Masoprocol cream 10% (meso-nordihydroguiaretic acid, Actinex - Reed and Carnrick) is now available in the USA for topical treatment of actinic keratoses.

A condom for women (Reality - Wisconsin Pharmacal) to prevent pregnancy and sexually transmitted diseases, including AIDS, has been approved for marketing by the US Food and Drug Administration (FDA). Already available in many family planning clinics, it will be available in pharmacies in a few months.

The US Food and Drug Administration (FDA) has approved 'early access' use of riluzole (Rilutek - Rh ne-Poulenc Rorer) for treatment of amyotrophic lateral sclerosis (ALS). is the first drug to become available for treatment of this condition. The premarketing supply is limited; the manufacturer (1-800-798-7425) has enough on hand to treat 3,000 of the 25,000 patients with the disease in the USA, and those 3,000 have already been selected through a lottery. Similar arrangements have been made in several European countries. Riluzole is not available commercially in any country.

Topotecan hydrochloride (Hycamtin - SmithKline Beecham) was recently approved by the U.S. Food and Drug Administration for parenteral use as a single agent in patients with metastatic ovarian cancer refractory to other drugs. Initial treatment for metastatic ovarian cancer usually consists of cisplatin (Platinol) or carboplatin (Paraplatin) plus paclitaxel (Taxol) or cyclophosphamide (Cytoxan, and others).

Many readers have asked the Medical Letter to evaluate St. John's wort, an herbal extract now widely sold in health food stores and pharmacies, for its effectiveness and safety in the treatment of depression. St. John's wort is licensed in Germany for treatment of anxiety, depression and insomnia. In the USA, it is considered a dietary supplement and has not been evaluated by the FDA.

Valrubicin (Valstar), formerly known as AD 32, has been approved by the FDA for intravesical treament of bladder cancer. The approval is limited to patients with carcinoma-in-situ refractory to BCG for whom immediate cystectomy is contraindicated.

Increased resistance of pneumococci to antimicrobial drugs may encourage more extensive use of pneumococcal polysaccharide vaccine.

The FDA has approved the use of a transcutaneous electrical nerve stimulation device (Cefaly – Cefaly Technology) for prevention of episodic migraine in patients ≥18 years old. The first device to be approved in the US for migraine prevention, it is available in Canada and Europe for treatment and prevention of migraines. A transcranial magnetic stimulation device (SpringTMS - eNeura Therapeutics) recently approved by the FDA for treatment of migraine preceded by aura will be reviewed in a future issue.

Turmeric is a spice derived from the Curcuma longa plant. Dietary supplements and foods containing turmeric are widely promoted for relief of pain and to improve joint mobility, immunity, digestion, cardiovascular health, depression, anxiety, memory, and cognition.

View the Table: Some Drug Interactions with Drugs for IBD