The enzyme alpha-galactosidase (Beano - AkPharma), derived from a mold and classified as a food, is sold without presecription in pharmacies and food stores. The manufacturer recommends taking the anzyme to decrease intestinal gas producted by eating the high-fiber diets now widely recommended in the USA.

Strontium-89 chloride was recently approved for marketing by the US Food and Drug Administration. It is offered for relief of pain caused by metastatic bone lesions

Ibutilide fumarate (Corvert - Pharmacia & Upjohn), a new antiarrhythmic drug for intravenous use, has been approved by the US Food and Drug Administration for acute termination of atrial fibrillation or flutter of recent onset.

Azelaic acid, a naturally occurring heptanedicarboxylic acid, has been marketed in the USA as a 20% cream (Azelex - Allergan) for treatment of acne. The drug has been available in Europe for several years.

Bicalutamide (Casodex - Zeneca), an oral nonsteroidal antiandrogen similar to flutamide (Eulexin - Medical Letter, 31:72, 1989), is now available in the USA for treat-ment of advanced prostate cancer. The drug is recommended by the manufacturer for use concurrently with an analog of luteinizing hormone-releasing hormone (LHRH) such as leuprolide (Lupron; Lupron Depot) or goserelin (Zoladex -Medical Letter, 32:102, 1990).

Tamsulosin (Flomax - Boehringer Ingelheim), an alpha 1 - adrenoreceptor blocker, has been approved by the FDA for treatment of benign prostatic hyperplasia (BPH). It is claimed to bind preferentially to alpha1 receptors in the prostate.

Raloxifene (Evista - Lilly), a benzothiophene that acts on estrogen receptors, has recently been marketed for prevention of postmenopausal osteoporosis. Only estrogen (alone or in combination with a progestin) and the bisphosphonate alendronate (Fosamax) were previously approved by the FDA for this indication.

Extracts made from leaves of the ginkgo tree (Ginkgo biloba) are available in the uSA as deitary supplements, in France and Germany as licensed drugs and worldwide as herbal remedies for treatment of dementia and many other indications.

Sucralose (Splenda - McNeil Specialty) has been approved by the FDA for use as a nonnutritive sweetener in beverages, baked goods and other foods, and as a tabletop sugar substitute (Fed Reg, 63:16417, April 3, 1998). Other non-caloric sweeteners available in the USA include saccharin (Sweet'n Low, and others), aspartame (NutraSweet, Equal) and acesulfame potassium (Sunette - Medical Letter, 30:116, 1988).

The FDA has approved the use of ulipristal acetate (ella – Watson) as an emergency contraceptive that can be taken up to 5 days after unprotected intercourse. It is available only by prescription.