The FDA has approved marketing of the corticosteroid budesonide in an oral inhalatoin powder formulation (Pulmicort Turbuhaler - Astra) for maintenance treatment of asthma in adults and children at least six years old. Budesonide has been available in the USA as an intranasal spray (Rhinocort) for treatment of allergic rhinitis since 1994 and has been used for inhalation treatment of asthma in Canada and Europe for ten years.

Bivalirudin is being promoted as an intravenous (IV) anticoagulant that can be used instead of heparin in patients with unstable angina undergoing coronary angioplasty.

Entecavir (Baraclude - Bristol-Myers Squibb), a nucleoside analog, has been approved by the FDA for treatment of adults with active chronic hepatitis B virus (HBV) infection.

Healthcare providers are often asked if drugs can be used past their expiration date. Because of legal restrictions and liability concerns, manufacturers do not sanction such use and usually do not comment on the safety or effectiveness of their products beyond the date on the label. Since our last article on this subject, more data have become available.

The investigational monoclonal antibody sotrovimab (VIR-7831; GSK/Vir Biotechnology) has been granted an FDA Emergency Use Authorization (EUA) for treatment of mild to moderate COVID-19 in patients ≥12 years old who weigh ≥40 kg and are at high risk of progressing to severe disease, including hospitalization and death.1 Two other monoclonal antibody regimens are authorized for the same indication: casirivimab (REGN10933) and imdevimab (REGN10987) administered together, and bamlanivimab (LY-CoV555) and etesevimab (LYCoV016) administered together. The FDA revoked its EUA...

The FDA has approved the complement C3 inhibitor pegcetacoplan (Syfovre – Apellis) for treatment of geographic atrophy (GA) secondary to age-related macular degeneration (AMD). Given as a series of monthly or every-other-month (EOM) intravitreal injections, it is the first drug to become available for use in patients with atrophic dry AMD. Subcutaneous pegcetacoplan was approved earlier as Empaveli for treatment of paroxysmal nocturnal hemoglobinuria.

Methadone, an opioid agonist that can be taken orally, has been used for maintenance treatment for many years in the USA (DM Novick et al, Drug Alcohol Depend, 33:235, 1993). Last year, the US Food and Drug Administration approved the distribution and use of L-alpha-acetyl-methadol (LAAM; ORLAAM - Bio Development Corporation, McLean, VA), a long-acting congener of methadone. LAAM, like methadone, will be available for this indication only through federal and state-regulated treatment programs.

Pilocarpine hydrochloride (Salagen- MGI Pharma), a cholinergic agonist long available in an ophthalmic formulation for treatment of glaucoma (Pilocar, and others), was recently approved by the US Food and Drug Administration (FDA) for oral treatment of radiation-induced xerostomia (dry mouth) in patients with head and neck cancer.

Gemcitabine (jem site a been) hydrochloride (Gemzar - Lilly), a nucleoside analog, has been approved by the US Food and Drug Administration for intravenous (IV) use in the first-line treatment of locally advanced or metastatic adenocarcinoma of the pancreas and in patients with pancreatic cancer previously treated with fluorouracil (Adrucil, and others). No previously available drug has had more than minor activity in treating this disease.

A study now available on the web site of The New England Journal of Medicine (LY Park-Wyllie et al. Outpatient gatifloxacin therapy and dysglycemia in older adults. www.nejm.org, published online March 1, 2006) reports an increased risk of hypoglycemia (RR 4.3) and hyperglycemia (RR 16.7) with use of gatifloxacin (Tequin), a fluoroquinolone antibiotic. The Medical Letter published an article on this risk in 2003 (vol. 45, page 64); at that time the extent to which other fluoroquinolones carried the same risk was unclear. The recent report indicates that, except for a slightly increased...