Tolcapone (Tasmar - Roche), a dihydroxy-methyl-nitrobenophenone, has been marketed as an adjunct to levodopa/carbidopa (Sinemet, and others) for treatment of Parkinson's disease in both stable patients and those with end-of-dose "wearing off"of levodopa.

Rituximab (Rituxan - IDEC Pharmaceutical/Genentech), a monoclonal antibody, has been approved by the FDA for treatment of low-grade B-cell non-Hodgkin's lymphoma. Most low-grade lymphomas are B-cell lymphomas.

Thalidomide (Thalomid - Celgene), a synthetic derivative of glutamic acid, has been approved by the FDA for use in treatment of leprosy. Thalidomide was marketed in Europe in 1957 as a sedative but withdrawn four years later after being associated with severe human teratogenicity. The drug has since been found to be effective for several different indications.

Candesartan cilexetil (Atacand - Astra) is the fourth angiotensin II receptor antagonist to become available in the USA for oral treatment of hypertension.

Cevimeline hydrochloride, an acetylcholine derivative, has been approved by the FDA for treatment of dry mouth symptoms caused by Sjogren's syndrome. Presumably it could also be used to treat radiation-induced xerostomia in patients with head and neck cancer. Pilocarpine hydrochloride is FDA-approved for both indications

PC Spes, a dietary supplement sold for "prostate health", is being used increasingly to treat prostate cancer.

An automatic, noninvasive, glucose-monitoring device (GlucoWatch Biographer) has been approved for marketing by the FDA. The manufacturer states that it is not meant to replace a regular blood glucose meter.

Azelaic acid 15% gel (Finacea Berlex) is now available in the US for treatment of mild to moderate rosacea. A 20% cream formulation of the drug (Azelex Allergan; Medical Letter 1996; 38:52) has been marketed here since 1996 for treatment of acne. The effectiveness of Finacea compared to its own vehicle and to metronidazole gel is discussed. Information on the drug's mechanism of action, adverse effects, dosage and cost are also included.

Our May 24, 2004 article on use of the immune response modulator imiquimod (Aldara) for treatment of actinic keratoses stated that no systemic effects have been detected. A physician reader objected, stating that he had developed fatigue while using the cream and had heard from dermatologists that other patients had also reported systemic effects.

At a US Senate hearing prompted by the withdrawal of Vioxx, an FDA officer cited 5 drugs as potentially dangerous. It may be useful to revisit Medical Letter reviews of these drugs.