The FDA has approved oteseconazole (Vivjoa – Mycovia), a new oral azole antifungal, to reduce the incidence of recurrent vulvovaginal candidiasis (RVVC) in females with a history of RVVC. Oteseconazole is the first drug to be approved in the US specifically for treatment of RVVC.

The FDA has approved rezafungin (Rezzayo – Cidara/Melinta), an intravenous echinocandin antifungal, for once-weekly treatment of candidemia and invasive candidiasis (IC) in adults with limited or no alternative options. It is the first new drug to become available in the US in more than 15 years for treatment of systemic Candida infections.

Shock-wave generators like those now widely used to disintegrate urinary tract stones (Medical Letter, 27:72, 1985) have recently also been tried for treatment of radiolucent gallbladder stones. Three different types of lithotripsy devices, manufactured by at least eight different companies, are being used to treat gallbladder stones in multicenter trials in many locations in the USA. None of these devices has been approved for marketing by the US Food and Drug Administration.

Flumazenil (Mazicon - Roche), a benzodiazepine receptor antagonist, has been approved by the US Food and Drug Administration to reverse the sedative effects of benzodiazepines after anesthesia, sedation for brief surgical or diagnostic procedures, or after benzodiazepine overdosage. The drug does not antagonize opioids, non-benzodiazepine sedatives, or anesthetic drugs.

Methylphenidate (Ritalin, and others) is now available in a new extended-release formulation (Concerta--Alza) for treatment of attention deficit/hyperactivity disorder (ADHD).

Direct-to-consumer advertisements are promoting the effectiveness of extended-release formulations of tolterodine tartrate (Detrol LA) and oxybutynin (Ditropan XL) for treatment of overactive bladder.

Escitalopram (Lexapro - Forest), the active S-enantiomer of racemic citalopram (Celexa - Forest), a selective serotonin reuptake inhibitor (SSRI), was recently approved by the FDA for treatment of depression. The manufacturer plans to stop promoting Celexa in favor of Lexapro; Celexa will continue to be available for patients already taking it.

A patch formulation of oxybutynin (Oxytrol - Watson) is now available for treatment of overactive bladder. It is claimed to be as effective as the oral drug, with less dry mouth.

An intraveneous (IV) formulation of ibuprofen (Caldolor - Cumberland) was recently approved by the FDA for use in adults. It can be administered alone for treatment of mild to moderate pain or as an adjunct to opioid analgesics for moderate to severe pain. It is also approved for reduction of fever.

A Medical Letter subscriber was surprised to discover that a new Citracal product contained not only calcium citrate, but also calcium carbonate. Citracal Plus Bone Density Builder actually contains more calcium carbonate per tablet than calcium citrate (240 mg vs. 60 mg). Another Citracal product, Citracal Plus Heart Health, also contains more calcium carbonate than calcium citrate. Many clinicians prefer calcium citrate because it can be taken with or without food, while calcium carbonate must be taken with food for optimal absorption. Other familiar over-the-counter (OTC) names also contain...