Recent articles in the press have trumpeted a new era in the management of Parkinson's disease: dopamine agonists have now replaced levodopa for initial treatment.

A transdermal contraceptive patch (Ortho Evra — Ortho-McNeil) has been approved by the FDA. Each 20 cm² patch contains 6 mg of the progestin norelgestromin (the active metabolite of norgestimate) and 0.75 mg of ethinyl estradiol.

Anakinra (Kineret - Amgen), an interleuken-1 (IL-1) receptor antagonist, has been approved by the FDA for treatment of moderately to severly active rheumatoid arthritis in adults who have failed at least one disease-modifying anti-rheumatic drug(DMARD) such as methotrexate (Medical Letter 2000; 24:57).

The FDA has approved the ophthalmic solutions riboflavin 5'-phosphate in 20% dextran (Photrexa Viscous – Avedro) and riboflavin 5'-phosphate alone (Photrexa) for use with ultraviolet A (UVA) light (KXL System) in the corneal collagen cross-linking treatment of two corneal disorders: progressive keratoconus and corneal ectasia following refractive surgery. It is the first corneal collagen cross-linking (CXL) treatment to be approved by the FDA.

The FDA has approved a higher-dose injectable formulation of the opioid antagonist naloxone (Zimhi – Adamis) for emergency treatment of opioid overdose. A single IM or SC injection of the new formulation delivers 5 mg of naloxone; injectable formulations that deliver 0.4 mg or 2 mg of the drug have been available for years. Naloxone is also available in intranasal formulations for the same indication (see Table 1).

In recent years, the availability of new types of lasers has improved the treatment of disfiguring cutaneous vascular abnormalities. Vascular lesions of the skin that can be treated with lasers include port-wine stains, telangiectases, and strawberry hemangiomas (RA Silverman, Pediatr Clin North Am, 38:811, Aug 1991).

Entacapone (Comtan), a catechol-O-methyltransferase (COMT) inhibitor, has been approved by the FDA for adjunctive use with levodopa/carbidopa in patients with Parkinson's disease who have end-of-dose "wearing off"symptoms.

Phytoestrogens, plant compounds that are converted to estrogens in the gut, are widely promoted as "natural"substitutes for estrogen in hormone replacement therapy.

The FDA has approved exemestane, an aromatase inhibitor, for the treatment of postmenopausal women with advanced breast cancer that has progressed during treatment with tamoxifen.

Ciclopirox nail lacquer (Penlac - Dermik) has been approved by the FDA for treatment of mild-to-moderate onychomycosis due to Trichophyton rubrum, without involvement of the lunula. The drug has been available for many years as a lotion and cream (Loprox) for treatment of cutaneous fungal infection