir approved by the FDA in 2014 for treatment of hepatitis C virus (HCV) genotype 1 infection,1 has now been approved for use in patients infected with HCV genotype 4, 5, or 6, and in patients co-infected with HCV and HIV-1. A 12-week course of...
The Medical Letter on Drugs and Therapeutics • December 21, 2015 (Issue 1484)
In 2007, an FDA advisory committee asked that placebo-controlled, dose-ranging trials be conducted to establish the efficacy of the oral decongestant phenylephrine (Sudafed PE, and others), which is sold over the counter (OTC) as a single agent and in combination with other drugs for treatment of cold and allergy symptoms. Phenylephrine replaced pseudoephedrine (Sudafed, and...
The Medical Letter on Drugs and Therapeutics • December 7, 2015 (Issue 1483)
Healthcare providers are often asked if drugs can be used past their expiration date. Because of legal restrictions and liability concerns, manufacturers do not sanction such use and usually do not even comment on the safety or effectiveness of their products beyond the date on the label. Since our last publication on this subject, more data have become available.
The Medical Letter on Drugs and Therapeutics • November 23, 2015 (Issue 1482)
The FDA has approved Technivie (Abbvie), a fixed-dose combination of the direct-acting antiviral agents ombitasvir and paritaprevir and the pharmacokinetic enhancer ritonavir, for oral treatment of chronic hepatitis C virus (HCV) genotype 4 infection in patients without cirrhosis. It is indicated for use in combination with ribavirin. Ombitasvir/paritaprevir/ritonavir copackaged with...
The Medical Letter on Drugs and Therapeutics • November 9, 2015 (Issue 1481)
The FDA recently announced labeling changes for the combination antiviral products Viekira Pak (ombitasvir/paritaprevir/ritonavir with dasabuvir)1 and Technivie (ombitasvir/paritaprevir/ritonavir)2 warning of a risk of serious, potentially fatal liver injury.3 ...
The Medical Letter on Drugs and Therapeutics • October 26, 2015 (Issue 1480)
The short-acting beta2-agonist albuterol sulfate is now available as a dry powder for inhalation (ProAir RespiClick – Teva) for prevention and treatment of broncho spasm in patients ≥12 years old. ProAir RespiClick is the only short-acting beta2-agonist dry powder inhaler available in the US.

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The Medical Letter on Drugs and Therapeutics • October 12, 2015 (Issue 1479)
Evolocumab (Repatha – Amgen), a subcutaneously injected PCSK9 inhibitor, has been approved by the FDA as an adjunct to diet and maximally tolerated statin therapy for adults with heterozygous familial hypercholesterolemia (HeFH) or clinical atherosclerotic cardiovascular disease who require additional lowering of LDL-cholesterol (LDL-C). It was also approved as an adjunct to diet and other...
The Medical Letter on Drugs and Therapeutics • September 28, 2015 (Issue 1478)
The FDA has approved naloxegol (Movantik – AstraZeneca), a pegylated derivative of the opioid antagonist naloxone, for oral treatment of opioid-induced constipation in adults with chronic noncancer pain. It is the only oral opioid antagonist approved for this indication in the US.
The Medical Letter on Drugs and Therapeutics • August 17, 2015 (Issue 1475)
The FDA has approved the subcutaneously injected PCSK9 (proprotein convertase subtilisin kexin type 9) inhibitor alirocumab (Praluent – Sanofi/Regeneron) as an adjunct to diet and maximally tolerated statin therapy for adults with heterozygous familial hypercholesterolemia (HeFH) or clinical atherosclerotic cardiovascular disease who require additional lowering of LDL-cholesterol (LDL-C)....