Many fermented foods contain tyramine as a byproduct formed by the bacterial breakdown of the amino acid tyrosine; it can also be formed by para-hydroxylation of phenylethylamine or dehydroxylation of DOPA and dopamine. Tyramine and some other amines found in food can cause hypertensive reactions in patients taking monoamine oxidase (MAO)inhibitors.

Cefpodoxime proxetil (Vantin - Upjohn), a new third-generation oral cephalosporin, has been approved for marketing by the US Food and Drug Administration. It is available for twice-daily treatment of pharyngitis, upper and lower respiratory infections, otitis media, urinary tract infections, skin and soft tissue infections, and for single-dose treatment of uncomplicated gonorrhea in men or women and anorectal gonorrhea in women.

Cetirizine (Zyrtec - Pfizer), a histamine H 1 -receptor antagonist, has been approved by the US Food and Drug Administration for treatment of seasonal allergic rhinitis, perennial allergic rhinitis and chronic idiopathic urticaria in adults and children more than 12 years old.

Carnitine is a naturally occurring amino acid derivative essential for transport of long-chain fatty acids into mitochondria. It is advertised on the Internet as a dietary supplement that can promote weight loss, increase energy, enhance athletic performance and slow aging. Levocarnitine (Carnitor - Sigma-Tau) has been FDA approved for oral and parenteral treatment of primary carnitine deficiency since 1986. Products containing levocarnitine and its synthetic derivative acetyl-L-carnitine are available as dietary supplements in the US.

The physiologic changes that occur with aging can affect the pharmacokinetics and pharmacodynamics of many prescription and over-the-counter drugs, increasing the likelihood of adverse effects.

A 23-valent polysaccharide vaccine (PPSV23; Pneumovax 23 - Merck) is the only pneumococcal vaccine approved for use in adults. It has reduced the risk of invasive pneumococcal disease (meningitis or bacteremic pneumonia), but not mortality, in immunocompetent older adults.2 PPSV23 has not been shown to reduce the risk of invasive pneumococcal disease (IPD) in immunocompromised patients.

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The FDA has approved five tumor necrosis factor (TNF) inhibitors for treatment of moderately to severely active rheumatoid arthritis (RA). TNF-α is a pro-inflammatory cytokine involved in the pathogenesis of many systemic inflammatory disorders.

The FDA has approved Trumenba (Pfizer), a vaccine that protects against invasive meningococcal disease caused by Neisseria meningitidis serogroup B, for use in adolescents and young adults 10-25 years old.

The FDA has approved dupilumab (Dupixent – Sanofi/Regeneron), a subcutaneously-injected fully human monoclonal antibody, for treatment of adults with moderate to severe atopic dermatitis (eczema) that has not responded to topical therapies. It can be used with or without topical corticosteroids.

View the Expanded Table: Some Drugs for Altitude Illness, Jet Lag, and Motion Sickness