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In Brief: Tegaserod (Zelnorm) Returns

   
The Medical Letter on Drugs and Therapeutics • May 06, 2019  (Issue 1571)
with tegaserod for 1-3 months, 13 (0.11%) had a confirmed ischemic event compared to only 1 (0.01%) of more than ...
Tegaserod maleate (Zelnorm), a 5-HT4 receptor partial agonist that increases gastrointestinal (GI) motility, was approved by the FDA in 2002 for short-term treatment of irritable bowel syndrome with constipation (IBS-C) in women and in 2004 for treatment of chronic idiopathic constipation (CIC) in adults <65 years old.In 2007, the manufacturer (Novartis) complied with an FDA request to stop marketing the drug based on an unpublished retrospective analysis of clinical trials in IBS-C and other GI motility disorders that showed a higher rate of ischemic cardiovascular events (including...
Med Lett Drugs Ther. 2019 May 6;61(1571):72 | Show Introduction Hide Introduction

Expanded Table: Some Available Insulins for Type 2 Diabetes (online only)

   
The Medical Letter on Drugs and Therapeutics • May 06, 2019  (Issue 1571)
/mL 3, 10 mL vials 3 mL KwikPen2 1-2 hrs 4-8 hrs 12-24 hrs ▶ Intermediate-acting human insulin ...
View the Expanded Table: Some Available Insulins
Med Lett Drugs Ther. 2019 May 6;61(1571):e73-7 | Show Introduction Hide Introduction

OTC Drugs for Seasonal Allergies

   
The Medical Letter on Drugs and Therapeutics • Apr 22, 2019  (Issue 1570)
of allergic rhinitis and allergic conjunctivitis are reviewed separately.1 INTRANASAL CORTICOSTEROIDS ...
Patients with seasonal allergies often experience nasal itching and congestion, sneezing, rhinorrhea, and itchy, watery eyes. Oral, intranasal, and ophthalmic preparations are widely available over the counter (OTC) for relief of symptoms. Prescription products for management of allergic rhinitis and allergic conjunctivitis are reviewed separately.
Med Lett Drugs Ther. 2019 Apr 22;61(1570):57-60 | Show Introduction Hide Introduction

Ozenoxacin 1% Cream (Xepi) for Impetigo

   
The Medical Letter on Drugs and Therapeutics • Apr 22, 2019  (Issue 1570)
Ozenoxacin 1% Cream (Xepi) for Impetigo ...
The FDA has approved a 1% cream formulation of ozenoxacin (Xepi – Cutanea), a nonfluorinated quinolone antibiotic, for treatment of impetigo caused by Staphylococcus aureus or Streptococcus pyogenes in patients ≥2 months old.
Med Lett Drugs Ther. 2019 Apr 22;61(1570):63-4 | Show Introduction Hide Introduction

Eravacycline (Xerava) - An IV Tetracycline for Complicated Intra-Abdominal Infections

   
The Medical Letter on Drugs and Therapeutics • Apr 22, 2019  (Issue 1570)
is available.1 Pronunciation Key Eravacycline: er” a va sye’ kleen Xerava: zuh ra’ va Summary: Eravacycline ...
Eravacycline (Xerava – Tetraphase), a new synthetic tetracycline antibiotic, has been approved by the FDA for IV treatment of complicated intra-abdominal infections (cIAIs) in adults. Eravacycline is structurally similar to tigecycline (Tygacil, and generics), a broad-spectrum tetracycline approved by the FDA for IV treatment of complicated skin and skin structure infections, complicated intra-abdominal infections, and community-acquired pneumonia. A higher rate of mortality has been reported with use of tigecycline compared to other antibacterial drugs; it should be used only...
Med Lett Drugs Ther. 2019 Apr 22;61(1570):61-3 | Show Introduction Hide Introduction

Esketamine Nasal Spray (Spravato) for Treatment-Resistant Depression

   
The Medical Letter on Drugs and Therapeutics • Apr 08, 2019  (Issue 1569)
, triiodothyronine, or lithium.1 Electroconvulsive therapy (ECT) is often effective for treatment of severe ...
The FDA has approved esketamine (Spravato – Janssen), an N-methyl-D-aspartate (NMDA) receptor antagonist, for intranasal treatment (in conjunction with an oral antidepressant) of adults with treatment-resistant depression (TRD). This is the first FDA approval for esketamine, which is the S-enantiomer of the intravenous anesthetic ketamine (Ketalar, and generics). In recent years, IV ketamine has been increasingly used (off-label) for treatment of TRD.
Med Lett Drugs Ther. 2019 Apr 8;61(1569):54-6 | Show Introduction Hide Introduction

Sarecycline (Seysara) - Another Oral Tetracycline for Acne

   
The Medical Letter on Drugs and Therapeutics • Mar 25, 2019  (Issue 1568)
such as erythromycin or clindamycin.1,2 For moderate to severe inflammatory acne that does not respond to topical ...
Sarecycline (Seysara — Allergan), a new oral tetracycline antibiotic, has been approved by the FDA for once-daily treatment of inflammatory lesions of non-nodular moderate to severe acne in patients ≥9 years old.
Med Lett Drugs Ther. 2019 Mar 25;61(1568):43-4 | Show Introduction Hide Introduction

ZTlido - A New Lidocaine Patch for Postherpetic Neuralgia

   
The Medical Letter on Drugs and Therapeutics • Mar 25, 2019  (Issue 1568)
ZTlido — A New Lidocaine Patch for Postherpetic Neuralgia A lidocaine 1.8% patch (ZTlido – Scilex ...
A lidocaine 1.8% patch (ZTlido – Scilex) has been approved by the FDA for treatment of pain associated with postherpetic neuralgia (PHN). A lidocaine 5% patch (Lidoderm, and generics) was approved earlier for the same indication and has been used off-label for treatment of other types of localized pain. Both of these patches are available only by prescription. Lidocaine 4% patches (Aspercreme, IcyHot, and others) are available over the counter for back, neck, shoulder, and joint pain.
Med Lett Drugs Ther. 2019 Mar 25;61(1568):41-3 | Show Introduction Hide Introduction

Sulfonamide Cross-Reactivity

   
The Medical Letter on Drugs and Therapeutics • Mar 25, 2019  (Issue 1568)
of sulfanilamide. Both antibacterial and nonantibacterial sulfonamide drugs (see Table 1) contain a sulfonamide ...
A reader has questioned why the label for the COX-2 selective NSAID celecoxib (Celebrex, and generics), which contains a sulfonamide moiety, states that it is contraindicated for use in patients with an allergy to sulfonamides, while the labels of some other sulfonamide drugs recommend either caution or no precautions at all. The concept of cross-reactivity among sulfonamide drugs, particularly between antibacterial and nonantibacterial sulfonamides, has been controversial for many years.
Med Lett Drugs Ther. 2019 Mar 25;61(1568):44-6 | Show Introduction Hide Introduction

Desmopressin (Nocdurna and Noctiva) for Nocturnal Polyuria

   
The Medical Letter on Drugs and Therapeutics • Mar 25, 2019  (Issue 1568)
. Pharmacologic treatment has included off-label use of timed loop diuretics and desmopressin.1,2 Table 1 ...
The FDA has approved a sublingual tablet (Nocdurna – Ferring) and a nasal spray (Noctiva – Avadel) formulation of desmopressin acetate for treatment of nocturia due to nocturnal polyuria in adults who wake up ≥2 times per night to void. Nocdurna and Noctiva are the first two products to be approved in the US for this indication. Higher-strength nasal spray and oral tablet formulations of desmopressin (DDAVP, and others) have been available for years for treatment of diabetes insipidus and primary nocturnal enuresis (bedwetting in children). In 2007, the indication for primary...
Med Lett Drugs Ther. 2019 Mar 25;61(1568):46-8 | Show Introduction Hide Introduction