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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.
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.
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...
In Brief: Erenumab (Aimovig) Hypersensitivity
The Medical Letter on Drugs and Therapeutics • Mar 25, 2019 (Issue 1568)
of erenumabaooe
(Aimovig)1, a once-monthly, subcutaneously injected
calcitonin gene-related peptide (CGRP ...
The FDA has approved changes to the labeling of erenumab-aooe (Aimovig)1, a once-monthly, subcutaneously injected calcitonin gene-related peptide (CGRP) blocker approved in 2018 for prevention of migraine. The new label contains a warning about hypersensitivity reactions, including rash, angioedema, and anaphylaxis, that have been reported with post-marketing use of the drug.According to the label, most of these reactions were not serious and occurred within hours after receiving the drug, but some occurred more than one week after administration. Because these reactions are voluntarily...
Rifamycin (Aemcolo) for Treatment of Travelers' Diarrhea
The Medical Letter on Drugs and Therapeutics • Mar 11, 2019 (Issue 1567)
of TD.1) Most patients are infected via fecaloral
transmission from contaminated food or water ...
The FDA has approved rifamycin (Aemcolo – Cosmo/
Aries), a minimally absorbed oral antibiotic, for
treatment of adults with travelers' diarrhea (TD)
caused by noninvasive strains of Escherichia coli. It
is not recommended for treatment of diarrhea that is
complicated by fever and/or bloody stools. Topical
and injectable formulations of rifamycin have been
used in Europe for other indications for many years.
Xyosted - A Testosterone Auto-Injector for Hypogonadism
The Medical Letter on Drugs and Therapeutics • Mar 11, 2019 (Issue 1567)
concentrations into the normal
range.1 Testosterone cypionate, undecanoate, and
Table 1. Some Injectable ...
The FDA has approved an auto-injector formulation of
testosterone enanthate (Xyosted – Antares Pharma) for
once-weekly subcutaneous self-administration in adult
males with conditions associated with a deficiency or
absence of endogenous testosterone. It is the first subcutaneous
formulation of testosterone to be approved by
the FDA. Xyosted is contraindicated for treatment of low
testosterone levels associated with aging.
An Epinephrine Prefilled Syringe (Symjepi) for Anaphylaxis
The Medical Letter on Drugs and Therapeutics • Feb 25, 2019 (Issue 1566)
.
Pronunciation Key
Symjepi: sim jep’ ee
Table 1. Epinephrine Products for Anaphylaxis
Epinephrine Injection ...
The FDA has approved a manually
injected, single-dose, prefilled
epinephrine syringe (Symjepi –
Adamis/Sandoz) for emergency
treatment of anaphylaxis. The new
device is approved in 0.3- and
0.15-mg strengths for treatment of
patients weighing ≥30 kg and 15 to
30 kg, respectively; only the 0.3-mg
strength is currently available.
According to Sandoz, Symjepi will be made available
first to institutions and later to the retail market.
Cardiovascular Benefits of SGLT2 Inhibitors and GLP-1 Receptor Agonists in Type 2 Diabetes
The Medical Letter on Drugs and Therapeutics • Feb 25, 2019 (Issue 1566)
Cardiovascular Benefits of SGLT2 Inhibitors and GLP-1 Receptor Agonists in Type 2 Diabetes ...
Since 2008, because of safety concerns, the FDA has
mandated that long-term cardiovascular outcomes trials
be conducted for all new drugs for type 2 diabetes.
Reductions in the incidence of macrovascular complications
in these trials with some sodium-glucose
co-transporter 2 (SGLT2) inhibitors and glucagon-like
peptide 1 (GLP-1) receptor agonists in patients at risk
for cardiovascular disease (see Table 1) have led to
new recommendations.
Drug Interaction: Opioids and Oral P2Y12 Platelet Inhibitors
The Medical Letter on Drugs and Therapeutics • Feb 25, 2019 (Issue 1566)
onset of action.1
ACS — Aspirin plus an oral P2Y12 inhibitor is commonly
used for initial treatment ...
The FDA has required manufacturers of the oral P2Y12
platelet inhibitors clopidogrel (Plavix, and generics),
prasugrel (Effient, and generics), and ticagrelor
(Brilinta) to warn in the product labels that the
absorption of these drugs may be delayed or reduced
when taken with an opioid agonist.
Elderberry for Influenza
The Medical Letter on Drugs and Therapeutics • Feb 25, 2019 (Issue 1566)
strains in vitro.1-3 In two small studies
(conducted outside the US), adults with influenza A
or B virus ...
Patients may ask about taking elderberry for prevention
and treatment of influenza. Products containing
elderberry are promoted for relief of cold and flu
symptoms and as an immune system booster.