1
In Brief: Alternatives to Adderall
The Medical Letter on Drugs and Therapeutics • November 28, 2022; (Issue 1664)
The short-acting formulation of mixed amphetamine
salts (Adderall, and generics) FDA-approved for
treatment of attention-deficit hyperactivity disorder
(ADHD) and narcolepsy, is currently in short supply in
the US. Until an adequate supply is restored, patients
may be looking for alternatives.
2
COVID-19 Update: Metformin to Prevent Long Covid?
The Medical Letter on Drugs and Therapeutics • May 29, 2023; (Issue 1677)
Results from a double-blind trial suggest that off-label
use of the oral antihyperglycemic drug metformin
in patients with COVID-19 may decrease the risk
of post-acute sequelae of SARS-CoV-2 infection
("long COVID").
3
COVID-19 Update: An EUA for Vilobelimab (Gohibic) for COVID-19
The Medical Letter on Drugs and Therapeutics • May 29, 2023; (Issue 1677)
The investigational anti-complement component 5a
(C5a) antibody vilobelimab (Gohibic – InflaRx) has
been granted an FDA Emergency Use Authorization
(EUA) for IV treatment of hospitalized adults
with COVID-19 beginning within 48 hours after
invasive mechanical ventilation (IMV) or extracorporeal
membrane oxygenation (ECMO) is started.
Vilobelimab is the first anti-C5a antibody to become
available in the US.
4
Live Fecal Microbiota Oral Capsules (Vowst) for Prevention of CDI Recurrence
The Medical Letter on Drugs and Therapeutics • May 29, 2023; (Issue 1677)
The FDA has approved Vowst (Seres Therapeutics/Nestle HealthScience), an oral capsule containing live
fecal microbiota spores, for prevention of additional
recurrences of Clostridioides difficile infection (CDI)
in adults. Vowst is the first orally administered
microbiota-based treatment to be approved for
this indication. A rectally-administered live fecal
microbiota-based suspension (Rebyota) was
approved in 2022 for the same indication. Neither
product is approved for acute treatment of CDI.
5
Cariprazine (Vraylar) for Adjunctive Treatment of Depression
The Medical Letter on Drugs and Therapeutics • May 29, 2023; (Issue 1677)
The FDA has approved the second-generation
antipsychotic drug cariprazine (Vraylar — Abbvie) for
adjunctive treatment of major depressive disorder
(MDD) in adults. Cariprazine was previously approved
for treatment of schizophrenia and bipolar depression,
and for acute treatment of manic or mixed episodes
associated with bipolar I disorder.
6
Eflapegrastim (Rolvedon) for Prevention of Chemotherapy-Induced Febrile Neutropenia
The Medical Letter on Drugs and Therapeutics • May 29, 2023; (Issue 1677)
Eflapegrastim-xnst ((Rolvedon) [Spectrum]; previously
called Rolontis), a granulocyte colony-stimulating
factor (G-CSF) conjugated to an Fc fragment of human
IgG4, has been approved by the FDA to decrease
the incidence of infection, as manifested by febrile
neutropenia, in adults with nonmyeloid malignancies
receiving myelosuppressive chemotherapy that can
cause clinically significant febrile neutropenia.
7
Drugs for Migraine
The Medical Letter on Drugs and Therapeutics • June 12, 2023; (Issue 1678)
An oral nonopioid analgesic is often sufficient for
acute treatment of mild to moderate migraine pain
without severe nausea or vomiting. A triptan is the
drug of choice for treatment of moderate to severe
migraine in most patients without vascular disease.
Treatment of pain when it is still mild to moderate in
intensity improves headache response and reduces
the risk of recurrence.
8
Comparison Table: Triptans for Migraine (online only)
The Medical Letter on Drugs and Therapeutics • June 12, 2023; (Issue 1678)
View the Comparison Table: Triptans for Migraine
9
Comparison Table: Some Drugs for Migraine Prevention in Adults (online only)
The Medical Letter on Drugs and Therapeutics • June 12, 2023; (Issue 1678)
View the Comparison Table: Some Drugs for Migraine Prevention in Adults
10
In Brief: Fexofenadine (Allegra) and Fruit Juice
The Medical Letter on Drugs and Therapeutics • May 30, 2011; (Issue 1365)
Fexofenadine (Allegra, and others) is the most recent second-generation H1-antihistamine to become available over the counter (OTC). Cetirizine (Zyrtec, and others) and loratadine (Claritin, and others) are already available OTC. Cetirizine can be sedating in usual doses. Loratadine can be sedating in higher-than-usual doses. Fexofenadine remains nonsedating even in higher doses.