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The Medical Letter on Drugs and Therapeutics • July 17, 2017 (Issue 1525)
The FDA has approved the fully-human programmed death ligand 1 (PD-L1) blocking antibody avelumab (Bavencio – EMD Serono/Pfizer) for treatment of metastatic Merkel cell carcinoma (MCC) in patients ≥12 years old. Avelumab is the first drug to be approved in the US for this rare skin cancer. About 1600 people in the US, most commonly older adults (mean age at presentation is 75 years), are...
The Medical Letter on Drugs and Therapeutics • June 5, 2017 (Issue 1522)
Opioid use disorder is a chronic, relapsing disease with both physical and psychiatric components. It is associated with economic hardship, social isolation, incarceration, increased rates of blood-borne infections such as HIV and viral hepatitis, adverse pregnancy outcomes, and increased mortality. According to the CDC, there were 33,091 deaths related to opioid overdose in the US in 2015, more...
The Medical Letter on Drugs and Therapeutics • June 5, 2017 (Issue 1522)
View Comparison Table: Some Drugs for Maintenance Treatment of Opioid Use Disorder
The Medical Letter on Drugs and Therapeutics • May 22, 2017 (Issue 1521)
Per capita spending on prescription drugs in the US is higher than in other industrialized nations, including Canada.
The Medical Letter on Drugs and Therapeutics • April 24, 2017 (Issue 1519)
The FDA has warned that eluxadoline (Viberzi – Allergan), a mu-opioid receptor agonist and delta-opioid receptor antagonist approved in 2015 for treatment of irritable bowel syndrome with diarrhea (IBS-D),1 should not be used in patients without a gallbladder because of an increased risk of serious pancreatitis.2...
The Medical Letter on Drugs and Therapeutics • April 24, 2017 (Issue 1519)
The 2017 adult immunization schedule approved by the CDC's Advisory Committee on Immunization Practices (ACIP) includes some new or revised recommendations.1 The complete schedule is available on the CDC's website (www.cdc.gov/vaccines/schedule). New recommendations for use of influenza...
The Medical Letter on Drugs and Therapeutics • February 27, 2017 (Issue 1515)
The antiplatelet drug clopidogrel (Plavix, and others) reduces major cardiovascular events, but can cause bleeding. Proton pump inhibitors (PPIs) are often used with clopidogrel to prevent gastrointestinal bleeding, however, some evidence suggests that PPIs may interfere with the activation of clopidogrel and diminish its antiplatelet effect. FDA-approved labeling recommends avoiding...
The Medical Letter on Drugs and Therapeutics • January 30, 2017 (Issue 1513)
Drugs for Diabetes (Med Lett Drugs Ther 2017; 59:9)
In the 4th paragraph of the GLP-1 receptor agonists section, we mistakenly stated that Xultophy 100/3.6 is a combination of insulin degludec and albiglutide; Xultophy 100/3.6 is a combination of insulin degludec and liraglutide.

Another...
The Medical Letter on Drugs and Therapeutics • December 5, 2016 (Issue 1509)
Therapeutics (AZCERT) has recently added the proton pump inhibitors (PPIs) omeprazole (Prilosec, and others), esomeprazole (Nexium, and others), lansoprazole (Prevacid, and others), and pantoprazole (Protonix, and generics) to its lists of Drugs with Conditional Risk of Torsades de Pointes (TdP) and Drugs to Avoid in Patients with Congenital Long QT Syndrome....
The Medical Letter on Drugs and Therapeutics • December 5, 2016 (Issue 1509)
The FDA has approved Lomaira (KVK Tech), an 8-mg tablet formulation of phentermine that can be taken up to three times daily before meals, as an adjunct to lifestyle modifications for weight loss. It is only approved for short-term use (a few weeks) in adults with a body mass index (BMI) ≥30 kg/m2, or with a BMI ≥27 kg/m2 in addition to a weight-related comorbidity...
The Medical Letter on Drugs and Therapeutics • December 5, 2016 (Issue 1509)
In our recent article on Lipid-Lowering Drugs,1 we said that statins can reduce the risk of first cardiovascular events and death (primary prevention) in patients at high risk for atherosclerotic cardiovascular disease (CVD) and significantly reduce the incidence of cardiovascular events in patients at lower risk for CVD. Now the United States Preventive...
The Medical Letter on Drugs and Therapeutics • September 26, 2016 (Issue 1504)
Differin Gel 0.1% (Galderma), a topical formulation of the retinoid adapalene, will soon be available over the counter (OTC) for once-daily treatment of acne in patients ≥12 years old. It is the first topical retinoid to be approved for sale over the counter.

All topical retinoids normalize keratinization and appear to have anti-inflammatory effects; whether any one topical...
The Medical Letter on Drugs and Therapeutics • September 12, 2016 (Issue 1503)
The PCSK9 inhibitor evolocumab (Repatha – Amgen) is now available in a single-dose, hands-free device (Repatha Pushtronex) for once-monthly subcutaneous infusion. Evolocumab is FDA-approved as an adjunct to diet and maximally tolerated statin therapy for patients with heterozygous familial hypercholesterolemia (HeFH) or clinical atherosclerotic cardiovascular disease who require...
The Medical Letter on Drugs and Therapeutics • September 12, 2016 (Issue 1503)
News about recent price increases for EpiPen and EpiPen Jr (Mylan) may have patients asking about other options for emergency treatment of anaphylaxis. Adrenaclick and its generic equivalent (epinephrine injection auto-injector) are the only other epinephrine auto-injectors currently available in the US. According to Impax (the manufacturer of both the brand and generic...
The Medical Letter on Drugs and Therapeutics • September 12, 2016 (Issue 1503)
The FDA has approved defibrotide sodium (Defitelio – Jazz), a mixture of mostly single-stranded polydeoxyribonucleotide sodium salts, for treatment of adults and children with hepatic veno-occlusive disease (also known as sinusoidal obstruction syndrome) and renal or pulmonary dysfunction following hematopoietic stem cell transplantation (HSCT). It is the first drug to be approved by the...
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.

Download complete U...
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 • 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 • 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...