Botulinum toxin Type A (Oculinum - Allergan), used investigationally for many years to treat ocular muscle disorders (Medical Letter, 29:101, 1987), has now been approved by the US Food and Drug Administration for intramuscular treatment of strabismus and blepharospasm in patients more than 12 years old.

Capsaicin, a vanillyl alkaloid found in hot peppers and related plants, is now available without a prescription as Zostrix-HP (GenDerm) for topical relief of pain due to diabetic neuropathy, herpes zoster, or arthritis. The new formulation contains 0.075% capsaicin; the drug was previously available in a 0.025% concentration as Zostrix.

Flecainide (Tambocor -3M Pharmaceuticals), first introduced in 1985 for treatment of ventricular arrhythmias, was recently approved by the US Food and Drug Administration for oral use to prevent supraventricular arrhythmias. The indications for using flecainide to treat ventricular arrhythmias were limited after a controlled trial found that post-myocardial infarction patients with asymptomatic ventricular arrhythmias who took the drug had twice as high a mortality rate as patients who took placebo (DS Echt et al, N Engl Med, 324:781, 1991).

Most patients with diabetes mellitus now test their own blood glucose. In recent years, meters commercially available for self-testing have become smaller and easier to use.

Rifabutin (formerly ansamycin; Mycobutin - Adria), a rifamycin antibiotic similar to rifampin (Rifadin, Rimactane) was recently approved by the US Food and Drug Administration for prevention of disseminated Mycobacterium avium complex (MAC) disease in patients with advanced HIV infection.

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.

Calcipotriene ointment 0.005% (calcipotriol; Dovonex - Westwood Squibb), a synthetic vitamin D 3 analog previously available in Europe and Canada, has now been approved by the US Food and Drug Administration (FDA) for treatment of moderate plaque psoriasis, the most common form of the disease.

The US Food and Drug Administration has approved the marketing of 5% doxepin hydrochloride cream (Zonalon - GenDerm) for treatment of pruritus due to eczematous dermatoses. Oral doxepin is used as a tricyclic antidepressant (Sinequan, and others).

Acarbose (Precose -Bayer), an oral alpha-glucosidase inhibitor that has been available in Europe for several years, was recently approved by the US Food and Drug Administration (FDA) for treatment of non-insulin-dependent diabetes mellitus (NIDDM).

Dexfenfluramine (Redux - Wyeth-Ayerst) has been approved by the US Food and Drug Administration as an aid to diet for treatment of obesity and maintenance of weight loss. Dexfenfluramine is the dextrorotatory isomer of d,l-fenfluramine (Pondimin), which has been marketed for short-term weight reduction for many years and recently has been widely used in combination with phentermine (Ionamin, and others), a sympathomimetic drug (Medical Letter, 36:107, 1994).