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
In Brief: OTC Ivermectin for Head Lice
The Medical Letter on Drugs and Therapeutics • June 26, 2023; (Issue 1679)
Topical ivermectin lotion 0.5% (Sklice, and generics),
which has been available by prescription since 2012,
is now FDA-approved for sale over the counter (OTC)
for treatment of head lice in patients ≥6 months old.
Ivermectin is also available by prescription as a 1%
cream (Soolantra) approved for topical treatment of
inflammatory lesions of rosacea and in oral tablets
(Stromectol, and generics) for treatment of various
parasitic infections.
3
Drugs for Asthma
The Medical Letter on Drugs and Therapeutics • November 25, 2024; (Issue 1716)
The goal of asthma treatment is to control symptoms,
prevent exacerbations, and maintain normal lung
function. Management of acute exacerbations in the
emergency department is not discussed here.
4
Comparison Chart: Some Inhaled Drugs for Treatment of Asthma (online only)
The Medical Letter on Drugs and Therapeutics • November 25, 2024; (Issue 1716)
View the Comparison Chart: Some Inhaled Drugs for Treatment of Asthma
5
In Brief: Femlyv – An Orally Disintegrating Hormonal Contraceptive
The Medical Letter on Drugs and Therapeutics • December 9, 2024; (Issue 1717)
Femlyv (Millicent), an orally disintegrating tablet
containing ethinyl estradiol and norethindrone
acetate, has been approved by the FDA for prevention
of pregnancy in females with a body mass index (BMI)
≤35 kg/m2. It is the first hormonal contraceptive to
become available in an orally disintegrating tablet
formulation. Traditional oral and chewable tablets
containing ethinyl estradiol and norethindrone acetate
in a wide range of doses, including those found in
Femlyv, have been available in the US for years.
6
Comparison Chart: Correct Use of Inhalers for Asthma (online only)
The Medical Letter on Drugs and Therapeutics • November 25, 2024; (Issue 1716)
View the Comparison Chart: Correct Use of Inhalers for Asthma
7
In Brief: New FDA Warning of Pulmonary Aspiration with GLP-1 Receptor Agonists
The Medical Letter on Drugs and Therapeutics • November 22, 2024; (Issue 5093)
The package inserts of the GLP-1 receptor agonists
dulaglutide (Trulicity), exenatide (Byetta, Bydureon
BCise), liraglutide (Saxenda, Victoza), and semaglutide
(Ozempic, Rybelsus, Wegovy) and the dual glucosedependent
insulinotropic polypeptide (GIP)/GLP-1
receptor agonist tirzepatide (Mounjaro, Zepbound)
have been updated to include rare postmarketing
reports of pulmonary aspiration associated with their
use in patients undergoing elective surgery or other
procedures requiring general anesthesia or deep
sedation who had residual gastric contents despite
preoperative fasting.
8
In Brief: A New Non-Small Cell Lung Cancer Indication for Osimertinib (Tagrisso) (online only)
The Medical Letter on Drugs and Therapeutics • November 11, 2024; (Issue 1715)
The oral kinase inhibitor osimertinib (Tagrisso –
AstraZeneca), which has been available for years for
treatment of non-small cell lung cancer (NSCLC) in
adults with epidermal growth factor receptor (EGFR)
exon 19 deletions or exon 21 L858R mutations, has now
been approved for treatment of unresectable stage III
EGFR-mutated NSCLC. About 20-30% of patients with
NSCLC have locally advanced stage III NSCLC, and
60-90% of these patients have unresectable disease.
Osimertinib is the first targeted therapy to be approved
for the new indication.
9
Capvaxive – A 21-Valent Pneumococcal Conjugate Vaccine
The Medical Letter on Drugs and Therapeutics • October 14, 2024; (Issue 1713)
The FDA has licensed Capvaxive (PCV21; Merck),
a 21-valent pneumococcal conjugate vaccine, for
prevention of invasive pneumococcal disease (IPD)
and pneumococcal pneumonia in adults. Four other
pneumococcal vaccines are currently available in the
US: Prevnar 20 (PCV20), Vaxneuvance (PCV15), and
Prevnar 13 (PCV13) are conjugate vaccines licensed
for use in persons ≥6 weeks old, and Pneumovax 23
(PPSV23) is a pneumococcal polysaccharide vaccine
licensed for use in persons ≥2 years old (see Table 1).
10
Airsupra: An Inhaled Albuterol/Budesonide Combination for Asthma
The Medical Letter on Drugs and Therapeutics • March 18, 2024; (Issue 1698)
The FDA has approved Airsupra (AstraZeneca), a
metered-dose inhaler containing the short-acting
beta2-agonist (SABA) albuterol and the inhaled
corticosteroid (ICS) budesonide, for use as needed for
treatment or prevention of bronchoconstriction and to
reduce the risk of exacerbations in patients ≥18 years
old with asthma. Airsupra is the first combination of
a SABA and an ICS to become available in the US. It is
not approved for use as maintenance therapy.