Matching articles for "Drug abuse"
Nalmefene Returns for Reversal of Opioid Overdose
The Medical Letter on Drugs and Therapeutics • September 5, 2022; (Issue 1658)
The FDA has approved a generic injectable formulation
of the opioid antagonist nalmefene (Purdue) for the
management of known or suspected opioid overdose.
Revex, the reference product, was withdrawn from...
The FDA has approved a generic injectable formulation
of the opioid antagonist nalmefene (Purdue) for the
management of known or suspected opioid overdose.
Revex, the reference product, was withdrawn from the
market in 2008 for commercial reasons.
Zimhi - A Higher-Dose Injectable Naloxone for Opioid Overdose
The Medical Letter on Drugs and Therapeutics • April 18, 2022; (Issue 1648)
The FDA has approved a higher-dose injectable
formulation of the opioid antagonist naloxone
(Zimhi – Adamis) for emergency treatment of opioid
overdose. A single IM or SC injection of the new
formulation...
The FDA has approved a higher-dose injectable
formulation of the opioid antagonist naloxone
(Zimhi – Adamis) for emergency treatment of opioid
overdose. A single IM or SC injection of the new
formulation delivers 5 mg of naloxone; injectable
formulations that deliver 0.4 mg or 2 mg of the drug
have been available for years. Naloxone is also
available in intranasal formulations for the same
indication (see Table 1).
In Brief: Higher-Dose Naloxone Nasal Spray (Kloxxado) for Opioid Overdose
The Medical Letter on Drugs and Therapeutics • September 20, 2021; (Issue 1633)
The FDA has approved a higher-dose intranasal
naloxone formulation (Kloxxado – Hikma) for
emergency treatment of opioid overdose. A single
spray of the new formulation delivers 8 mg of
naloxone; a...
The FDA has approved a higher-dose intranasal
naloxone formulation (Kloxxado – Hikma) for
emergency treatment of opioid overdose. A single
spray of the new formulation delivers 8 mg of
naloxone; a formulation that delivers 4 mg per spray
(Narcan) was approved in 2015.
Opioids for Pain
The Medical Letter on Drugs and Therapeutics • April 9, 2018; (Issue 1544)
Use of nonopioid drugs for pain was reviewed in a
previous issue. For many types of moderate to severe acute pain, acetaminophen and/or an NSAID may be as effective as an opioid. Immediate-release formulations...
Use of nonopioid drugs for pain was reviewed in a
previous issue. For many types of moderate to severe acute pain, acetaminophen and/or an NSAID may be as effective as an opioid. Immediate-release formulations of full opioid agonists should generally be used for acute pain that is severe enough to require treatment with an opioid. Use of extended-release or long-acting opioid formulations initially and treatment durations >1 week have been associated with an increased risk of unintended long-term use.
Once-Monthly Subcutaneous Buprenorphine (Sublocade) for Opioid Use Disorder
The Medical Letter on Drugs and Therapeutics • February 26, 2018; (Issue 1541)
The FDA has approved a subcutaneous (SC)
extended-release formulation of the mu-opioid
receptor partial agonist and kappa-opioid receptor
antagonist buprenorphine (Sublocade – Indivior)
for once-monthly...
The FDA has approved a subcutaneous (SC)
extended-release formulation of the mu-opioid
receptor partial agonist and kappa-opioid receptor
antagonist buprenorphine (Sublocade – Indivior)
for once-monthly treatment of moderate to severe
opioid use disorder. Sublocade is the first injectable
buprenorphine product to be approved in the US.
Buprenorphine is also available in sublingual
formulations with or without the opioid antagonist
naloxone, in a buccal formulation with naloxone, and
as a subdermal implant (Probuphine).
Drugs for Opioid Use Disorder
The Medical Letter on Drugs and Therapeutics • June 5, 2017; (Issue 1522)
Opioid use disorder is a chronic, relapsing disease with both physical and psychiatric components. It is
associated with economic hardship, social isolation,
incarceration, increased rates of...
Opioid use disorder is a chronic, relapsing disease with both physical and psychiatric components. It is
associated with economic hardship, social isolation,
incarceration, increased rates of blood-borne
infections such as HIV and viral hepatitis, adverse
pregnancy outcomes, and increased mortality.
According to the CDC, there were 33,091 deaths
related to opioid overdose in the US in 2015, more
than in any previous year. Several guidelines on the
management of opioid use disorder have recently
been published.
Abuse-Deterrent Opioids
The Medical Letter on Drugs and Therapeutics • June 5, 2017; (Issue 1522)
Development of abuse-deterrent opioid products,
including reformulation of existing products, has
become a priority for drug manufacturers and
public health advocates. Since our last article on
this...
Development of abuse-deterrent opioid products,
including reformulation of existing products, has
become a priority for drug manufacturers and
public health advocates. Since our last article on
this subject, several new abuse-deterrent opioid
formulations have been approved by the FDA,
including an oxycodone tablet formulation (Roxybond
– Inspirion) that is the first immediate-release opioid
product FDA-approved to include claims of abuse
deterrence in its labeling. No opioid formulation
prevents consumption of a large number of intact
dosage units, the most common method of abuse.
Abuse-deterrent formulations have one or more
properties that make their intentional nontherapeutic
use more difficult, less attractive, or less rewarding.
Arymo ER - A New Abuse-Deterrent Morphine Formulation
The Medical Letter on Drugs and Therapeutics • April 24, 2017; (Issue 1519)
The FDA has approved Arymo ER (Egalet), a new
extended-release, abuse-deterrent tablet formulation
of morphine sulfate, for management of pain severe
enough to require daily, around-the-clock,...
The FDA has approved Arymo ER (Egalet), a new
extended-release, abuse-deterrent tablet formulation
of morphine sulfate, for management of pain severe
enough to require daily, around-the-clock, long-term
opioid treatment and for which alternative treatment
options are inadequate. Arymo ER can only be
marketed to deter abuse by injection because another
single-entity, extended-release morphine product,
MorphaBond, which has not been marketed to date,
has marketing exclusivity for deterrence of abuse by
the intranasal route through October 2018.
A New Abuse-Deterrent Opioid - Xtampza ER
The Medical Letter on Drugs and Therapeutics • June 20, 2016; (Issue 1497)
The FDA has approved Xtampza ER (Collegium),
a new extended-release, abuse-deterrent capsule
formulation of oxycodone, for management of pain
severe enough to require daily, around-the-clock,
long-term...
The FDA has approved Xtampza ER (Collegium),
a new extended-release, abuse-deterrent capsule
formulation of oxycodone, for management of pain
severe enough to require daily, around-the-clock,
long-term opioid treatment and for which alternative
treatment options are inadequate.
Clarification: Half-Life of Heroin
The Medical Letter on Drugs and Therapeutics • February 29, 2016; (Issue 1489)
A reader expressed concern that a statement in our article Naloxone (Narcan) Nasal Spray for Opioid Overdose (Med Lett Drugs Ther 2016; 58:1) might be misleading. We stated that heroin has a half-life of 2-6...
A reader expressed concern that a statement in our article Naloxone (Narcan) Nasal Spray for Opioid Overdose (Med Lett Drugs Ther 2016; 58:1) might be misleading. We stated that heroin has a half-life of 2-6 minutes, which is correct, but heroin is a prodrug that is rapidly metabolized to 6-acetylmorphine and morphine. The risk of respiratory depression is related to those active metabolites, and it may persist well beyond the clearance of heroin from the blood.
Naloxone (Narcan) Nasal Spray for Opioid Overdose
The Medical Letter on Drugs and Therapeutics • January 4, 2016; (Issue 1485)
The recent increase in deaths due to overdose of
heroin and prescription opioids in the US has renewed
interest in the opioid antagonist naloxone, particularly
in making it available to first responders and...
The recent increase in deaths due to overdose of
heroin and prescription opioids in the US has renewed
interest in the opioid antagonist naloxone, particularly
in making it available to first responders and to
relatives and close friends of persons using heroin or
taking prescription opioids. IV or IM administration
by healthcare professionals is preferred, but
peripheral venous access may be difficult to obtain
in IV drug abusers, and exposure to their blood may
be hazardous.
Abuse-Deterrent Opioid Formulations
The Medical Letter on Drugs and Therapeutics • August 31, 2015; (Issue 1476)
Development of abuse-deterrent opioid products,
including reformulation of existing products, has
become a priority for drug manufacturers and public
health advocates. Three available opioid...
Development of abuse-deterrent opioid products,
including reformulation of existing products, has
become a priority for drug manufacturers and public
health advocates. Three available opioid formulations,
OxyContin (Purdue), Embeda (Pfizer), and Hysingla ER
(Purdue), now include claims of abuse deterrence in
their package inserts.
In Brief: A Naloxone Auto-Injector (Evzio)
The Medical Letter on Drugs and Therapeutics • June 9, 2014; (Issue 1444)
A recent Medical Letter article reported renewed interest in the intranasal administration (off-label) of the opioid antagonist naloxone because of an increase in deaths from opioid overdose in the US.1 Now the...
A recent Medical Letter article reported renewed interest in the intranasal administration (off-label) of the opioid antagonist naloxone because of an increase in deaths from opioid overdose in the US.1 Now the FDA has approved a more practical alternative for emergency treatment of life-threatening opioid overdose in adults and children: a single-dose naloxone auto-injector (Evzio – Kaleo) for intramuscular or subcutaneous use.
Evzio will be available in kits containing two prefilled 0.4-mg auto-injectors with voice guidance and a "trainer" device that also has voice guidance, but does not contain medication or a needle. The manufacturer has not published a price for Evzio to date, but news reports indicate that each kit could cost hundreds of dollars, compared to about $20 for a standard 0.4-mg injectable dose of naloxone, which can be given intranasally.
1. Intranasal naloxone for treatment of opioid overdose. Med Lett Drugs Ther 2014; 56:21.
Download complete U.S. English article
Evzio will be available in kits containing two prefilled 0.4-mg auto-injectors with voice guidance and a "trainer" device that also has voice guidance, but does not contain medication or a needle. The manufacturer has not published a price for Evzio to date, but news reports indicate that each kit could cost hundreds of dollars, compared to about $20 for a standard 0.4-mg injectable dose of naloxone, which can be given intranasally.
1. Intranasal naloxone for treatment of opioid overdose. Med Lett Drugs Ther 2014; 56:21.
Download complete U.S. English article
Intranasal Naloxone for Treatment of Opioid Overdose
The Medical Letter on Drugs and Therapeutics • March 17, 2014; (Issue 1438)
The recent increase in deaths from heroin overdose in
the US has led to renewed interest in the opioid antagonist
naloxone, particularly in making it available as an intranasal
spray to paramedics and...
The recent increase in deaths from heroin overdose in
the US has led to renewed interest in the opioid antagonist
naloxone, particularly in making it available as an intranasal
spray to paramedics and possibly to relatives and
close friends of heroin users. Intravenous (IV) administration
is preferred, but peripheral venous access may
be difficult to obtain in IV drug abusers, and exposure
to their blood may be hazardous.
In Brief: Palladone Withdrawn
The Medical Letter on Drugs and Therapeutics • August 1, 2005; (Issue 1214)
The Medical Letter review of Palladone (hydromorphone HCl) extended-release capsules (March 14, 2005) warned that a lethal dose could be released if the new formulation was taken with alcohol. Because of that...
The Medical Letter review of Palladone (hydromorphone HCl) extended-release capsules (March 14, 2005) warned that a lethal dose could be released if the new formulation was taken with alcohol. Because of that risk, the FDA asked the manufacturer (Purdue) to withdraw the drug from the market (FDA News. July 13, 2005; FDC Reports – “The Pink Sheet” July 18, 2005; 67:3).
Palladone for Chronic Pain
The Medical Letter on Drugs and Therapeutics • March 14, 2005; (Issue 1204)
A once-daily extended-release (ER) oral formulation of the opioid analgesic hydromorphone hydrochloride (Palladone - Purdue Pharma) has been approved by the FDA for treatment of opioid-tolerant patients with...
A once-daily extended-release (ER) oral formulation of the opioid analgesic hydromorphone hydrochloride (Palladone - Purdue Pharma) has been approved by the FDA for treatment of opioid-tolerant patients with persistent moderate to severe pain. Hydromorphone HCl, a semisynthetic congener of morphine and active metabolite of hydrocodone that has been used since the 1920s, is also available in immediate-release oral, injectable and suppository forms (Dilaudid, and others).
Alprazolam (Xanax, and others) Revisited
The Medical Letter on Drugs and Therapeutics • January 17, 2005; (Issue 1200)
Alprazolam, a short-acting benzodiazepine, is one of the most widely prescribed drugs in the US. It is approved by the FDA for treatment of anxiety and panic disorder. An extended-release formulation, Xanax XR,...
Alprazolam, a short-acting benzodiazepine, is one of the most widely prescribed drugs in the US. It is approved by the FDA for treatment of anxiety and panic disorder. An extended-release formulation, Xanax XR, which can be taken once a day, recently became available for panic disorder.
Methamphetamine Abuse
The Medical Letter on Drugs and Therapeutics • August 2, 2004; (Issue 1188)
Methamphetamine, a highly addictive synthetic sympathomimetic, has again become important as a drug of abuse in the US. Its resurgence has been associated with unsafe sexual practices that have resulted in an...
Methamphetamine, a highly addictive synthetic sympathomimetic, has again become important as a drug of abuse in the US. Its resurgence has been associated with unsafe sexual practices that have resulted in an increase in HIV transmission, particularly among men who have sex with men (SJ Semple et al, J Subst Abuse Treat 2002; 22:149; A Urbina and K Jones, Clin Infect Dis 2004; 38:890).
Buprenorphine: An alternative to Methadone
The Medical Letter on Drugs and Therapeutics • February 17, 2003; (Issue 1150)
The FDA has approved the marketing of buprenorphine in sublingual tablets (Reckitt Benckiser) both alone (Subutex) and with naloxone (Suboxone) for treatment of opioid dependence. Previously available only...
The FDA has approved the marketing of buprenorphine in sublingual tablets (Reckitt Benckiser) both alone (Subutex) and with naloxone (Suboxone) for treatment of opioid dependence. Previously available only for parenteral use in treatment of pain (Buprenex, and others), it offers an alternative to methadone (Dolophine, and others), which is now often abused (New York Times, February 9, 2003; page 1). As a schedule III narcotic, buprenorphine will be subject to fewer prescribing restrictions than a schedule II drug such as methadone (MJ Kreek and FJ Vocci, J Subst Abuse Treat 2002; 23:93).w1150a
Acute Reactions to Drugs of Abuse
The Medical Letter on Drugs and Therapeutics • March 4, 2002; (Issue 1125)
Acute toxic reactions to drugs of abuse continue to be important problems. Some patients may have mixed intoxications with complex combinations of signs and...
Acute toxic reactions to drugs of abuse continue to be important problems. Some patients may have mixed intoxications with complex combinations of signs and symptoms.
Acute Reactions to Drugs of Abuse
The Medical Letter on Drugs and Therapeutics • May 10, 1996; (Issue 974)
Acute toxic reactions to drugs of abuse continue to be important problems. Since the last Medical Letter article on this subject (volume 32, page 92, 1990), new reactions and new approaches to treating them...
Acute toxic reactions to drugs of abuse continue to be important problems. Since the last Medical Letter article on this subject (volume 32, page 92, 1990), new reactions and new approaches to treating them have been reported.
Acute Reactions to Drugs of Abuse
The Medical Letter on Drugs and Therapeutics • October 5, 1990; (Issue 828)
...
Perinatal Toxicity of Cocaine
The Medical Letter on Drugs and Therapeutics • June 3, 1988; (Issue 767)
As cocaine continues to be widely available in the USA (Medical Letter, 28:69, 1986), new problems associated with its use continue to emerge. Some recent reports indicate that use of the drug during pregnancy...
As cocaine continues to be widely available in the USA (Medical Letter, 28:69, 1986), new problems associated with its use continue to emerge. Some recent reports indicate that use of the drug during pregnancy can damage the fetus, lead to abortion or premature labor, and cause toxic effects in the newborn infant.