Altretamine (Hexalen - US Bioscience; Hexastat - Rh ne-Poulenc in Canada), formerly known only by its chemical name, hexamethylmelamine, was recently approved by the US Food and Drug Administration as a single agent for palliative oral treatment of persistent or recurrent ovarian cancer.

Fludarabine phosphate (Fludara - Berlex), an analog of vidarabine (Vira-A), was recently approved by the U.S. Food and Drug Administration for treatment of patients with refractory chronic lymphocytic leukemia (CLL). The drug has not yet been marketed but is still available, as it has been for two years, through the National Cancer Institute.

Podofilox 0.5% solution (Condylox - Oclassen) was recently approved by the US Food and Drug Administration for treatment of (condylomata acuminata). The drug requires a prescription, but is labeled for application by the patient. Similar topical solutions previously available for this indication are approved only for application by the physician.

The US Food and Drug Administration has approved use of the angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten) for patients with left ventricular dysfunction after a myocardial infarction. ACE inhibitors, widely used for treatment of hypertension, in recent years have also been used for treatment of heart failure (Medical Letter, 35:40, 1993).

Thalidomide is now available as an investigational drug in the USA. A synthetic derivative of glutamic acid, it was marketed in Europe in 1957 as a sedative but withdrawn four years later after being associated with severe human teratogenicity (PF DArcy and JP Griffin, Adverse Drug React Toxicol Rev, 13:65, 1994). The drug has since been found effective for several different indications.

Anastrozole (Arimidex - Zeneca), a selective nonsteroidal aromatase inhibitor, has been approved by the US Food and Drug Administration (FDA) for treatment of postmenopausal women with advanced breast cancer that has progressed during treatment with tamoxifen (Nolvadex, and others).

Samarium-153 lexidronam (Quadramet - Dupont Pharma) has been approved by the FDA for relief of pain in patients with osteoblastic bone metastases. Strontium-89 (Metastron) has been available for several years for this indication (Medical Letter, 35:102, 1993).

Bromfenac sodium (Duract - Wyeth-Ayerst), a nonsteroidal anti-inflammatory drug (NSAID), has been approved by the US Food and Drug Administration (FDA) and is being heavily advertised as an alternative to narcotics for short-term treatment of pain.

RabAvert (Chiron), a new human rabies vaccine prepared in purified chick embryo cell culture (PCEC), has been marketed in the USA for pre- and post-exposure prophylaxis. It is available in other countries as Rabipur. Human rabies is rare in the United States, but thousands of people receive post-exposure prophylaxis every year (DL Noah et al, Ann Intern Med, 128:922, June 1, 1998).

The FDA has approved a topical 8% patch formulation of capsaicin (Qutenza – NeurogesX), available only by prescription, for local treatment of postherpetic neuralgia. Postherpetic neuralgia occurs after herpes zoster in about one third of patients ≥60 years old and can persist for months or even years.