Eletriptan hydrobromide (Relpax Pfizer) is now available in the US for oral treatment of migraine headache in adults. It is the seventh serotonin 5-HT1B/1D-receptor agonist (triptan) to be approved by the FDA for this indication. This review describes the pharmacokinetics, adverse effects, drug interactions and recommended dosage of eletriptan. Clinical trials comparing the new drug to placebo and to sumatriptan are presented. A dosage and cost table for all the triptans available in the US is also included. The review concludes with an overall assessment of eletriptan's efficacy and...

Pramlintide acetate (Symlin - Amylin Pharmaceuticals), a synthetic analog of human amylin, has been approved by the FDA as adjunctive treatment for patients with type 1 or type 2 diabetes who inject insulin at mealtimes and have failed to achieve glucose control. Pramlintide is injected subcutaneously before meals.

Many physicians believe that antimicrobial prophylaxis before procedures that may cause transient bacteremia can prevent endocarditis and prosthetic joint infection in patients at increased risk for these disorders. The effectiveness of this common practice has never been established by controlled trials in humans.

A highly concentrated omega-3 polyunsaturated fatty acid (PUFA) preparation (Omacor - Reliant) has been approved by the FDA as an adjunct to diet for treatment of very high plasma triglyceride concentrations (>=500 mg/dL). Omacor is a combination of the ethyl esters of icosapentaenoic (EPA) and docosahexaenoic (DHA) acids. It is the first drug derived from omega-3 PUFAs to be sold by prescription.

Conivaptan hydrochloride (Vaprisol - Astellas), a vasopressin antagonist, has been approved by the FDA for short-term intravenous (IV) treatment of euvolemic hyponatremia in hospitalized patients. Euvolemic hyponatremia is most often caused by the syndrome of inappropriate ADH secretion (SIADH), or by hypothyroidism or adrenal insufficiency. The drug has not been approved for treatment of hypervolemic hyponatremia, which is associated with congestive heart failure (CHF), cirrhosis and renal disease. It should not be used in hypovolemic hyponatremia, such as occurs when fluid losses are...

A new once-daily, low-dose oral formulation of doxycycline monohydrate (Oracea - CollaGenex) has been approved by the FDA for treatment of inflammatory papules and pustules associated with rosacea in adults.

Recent publicity about symptoms of ovarian cancer will prompt many questions from patients about testing for the disease. Early-stage epithelial ovarian cancer is potentially curable, with survival rates of 90-95%, but about 75% of women have advanced or metastatic disease at diagnosis. Between physical examination and exploratory surgery, 2 tests are commonly used.1Transvaginal ultrasound (TVUS) images the ovaries better than transabdominal ultrasound. In a study in which 25,327 asymptomatic women were screened with TVUS annually from 1987 to 2005, 364 patients had exploratory surgery, and 44...

Some recently published studies suggest that taking selective serotonin reuptake inhibitors (SSRIs) may increase the risk of developing osteoporosis. A relationship between SSRIs and osteoporosis is biologically plausible because bone has serotonin receptors, and SSRI-treated mice have reduced bone mass.

Chemotherapy can result in premature menopause and infertility in young women. Pretreatment fertility counseling followed by appropriate action may prevent some of these undesirable consequences.

Sumatriptan was first marketed in the US in 1993 as Imitrex for subcutaneous injection, followed by tablets for oral administration and then by a nasal spray. It is one of seven serotonin receptor agonists (“triptans”) marketed in the US for treatment of migraine, but it is the only one available for subcutaneous injection. Now the FDA has approved Sumavel DosePro> (Zogenix), a needle-free device for delivering sumatriptan succinate to subcutaneous tissue, for treatment of migraine and cluster headache in adults.