Fentanyl, a synthetic opioid previously available for parenteral use in anesthesia (Sublimaze, and others) and in a transdermal patch for chronic pain (Duragesic - Medical Letter, 34:97, 1992), has now also been marketed as a raspberry-colored lozenge on a plastic handle (Fentanyl Oralet - Abbott), which resembles a lollipop. The new formulation will probably be promoted mainly for premedication of children before anesthesia, but has also been approved by the US Food and Drug Administration (FDA) for preanesthetic use in adults and for use in anesthesia or 'monitored anesthesia care' in...

Captopril (Capoten - Bristol-Myers Squibb), an angiotensin-converting enzyme (ACE) inhibitor previously available for treatment of hypertension, has now been approved by the US Food and Drug Administration (FDA) for treatment of diabetic nephropathy in patients with insulin-dependent diabetes mellitus (IDDM). Diabetic nephropathy is the most common cause of end-stage renal disease in the United States.

Two products combining conjugated estrogens with medroxyprogesterone acetate (Prempro and - Wyeth-Ayerst) were recently approved for marketing by the US Food and Drug Administration. Both combine in one package tablets of Premarin, a conjugated equine estrogen product, with tablets of Cycrin, a medroxyprogesterone acetate brand. With Prempro, both tablets are taken daily continuously; with Premphase, the estrogen is taken daily, but the progestin is taken sequentially on days 15 through 28 of each 28-day cycle.

The Prostatron, a microwave device manufactured by EDAP Technomed in Cambridge, MA, has been approved by the US Food and Drug Administration for treating symptoms of benign prostatic hyperplasia (BPH).

Miglitol, an oral alpha-glucosidase inhibitor similar to acarbase, is now available for treatment of type 2 diabetes.

Caduet (Pfizer), a combination of the calcium-channel blocker amlodipine (Norvasc - Pfizer) and the HMG-CoA reductase inhibitor (statin) atorvastatin (Lipitor - Pfizer), is now available in the US. It was approved by the FDA for use in patients with indications for treatment with both amlodipine, which is used to treat hypertension and/or angina pectoris, and atorvastatin, which is used to treat dyslipidemia. The combination is bioequivalent to the 2 components taken separately.

In the Medical Letter article on Ferumoxytol (Feraheme) - A New Parenteral Iron Formulation (2010; 52:23), the last sentence of the Dosage, Administration and Cost paragraph should have listed the cost of 1 gram of sodium ferric gluconate (Ferrlecit) as about $600.

The FDA has approved the marketing of the Alair Bronchial Thermoplasty System (Asthmatx) for treatment of severe persistent asthma in patients ≥18 years old whose asthma is not well controlled with inhaled corticosteroids and long-acting beta₂-agonists.

Renal colic is a common problem in emergency departments. Stones <5 mm in diameter often pass spontaneously; stones >10 mm in diameter generally do not. The usual treatment for stones that do not pass is ureteroscopy with laser lithotripsy or shockwave lithotripsy. Some clinicians have suggested that off-label use of an oral alpha-adrenergic blocker such as tamsulosin (Flomax, and others) or calcium channel blocker such as nifedipine (Procardia XL, and others) could be tried first, with or without a corticosteroid. Both adrenoreceptors and calcium channels may have a role in the...

The FDA has approved the partial opioid agonist buprenorphine in a transdermal formulation (Butrans – Purdue) for treatment of moderate to severe chronic pain. Buprenorphine has been available in the US for years in parenteral formulations for pain and in sublingual tablets for opioid dependence.1 Transdermal buprenorphine has been available in Europe for several years.2