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Matching articles for "NSAIDs"

Intravenous Acetaminophen/Ibuprofen (Combogesic IV)

The Medical Letter on Drugs and Therapeutics • April 29, 2024; (Issue 1701)

The FDA has approved Combogesic IV (Hikma), an IV solution containing acetaminophen and ibuprofen, to treat mild to moderate pain (alone) or moderate to severe pain (in combination with an opioid) in...

The FDA has approved Combogesic IV (Hikma), an IV solution containing acetaminophen and ibuprofen, to treat mild to moderate pain (alone) or moderate to severe pain (in combination with an opioid) in adults when IV analgesia is considered clinically necessary. Single-drug IV solutions containing ibuprofen (Caldolor) and acetaminophen have been available in the US for years.

Med Lett Drugs Ther. 2024 Apr 29;66(1701):68-9 | Show Full Introduction Hide Full Introduction

Drugs for Gout

The Medical Letter on Drugs and Therapeutics • October 30, 2023; (Issue 1688)

Drugs for gout are used to reduce the pain and inflammation of acute flares, decrease the frequency of exacerbations, and lower serum urate levels to prevent recurrent flares, development of tophi,...

Med Lett Drugs Ther. 2023 Oct 30;65(1688):169-75 | Show Full Introduction Hide Full Introduction

Drugs for Migraine

The Medical Letter on Drugs and Therapeutics • June 12, 2023; (Issue 1678)

An oral nonopioid analgesic is often sufficient for acute treatment of mild to moderate migraine pain without severe nausea or vomiting. A triptan is the drug of choice for treatment of moderate to severe migraine in most patients without vascular disease. Treatment of pain when it is still mild to moderate in intensity improves headache response and reduces the risk of recurrence.

Med Lett Drugs Ther. 2023 Jun 12;65(1678):89-96 | Show Full Introduction Hide Full Introduction

Opioids for Pain

The Medical Letter on Drugs and Therapeutics • December 12, 2022; (Issue 1665)

A new CDC guideline for prescribing opioids for pain recently became available. Nonopioid drugs for pain were reviewed in a previous...

A new CDC guideline for prescribing opioids for pain recently became available. Nonopioid drugs for pain were reviewed in a previous issue.

Med Lett Drugs Ther. 2022 Dec 12;64(1665):193-200 | Show Full Introduction Hide Full Introduction

Nonopioid Drugs for Pain

The Medical Letter on Drugs and Therapeutics • March 7, 2022; (Issue 1645)

Nonopioid drugs can be used in the treatment of many nociceptive and neuropathic pain conditions. For severe pain, especially severe chronic cancer pain, use of opioids may be necessary....

Nonopioid drugs can be used in the treatment of many nociceptive and neuropathic pain conditions. For severe pain, especially severe chronic cancer pain, use of opioids may be necessary. Noninvasive nonpharmacologic treatments, including physical and psychological therapies, have been shown to improve pain and function in patients with some common chronic pain conditions and are unlikely to cause serious harms. A multimodal approach to analgesic therapy can increase pain control while reducing opioid use and adverse effects.

Med Lett Drugs Ther. 2022 Mar 7;64(1645):33-40 | Show Full Introduction Hide Full Introduction

Comparison Table: Some Nonopioid Analgesics for Pain (online only)

The Medical Letter on Drugs and Therapeutics • March 7, 2022; (Issue 1645)

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View the Comparison Table: Some Nonopioid Analgesics for Pain

Med Lett Drugs Ther. 2022 Mar 7;64(1645):e40-3 | Show Full Introduction Hide Full Introduction

Bupivacaine/Meloxicam (Zynrelef) for Postsurgical Pain

The Medical Letter on Drugs and Therapeutics • January 24, 2022; (Issue 1642)

The FDA has approved a fixed-dose combination of the amide local anesthetic bupivacaine and the nonsteroidal anti-inflammatory drug (NSAID) meloxicam as an extended-release (ER) solution (Zynrelef – Heron) for single-dose, intraoperative, soft-tissue or periarticular instillation to provide postsurgical analgesia for up to 72 hours in adults undergoing foot and ankle, small-to-medium open abdominal, or lower extremity total joint arthroplasty surgical procedures.

Med Lett Drugs Ther. 2022 Jan 24;64(1642):13-5 | Show Full Introduction Hide Full Introduction

Drugs for Rheumatoid Arthritis

The Medical Letter on Drugs and Therapeutics • November 15, 2021; (Issue 1637)

Rheumatoid arthritis (RA) is prevalent in 0.5% of adults in the US; it is about 2.5 times more common in women than in men. Guidelines for treatment of RA from the American College of Rheumatology were recently updated. The goal of treatment is to minimize disease activity and prevent irreversible joint damage.

Med Lett Drugs Ther. 2021 Nov 15;63(1637):177-84 | Show Full Introduction Hide Full Introduction

Atogepant (Qulipta) for Migraine Prevention

The Medical Letter on Drugs and Therapeutics • November 1, 2021; (Issue 1636)

Atogepant (Qulipta – Abbvie), an oral small-molecule calcitonin gene-related peptide (CGRP) receptor antagonist ("gepant"), has been approved by the FDA for prevention of episodic migraine in adults....

Atogepant (Qulipta – Abbvie), an oral small-molecule calcitonin gene-related peptide (CGRP) receptor antagonist ("gepant"), has been approved by the FDA for prevention of episodic migraine in adults. It is the second oral CGRP receptor antagonist to be approved in the US for this indication; the first was rimegepant (Nurtec ODT), which is also approved for acute treatment of migraine. Parenteral CGRP monoclonal antibodies are approved for prevention of migraine (see Table 3).

Med Lett Drugs Ther. 2021 Nov 1;63(1636):169-71 | Show Full Introduction Hide Full Introduction

Rilonacept (Arcalyst) for Recurrent Pericarditis

The Medical Letter on Drugs and Therapeutics • September 6, 2021; (Issue 1632)

Rilonacept (Arcalyst – Kiniksa), an interleukin-1 (IL-1) antagonist that has been available for years for treatment of cryopyrin-associated periodic syndromes, has now been approved by the FDA for...

Rilonacept (Arcalyst – Kiniksa), an interleukin-1 (IL-1) antagonist that has been available for years for treatment of cryopyrin-associated periodic syndromes, has now been approved by the FDA for treatment of recurrent pericarditis and prevention of further recurrences in patients ≥12 years old. It is the first drug to be approved in the US for this indication. Anakinra (Kineret), an IL-1 receptor antagonist FDA-approved for treatment of rheumatoid arthritis, has been used off-label for years for treatment of recurrent pericarditis.

Med Lett Drugs Ther. 2021 Sep 6;63(1632):143-4 | Show Full Introduction Hide Full Introduction

Myfembree for Fibroid-Associated Heavy Menstrual Bleeding

The Medical Letter on Drugs and Therapeutics • August 9, 2021; (Issue 1630)

Myfembree (Myovant/Pfizer), an oral fixed-dose combination of the gonadotropin-releasing hormone (GnRH) receptor antagonist relugolix, the estrogen estradiol, and the progestin norethindrone acetate, has...

Myfembree (Myovant/Pfizer), an oral fixed-dose combination of the gonadotropin-releasing hormone (GnRH) receptor antagonist relugolix, the estrogen estradiol, and the progestin norethindrone acetate, has been approved by the FDA for management of heavy menstrual bleeding associated with uterine leiomyomas (fibroids) in premenopausal women. It is the second product to be approved in the US for this indication; Oriahnn, which contains the GnRH receptor antagonist elagolix in combination with estradiol and norethindrone acetate, was approved earlier. Relugolix was approved for treatment of advanced prostate cancer as Orgovyx in 2020.

Med Lett Drugs Ther. 2021 Aug 9;63(1630):121-3 | Show Full Introduction Hide Full Introduction

Oriahnn for Fibroid-Associated Heavy Menstrual Bleeding

The Medical Letter on Drugs and Therapeutics • April 5, 2021; (Issue 1621)

Oriahnn (Abbvie), a fixed-dose combination of the gonadotropin-releasing hormone (GnRH) receptor antagonist elagolix, the estrogen estradiol, and the progestin norethindrone acetate copackaged with elagolix...

Oriahnn (Abbvie), a fixed-dose combination of the gonadotropin-releasing hormone (GnRH) receptor antagonist elagolix, the estrogen estradiol, and the progestin norethindrone acetate copackaged with elagolix alone, has been approved by the FDA for oral treatment of heavy menstrual bleeding associated with uterine leiomyomas (fibroids) in premenopausal women. It is the first product to be approved in the US for this indication. Elagolix (Orilissa) has been available since 2018 for treatment of moderate to severe pain associated with endometriosis. The GnRH receptor antagonist relugolix (Orgovyx), which is approved for treatment of advanced prostate cancer, is being reviewed by the FDA for use in combination with estradiol and norethindrone acetate for the same indication as Oriahnn.

Med Lett Drugs Ther. 2021 Apr 5;63(1621):51-2 | Show Full Introduction Hide Full Introduction

Orphengesic Forte - An Old Analgesic Combination Returns

The Medical Letter on Drugs and Therapeutics • November 16, 2020; (Issue 1611)

A fixed-dose combination of orphenadrine citrate, aspirin, and caffeine (Orphengesic Forte – Galt; previously available as Norgesic Forte) has been approved as a prescription drug by the FDA for treatment...

A fixed-dose combination of orphenadrine citrate, aspirin, and caffeine (Orphengesic Forte – Galt; previously available as Norgesic Forte) has been approved as a prescription drug by the FDA for treatment of mild to moderate pain caused by acute musculoskeletal disorders. Single-ingredient generic orphenadrine citrate is available by prescription in oral and injectable formulations and has been used for years as an adjunct for treatment of acute musculoskeletal pain. Orphengesic Forte is being marketed as a non-opioid alternative for pain relief.

Med Lett Drugs Ther. 2020 Nov 16;62(1611):180-1 | Show Full Introduction Hide Full Introduction

In Brief: New Warnings on NSAID Use in Pregnancy

The Medical Letter on Drugs and Therapeutics • November 2, 2020; (Issue 1610)

The FDA has required a new warning in the labels of prescription and over-the-counter products containing nonsteroidal anti-inflammatory drugs (NSAIDs) advising against their use during pregnancy beginning at 20 weeks’ gestation because of a risk of renal dysfunction in the fetus that could lead to low amniotic fluid levels (oligohydramnios) and neonatal renal impairment. NSAID labels previously warned against use of the drugs beginning at 30 weeks' gestation because of a risk for premature closure of the ductus arteriosus and persistent neonatal pulmonary hypertension

Med Lett Drugs Ther. 2020 Nov 2;62(1610):175 | Show Full Introduction Hide Full Introduction

Drugs for Migraine

The Medical Letter on Drugs and Therapeutics • October 5, 2020; (Issue 1608)

An oral nonopioid analgesic is often sufficient for acute treatment of mild to moderate migraine headache without severe nausea or vomiting. A triptan is the drug of choice for treatment of moderate to severe migraine headache pain in most patients without vascular disease. Early treatment of pain when it is still mild to moderate in intensity improves headache response and reduces the risk of recurrence.

Med Lett Drugs Ther. 2020 Oct 5;62(1608):153-60 | Show Full Introduction Hide Full Introduction

IV Meloxicam (Anjeso) for Pain

The Medical Letter on Drugs and Therapeutics • June 29, 2020; (Issue 1601)

The FDA has approved Anjeso (Baudax Bio), an IV formulation of the nonsteroidal anti-inflammatory drug (NSAID) meloxicam, for once-daily treatment of moderate to severe pain in adults. Oral...

The FDA has approved Anjeso (Baudax Bio), an IV formulation of the nonsteroidal anti-inflammatory drug (NSAID) meloxicam, for once-daily treatment of moderate to severe pain in adults. Oral meloxicam (Mobic, and others), which is only indicated for treatment of chronic pain associated with osteoarthritis or rheumatoid arthritis, has been available for 20 years. IV formulations of ketorolac, ibuprofen (Caldolor), and acetaminophen (Ofirmev) are also available for treatment of pain.

Med Lett Drugs Ther. 2020 Jun 29;62(1601):100-2 | Show Full Introduction Hide Full Introduction

Rimegepant (Nurtec ODT) for Acute Treatment of Migraine

The Medical Letter on Drugs and Therapeutics • May 4, 2020; (Issue 1597)

The FDA has approved an orally disintegrating tablet (ODT) formulation of rimegepant (Nurtec ODT – Biohaven), a small-molecule calcitonin gene-related peptide (CGRP) receptor antagonist ("gepant"),...

The FDA has approved an orally disintegrating tablet (ODT) formulation of rimegepant (Nurtec ODT – Biohaven), a small-molecule calcitonin gene-related peptide (CGRP) receptor antagonist ("gepant"), for acute treatment of migraine with or without aura in adults. Rimegepant is the second oral gepant to become available in the US; ubrogepant (Ubrelvy), which is approved for the same indication, was the first. Four parenteral CGRP antagonists, erenumab (Aimovig), fremanezumab (Ajovy), galcanezumab (Emgality), and eptinezumab (Vyepti), are approved for prevention of migraine.

Med Lett Drugs Ther. 2020 May 4;62(1597):70-2 | Show Full Introduction Hide Full Introduction

Drugs for Osteoarthritis

The Medical Letter on Drugs and Therapeutics • April 20, 2020; (Issue 1596)

Many different drugs are used for treatment of osteoarthritis pain, but none of them prevent progression of the disease. Nonpharmacologic approaches including weight management, exercise, tai chi, physical therapy, assistive devices, and total joint arthroplasty can also be used. The American College of Rheumatology (ACR) has published new guidelines for the management of osteoarthritis of the hip, hand, and knee.

Med Lett Drugs Ther. 2020 Apr 20;62(1596):57-62 | Show Full Introduction Hide Full Introduction

Some Drugs for COVID-19

The Medical Letter on Drugs and Therapeutics • April 6, 2020; (Issue 1595)

The severity and rapid spread of COVID-19 (caused by SARS-CoV-2) have raised questions about the use of some drugs in patients with the disease and whether currently available drugs could be effective in treating it. Definitive answers are lacking, but some recommendations can be made. For additional information on specific drugs, see our table Some Drugs Being Considered for Treatment of COVID-19.

Med Lett Drugs Ther. 2020 Apr 6;62(1595):49-50 | Show Full Introduction Hide Full Introduction

Table: Treatments Considered for COVID-19 (Archived) (online only)

The Medical Letter on Drugs and Therapeutics • April 6, 2020; (Issue 1595)

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View the Table: Treatments Considered for COVID-19

Med Lett Drugs Ther. 2020 Apr 6;62(1595):e1-289 | Show Full Introduction Hide Full Introduction

Some Drugs for COVID-19

The Medical Letter on Drugs and Therapeutics • April 6, 2020; (Issue 1919)

Med Lett Drugs Ther. 2020 Apr 6;62(1919):1 | Show Full Introduction Hide Full Introduction

Lasmiditan (Reyvow) and Ubrogepant (Ubrelvy) for Acute Treatment of Migraine

The Medical Letter on Drugs and Therapeutics • March 9, 2020; (Issue 1593)

Lasmiditan (Reyvow – Lilly), an oral serotonin (5-HT1F) receptor agonist, and ubrogepant (Ubrelvy – Allergan), an oral calcitonin gene-related peptide (CGRP) receptor antagonist, have been approved by...

Lasmiditan (Reyvow – Lilly), an oral serotonin (5-HT_1F) receptor agonist, and ubrogepant (Ubrelvy – Allergan), an oral calcitonin gene-related peptide (CGRP) receptor antagonist, have been approved by the FDA for acute treatment of migraine with or without aura in adults.

Med Lett Drugs Ther. 2020 Mar 9;62(1593):35-9 | Show Full Introduction Hide Full Introduction

Drugs for Psoriatic Arthritis

The Medical Letter on Drugs and Therapeutics • December 30, 2019; (Issue 1588)

Psoriatic arthritis is a chronic inflammatory arthropathy associated with psoriasis. A recent review found that about 20% of patients with psoriasis have psoriatic arthritis. Updated guidelines for...

Med Lett Drugs Ther. 2019 Dec 30;61(1588):203-10 | Show Full Introduction Hide Full Introduction

Qmiiz ODT - An Orally Disintegrating Meloxicam Tablet

The Medical Letter on Drugs and Therapeutics • September 23, 2019; (Issue 1581)

The FDA has approved Qmiiz ODT (TerSera), an orally disintegrating tablet formulation of the prescription NSAID meloxicam. Qmiiz ODT, like conventional oral meloxicam tablets (Mobic, and generics), is...

The FDA has approved Qmiiz ODT (TerSera), an orally disintegrating tablet formulation of the prescription NSAID meloxicam. Qmiiz ODT, like conventional oral meloxicam tablets (Mobic, and generics), is indicated for relief of the symptoms of osteoarthritis (OA) and rheumatoid arthritis (RA) in adults and of juvenile RA in children who weigh ≥60 kg. Vivlodex, a low-dose capsule formulation of meloxicam, is FDA-approved only for management of OA pain.

Med Lett Drugs Ther. 2019 Sep 23;61(1581):151-2 | Show Full Introduction Hide Full Introduction

Benzhydrocodone/Acetaminophen (Apadaz) for Pain

The Medical Letter on Drugs and Therapeutics • July 15, 2019; (Issue 1576)

The FDA has approved Apadaz (KemPharm), a short-acting, fixed-dose combination of benzhydrocodone and acetaminophen, for short-term management (≤14 days) of acute pain severe enough to require an opioid...

The FDA has approved Apadaz (KemPharm), a short-acting, fixed-dose combination of benzhydrocodone and acetaminophen, for short-term management (≤14 days) of acute pain severe enough to require an opioid and for which alternative treatment options are inadequate. Benzhydrocodone is a prodrug of hydrocodone. Fixed-dose combinations of short-acting hydrocodone and acetaminophen or ibuprofen have been available for years and are the most abused opioid products in the US. Apadaz was developed under the presumption that inclusion of the inactive prodrug would reduce the potential for abuse of the combination by non-oral routes such as smoking, snorting, or injection, but the FDA did not approve Apadaz as an abuse-deterrent formulation.

Med Lett Drugs Ther. 2019 Jul 15;61(1576):110-2 | Show Full Introduction Hide Full Introduction

Drugs for Gout

The Medical Letter on Drugs and Therapeutics • March 11, 2019; (Issue 1567)

Drugs for gout reduce the pain and inflammation of acute flares and lower serum urate levels in order to prevent recurrent flares, development of tophi, and joint...

Drugs for gout reduce the pain and inflammation of acute flares and lower serum urate levels in order to prevent recurrent flares, development of tophi, and joint damage.

Med Lett Drugs Ther. 2019 Mar 11;61(1567):33-7 | Show Full Introduction Hide Full Introduction

Elagolix (Orilissa) - An Oral GnRH Antagonist for Endometriosis Pain

The Medical Letter on Drugs and Therapeutics • September 24, 2018; (Issue 1556)

The FDA has approved elagolix (Orilissa – AbbVie), an oral gonadotropin-releasing hormone (GnRH) antagonist, for management of moderate to severe pain associated with...

The FDA has approved elagolix (Orilissa – AbbVie), an oral gonadotropin-releasing hormone (GnRH) antagonist, for management of moderate to severe pain associated with endometriosis.

Med Lett Drugs Ther. 2018 Sep 24;60(1556):158-60 | Show Full Introduction Hide Full Introduction

Two New Intra-Articular Injections for Knee Osteoarthritis

The Medical Letter on Drugs and Therapeutics • August 27, 2018; (Issue 1554)

The FDA has approved a single-injection hyaluronic acid gel (Durolane – Bioventus) and an extended-release (ER) formulation of the synthetic corticosteroid triamcinolone acetonide (Zilretta – Flexion)...

The FDA has approved a single-injection hyaluronic acid gel (Durolane – Bioventus) and an extended-release (ER) formulation of the synthetic corticosteroid triamcinolone acetonide (Zilretta – Flexion) for intra-articular (IA) treatment of osteoarthritic knee pain.

Med Lett Drugs Ther. 2018 Aug 27;60(1554):142-4 | Show Full Introduction Hide Full Introduction

Drugs for Rheumatoid Arthritis

The Medical Letter on Drugs and Therapeutics • July 30, 2018; (Issue 1552)

Disease-modifying antirheumatic drugs (DMARDs) are used for initial treatment of rheumatoid arthritis (RA) to achieve clinical remission and prevent irreversible joint damage (see Table 1). DMARDs generally do not have an immediate analgesic effect, but over time they can control symptoms and have been shown to delay and possibly stop progression of the disease. Methotrexate (Trexall, and others) is generally the drug of choice; it can be used for patients with low, moderate, or high disease activity. For mild disease, some clinicians prefer to start with hydroxychloroquine (Plaquenil, and generics) and/or sulfasalazine (Azulfidine, and others).

Med Lett Drugs Ther. 2018 Jul 30;60(1552):123-8 | Show Full Introduction Hide Full Introduction

Baricitinib (Olumiant) for Rheumatoid Arthritis

The Medical Letter on Drugs and Therapeutics • July 16, 2018; (Issue 1551)

The FDA has approved the Janus kinase (JAK) inhibitor baricitinib (Olumiant – Lilly) for oral treatment of adults with moderately to severely active rheumatoid arthritis (RA) that has not responded...

The FDA has approved the Janus kinase (JAK) inhibitor baricitinib (Olumiant – Lilly) for oral treatment of adults with moderately to severely active rheumatoid arthritis (RA) that has not responded adequately to one or more tumor necrosis factor (TNF) inhibitors. Baricitinib is the second JAK inhibitor to be approved for treatment of RA; tofacitinib (Xeljanz, Xeljanz XR) was the first.

Med Lett Drugs Ther. 2018 Jul 16;60(1551):120-1 | Show Full Introduction Hide Full Introduction

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 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.

Med Lett Drugs Ther. 2018 Apr 9;60(1544):57-64 | Show Full Introduction Hide Full Introduction

Nonopioid Drugs for Pain

The Medical Letter on Drugs and Therapeutics • February 12, 2018; (Issue 1540)

Nonopioid drugs can be used in the treatment of many nociceptive and neuropathic pain conditions. Use of opioids for pain will be reviewed in a future...

Nonopioid drugs can be used in the treatment of many nociceptive and neuropathic pain conditions. Use of opioids for pain will be reviewed in a future issue.

Med Lett Drugs Ther. 2018 Feb 12;60(1540):24-32 | Show Full Introduction Hide Full Introduction

Comparison Table: Some Nonopioid Analgesics for Pain (online only)

The Medical Letter on Drugs and Therapeutics • February 12, 2018; (Issue 1540)

...

View the Comparison Table: Some Nonopioid Analgesics for Pain

Med Lett Drugs Ther. 2018 Feb 12;60(1540):e32-5 | Show Full Introduction Hide Full Introduction

Drugs for GERD and Peptic Ulcer Disease

The Medical Letter on Drugs and Therapeutics • January 15, 2018; (Issue 1538)

Gastroesophageal reflux disease (GERD) is the most frequent GI condition encountered in the outpatient setting; it affects about 20% of the US population. Heartburn and regurgitation are the classic...

Med Lett Drugs Ther. 2018 Jan 15;60(1538):9-16 | Show Full Introduction Hide Full Introduction

Safety of Long-Term PPI Use

The Medical Letter on Drugs and Therapeutics • August 14, 2017; (Issue 1527)

Proton pump inhibitors (PPIs), which are used for treatment of gastroesophageal reflux disease (GERD) and for prevention of upper gastrointestinal adverse effects caused by NSAIDs and aspirin, are one of the most commonly prescribed classes of drugs in the US. All PPIs are similarly effective and generally well tolerated, but their long-term use has been associated with a number of safety concerns. Recommendations addressing these concerns have recently been published.

Med Lett Drugs Ther. 2017 Aug 14;59(1527):131-3 | Show Full Introduction Hide Full Introduction

Sarilumab (Kevzara) for Rheumatoid Arthritis

The Medical Letter on Drugs and Therapeutics • August 14, 2017; (Issue 1527)

The FDA has approved the interleukin (IL)-6 inhibitor sarilumab (Kevzara – Sanofi) for second-line treatment of adults with moderately to severely active rheumatoid arthritis (RA). It is the second...

The FDA has approved the interleukin (IL)-6 inhibitor sarilumab (Kevzara – Sanofi) for second-line treatment of adults with moderately to severely active rheumatoid arthritis (RA). It is the second IL-6 inhibitor to be approved for this indication; tocilizumab (Actemra) was approved earlier.

Med Lett Drugs Ther. 2017 Aug 14;59(1527):134-6 | Show Full Introduction Hide Full Introduction

FDA Warns Against Use of Codeine and Tramadol in Children and Breastfeeding Women

The Medical Letter on Drugs and Therapeutics • May 22, 2017; (Issue 1521)

The FDA has issued new warnings about the use of the opioid analgesics codeine and tramadol in children, particularly those...

The FDA has issued new warnings about the use of the opioid analgesics codeine and tramadol in children, particularly those <12 years old, and in breastfeeding women due to concerns about the risk of respiratory depression and death. The FDA previously issued warnings about these drugs in 2013 and 2015.

Med Lett Drugs Ther. 2017 May 22;59(1521):86-8 | Show Full Introduction Hide Full Introduction

Drugs for Migraine

The Medical Letter on Drugs and Therapeutics • February 13, 2017; (Issue 1514)

An oral nonopioid analgesic may be sufficient for treatment of mild to moderate migraine without severe nausea or vomiting. A triptan is the drug of choice for treatment of moderate to severe migraine. Use of a triptan early in an attack when pain is still mild to moderate in intensity improves headache response and reduces recurrence rates.

Med Lett Drugs Ther. 2017 Feb 13;59(1514):27-32 | Show Full Introduction Hide Full Introduction

Celecoxib Safety Revisited

The Medical Letter on Drugs and Therapeutics • December 19, 2016; (Issue 1510)

The results of a clinical trial (PRECISION) comparing the cardiovascular safety of the COX-2 selective NSAID celecoxib (Celebrex, and generics) with that of ibuprofen and naproxen, which are...

The results of a clinical trial (PRECISION) comparing the cardiovascular safety of the COX-2 selective NSAID celecoxib (Celebrex, and generics) with that of ibuprofen and naproxen, which are nonselective, have been described in the lay press in terms that may overestimate the safety of celecoxib.

Med Lett Drugs Ther. 2016 Dec 19;58(1510):159 | Show Full Introduction Hide Full Introduction

SGLT2 Inhibitors and Renal Function

The Medical Letter on Drugs and Therapeutics • July 18, 2016; (Issue 1499)

At the same time that the FDA announced it was strengthening existing warnings about the risk of acute kidney injury in patients with type 2 diabetes treated with the sodium-glucose co-transporter 2 (SGLT2) inhibitors canagliflozin (Invokana, and others) and dapagliflozin (Farxiga, and others), a study was published showing that the third SGLT2 inhibitor, empagliflozin (Jardiance, and others), slowed the progression of renal dysfunction in patients with type 2 diabetes.

Med Lett Drugs Ther. 2016 Jul 18;58(1499):91-2 | Show Full Introduction Hide Full Introduction

Low-Dose Meloxicam (Vivlodex) for Osteoarthritis Pain

The Medical Letter on Drugs and Therapeutics • March 14, 2016; (Issue 1490)

The FDA has approved Vivlodex (Iroko), a low-dose formulation of the nonsteroidal anti-inflammatory drug meloxicam (Mobic, and generics), for management of osteoarthritis pain. According to the manufacturer,...

The FDA has approved Vivlodex (Iroko), a low-dose formulation of the nonsteroidal anti-inflammatory drug meloxicam (Mobic, and generics), for management of osteoarthritis pain. According to the manufacturer, the new formulation aligns with stronger FDA warnings about the cardiovascular risks of NSAIDs and the recommendation to use the lowest possible doses of these drugs.

Med Lett Drugs Ther. 2016 Mar 14;58(1490):35-6 | Show Full Introduction Hide Full Introduction

Patiromer (Veltassa) for Hyperkalemia

The Medical Letter on Drugs and Therapeutics • February 15, 2016; (Issue 1488)

The FDA has approved patiromer (Veltassa – Relypsa), an oral potassium binder, for treatment of hyperkalemia. It is the first drug to be approved for this indication since the cation-exchange resin sodium...

The FDA has approved patiromer (Veltassa – Relypsa), an oral potassium binder, for treatment of hyperkalemia. It is the first drug to be approved for this indication since the cation-exchange resin sodium polystyrene sulfonate (Kayexalate, and others) in 1958. Patiromer is not indicated for emergency correction of life-threatening hyperkalemia. Sodium zirconium cyclosilicate, another oral potassium binder, is currently being reviewed by the FDA; a decision on its approval is expected in May 2016.

Med Lett Drugs Ther. 2016 Feb 15;58(1488):23-4 | Show Full Introduction Hide Full Introduction

ColciGel - A Homeopathic Colchicine Gel for Gout

The Medical Letter on Drugs and Therapeutics • January 4, 2016; (Issue 1485)

Homeopathic drugs characteristically consist of very large dilutions of "proven" substances. Serial dilutions of 1:10 are designated by the Roman numeral X. ColciGel (Gensco), a prescription homeopathic gel...

Homeopathic drugs characteristically consist of very large dilutions of "proven" substances. Serial dilutions of 1:10 are designated by the Roman numeral X. ColciGel (Gensco), a prescription homeopathic gel containing a 10,000-fold dilution of colchicine (colchicinum 4X), is now being marketed for topical treatment and prophylaxis of gout.

Med Lett Drugs Ther. 2016 Jan 4;58(1485):5-6 | Show Full Introduction Hide Full Introduction

Intravenous Diclofenac (Dyloject)

The Medical Letter on Drugs and Therapeutics • December 21, 2015; (Issue 1484)

The FDA has approved Dyloject (Hospira), an IV formulation of the NSAID diclofenac sodium, for use in adults. It can be administered alone for treatment of mild to moderate pain or in combination with...

The FDA has approved Dyloject (Hospira), an IV formulation of the NSAID diclofenac sodium, for use in adults. It can be administered alone for treatment of mild to moderate pain or in combination with opioid analgesics for moderate to severe pain. Dyloject is the first injectable formulation of diclofenac to become available in the US.

Med Lett Drugs Ther. 2015 Dec 21;57(1484):171-2 | Show Full Introduction Hide Full Introduction

Drugs for Psoriatic Arthritis (online only)

The Medical Letter on Drugs and Therapeutics • June 8, 2015; (Issue 1470)

Psoriatic arthritis is a chronic inflammatory arthropathy that develops in up to 40% of patients with psoriasis. Several guidelines for treatment of psoriatic arthritis have been...

Psoriatic arthritis is a chronic inflammatory arthropathy that develops in up to 40% of patients with psoriasis. Several guidelines for treatment of psoriatic arthritis have been published.

Med Lett Drugs Ther. 2015 Jun 8;57(1470):e88-92 | Show Full Introduction Hide Full Introduction

Edoxaban (Savaysa) - The Fourth New Oral Anticoagulant

The Medical Letter on Drugs and Therapeutics • March 30, 2015; (Issue 1465)

The FDA has approved edoxaban (Savaysa – Daiichi Sankyo), a once-daily, oral, direct factor Xa inhibitor, for treatment of venous thromoboembolism (VTE) and for prevention of stroke and systemic...

The FDA has approved edoxaban (Savaysa – Daiichi Sankyo), a once-daily, oral, direct factor Xa inhibitor, for treatment of venous thromoboembolism (VTE) and for prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. It is the fourth new oral anticoagulant to be approved for VTE and nonvalvular atrial fibrillation.

Med Lett Drugs Ther. 2015 Mar 30;57(1465):43-5 | Show Full Introduction Hide Full Introduction

Drugs for Rheumatoid Arthritis

The Medical Letter on Drugs and Therapeutics • December 22, 2014; (Issue 1458)

For initial treatment of rheumatoid arthritis, most expert clinicians prescribe a disease-modifying antirheumatic drug (DMARD) and add a nonsteroidal anti-inflammatory drug (NSAID) or a corticosteroid to control symptoms. Methotrexate is generally the DMARD of choice...

DMARDs
Disease-modifying antirheumatic drugs (DMARDs) are used early in the treatment of rheumatoid arthritis (RA) to achieve clinical remission, prevent irreversible damage to joints, and minimize toxicity associated with nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. DMARDs generally do not have an immediate analgesic effect, but over time can control symptoms and have been shown to delay and possibly stop progression of the disease. Methotrexate (Rheumatrex, and others) is generally the first DMARD prescribed; it can be used to treat mild, moderate, or severe RA. For mild disease, some clinicians prefer to start with hydroxychloroquine (Plaquenil, and generics) and/or sulfasalazine (Azulfidine, and others).

Med Lett Drugs Ther. 2014 Dec 22;56(1458):127-32 | Show Full Introduction Hide Full Introduction

Rescheduling of Hydrocodone Combination Products

The Medical Letter on Drugs and Therapeutics • October 13, 2014; (Issue 1453)

The Drug Enforcement Administration (DEA) has reclassified all hydrocodone combination products as schedule II controlled substances; they were previously classified as schedule III. Hydrocodone alone...

Med Lett Drugs Ther. 2014 Oct 13;56(1453):101-2 | Show Full Introduction Hide Full Introduction

Drugs for Osteoarthritis

The Medical Letter on Drugs and Therapeutics • September 1, 2014; (Issue 1450)

Many different drugs are used for treatment of osteoarthritis pain, but none of them prevent progression of the disease. Many nonpharmacologic approaches are available as well, including weight...

Many different drugs are used for treatment of osteoarthritis pain, but none of them prevent progression of the disease. Many nonpharmacologic approaches are available as well, including weight management, exercise, physical therapy, assistive devices, and total joint arthroplasty. New guidelines for the management of osteoarthritis have recently been published.

Med Lett Drugs Ther. 2014 Sep 1;56(1450):80-4 | Show Full Introduction Hide Full Introduction

In Brief: Generic Celecoxib

The Medical Letter on Drugs and Therapeutics • July 21, 2014; (Issue 1447)

The FDA has authorized two manufacturers (Teva, Mylan) to market generic formulations of celecoxib (Celebrex – Pfizer), the only COX-2 selective inhibitor remaining on the US market. Celecoxib is less likely...

The FDA has authorized two manufacturers (Teva, Mylan) to market generic formulations of celecoxib (Celebrex – Pfizer), the only COX-2 selective inhibitor remaining on the US market. Celecoxib is less likely than nonselective NSAIDs to cause gastric ulcers or other GI toxicity,1 and unlike traditional NSAIDs, it does not have an antiplatelet effect.

Celecoxib is much less COX-2 selective than rofecoxib (Vioxx), which was removed from the US market because of an increased risk of cardiovascular events. One analysis of randomized clinical trials that included a total of about 26,000 patients taking celecoxib found no evidence of an increased risk of cardiovascular thrombotic events compared to nonselective NSAIDs or placebo.2 A review of controlled observational studies found an increased cardiovascular risk with celecoxib (RR 1.17) that was similar to the risk with ibuprofen (RR 1.18) and slightly higher than the risk with naproxen (RR 1.09).3 All NSAIDs can cause renal toxicity, especially in the elderly.4

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Med Lett Drugs Ther. 2014 Jul 21;56(1447):59 | Show Full Introduction Hide Full Introduction

Apremilast (Otezla) for Psoriatic Arthritis

The Medical Letter on Drugs and Therapeutics • May 26, 2014; (Issue 1443)

Apremilast (Otezla – Celgene), an oral phosphodiesterase type-4 (PDE4) inhibitor, has been approved by the FDA for treatment of active psoriatic arthritis in adults. It is the fi rst PDE4 inhibitor to be...

Apremilast (Otezla – Celgene), an oral phosphodiesterase type-4 (PDE4) inhibitor, has been approved by the FDA for treatment of active psoriatic arthritis in adults. It is the fi rst PDE4 inhibitor to be approved for this indication.

Med Lett Drugs Ther. 2014 May 26;56(1443):41-2 | Show Full Introduction Hide Full Introduction

Drugs for Peptic Ulcer Disease and GERD

The Medical Letter on Drugs and Therapeutics • April 1, 2014; (Issue 140)

H2-RECEPTOR ANTAGONISTS (H2RAs) — Currently available H2RAs are listed in Table 1. These drugs inhibit the action of histamine at the H2-receptor of the gastric parietal cell, decreasing basal acid secretion and, to a lesser degree, food-stimulated acid secretion. All H2RAs are about equally effective for treatment of PUD and GERD. H2RAs are faster acting than PPIs in relieving symptoms of dyspepsia or GERD, but they are not as effective as PPIs in relieving symptoms or in healing erosive esophagitis. Repeated administration of H2RAs leads to pharmacologic tolerance and has been associated with the development of new dyspeptic symptoms. Rebound acid hypersecretion can occur after stopping H2RAs.

Treat Guidel Med Lett. 2014 Apr;12(140):25-30 | Show Full Introduction Hide Full Introduction

Drugs for Gout

The Medical Letter on Drugs and Therapeutics • March 17, 2014; (Issue 1438)

The goals of gout treatment are threefold: treating acute inflammation, preventing flares, and lowering serum urate...

The goals of gout treatment are threefold: treating acute inflammation, preventing flares, and lowering serum urate levels.

Med Lett Drugs Ther. 2014 Mar 17;56(1438):22-4 | Show Full Introduction Hide Full Introduction

Low-Dose Diclofenac (Zorvolex) for Pain

The Medical Letter on Drugs and Therapeutics • March 3, 2014; (Issue 1437)

The FDA has approved Zorvolex (Iroko), a low-dose oral formulation of the relatively COX-2 selective NSAID diclofenac, for treatment of mild-to-moderate acute pain in...

The FDA has approved Zorvolex (Iroko), a low-dose oral formulation of the relatively COX-2 selective NSAID diclofenac, for treatment of mild-to-moderate acute pain in adults.

Med Lett Drugs Ther. 2014 Mar 3;56(1437):19-20 | Show Full Introduction Hide Full Introduction

Certolizumab Pegol (Cimzia) and Ustekinumab (Stelara) for Psoriatic Arthritis

The Medical Letter on Drugs and Therapeutics • February 3, 2014; (Issue 1435)

Certolizumab pegol (Cimzia – UCB), a tumor necrosis factor (TNF) inhibitor previously approved for treatment of Crohn's disease and rheumatoid arthritis, and ustekinumab (Stelara – Janssen), a human...

Certolizumab pegol (Cimzia – UCB), a tumor necrosis factor (TNF) inhibitor previously approved for treatment of Crohn's disease and rheumatoid arthritis, and ustekinumab (Stelara – Janssen), a human interleukin-12 and -23 antagonist previously approved for treatment of moderate-to-severe plaque psoriasis, have now been approved by the FDA for treatment of active psoriatic arthritis.

Med Lett Drugs Ther. 2014 Feb 3;56(1435):10-2 | Show Full Introduction Hide Full Introduction

Drugs for Migraine

The Medical Letter on Drugs and Therapeutics • December 1, 2013; (Issue 136)

Treatment of migraine in the emergency department, which may involve use of intravenous drugs, is not discussed...

Treatment of migraine in the emergency department, which may involve use of intravenous drugs, is not discussed here.

Treat Guidel Med Lett. 2013 Dec;11(136):107-12 | Show Full Introduction Hide Full Introduction

Canakinumab (Ilaris) for Systemic Juvenile Idiopathic Arthritis

The Medical Letter on Drugs and Therapeutics • August 19, 2013; (Issue 1423)

The FDA has approved the interleukin-1 (IL-1) beta inhibitor canakinumab (Ilaris – Novartis) for treatment of systemic juvenile idiopathic arthritis (sJIA; formerly called juvenile rheumatoid arthritis or...

The FDA has approved the interleukin-1 (IL-1) beta inhibitor canakinumab (Ilaris – Novartis) for treatment of systemic juvenile idiopathic arthritis (sJIA; formerly called juvenile rheumatoid arthritis or Still’s disease) in children ≥2 years old. Canakinumab was approved earlier for treatment of cryopyrin-associated periodic syndromes (CAPS). Tocilizumab (Actemra), an interleukin-6 (IL-6) inhibitor that has been available since 2010 for treatment of rheumatoid arthritis in adults, was also recently approved by the FDA for sJIA. Canakinumab is the only IL-1 inhibitor approved for this indication.

Med Lett Drugs Ther. 2013 Aug 19;55(1423):65-6 | Show Full Introduction Hide Full Introduction

Drugs for Allergic Disorders

The Medical Letter on Drugs and Therapeutics • May 1, 2013; (Issue 129)

The use of drugs to prevent and control symptoms of allergic disorders can be optimized when patients avoid exposure to specific allergens and/or environmental conditions that trigger or worsen their...

Treat Guidel Med Lett. 2013 May;11(129):43-52 | Show Full Introduction Hide Full Introduction

Drugs for Pain

The Medical Letter on Drugs and Therapeutics • April 1, 2013; (Issue 128)

Pain can be acute or chronic. The two major types of chronic pain are nociceptive pain and neuropathic pain. Nociceptive pain can be treated with nonopioid analgesics or opioids. Neuropathic pain is less responsive to opioids and is often treated with adjuvant drugs such as antidepressants and antiepileptics. Combining different types of analgesics may provide an additive analgesic effect without increasing adverse effects.

Treat Guidel Med Lett. 2013 Apr;11(128):31-42 | Show Full Introduction Hide Full Introduction

Fentanyl Sublingual Spray (Subsys) for Breakthrough Cancer Pain

The Medical Letter on Drugs and Therapeutics • May 14, 2012; (Issue 1390)

The FDA has approved a sublingual spray formulation of fentanyl (Subsys – Insys) for management of breakthrough pain in adult cancer patients who are receiving and are tolerant to opioid therapy (taking...

The FDA has approved a sublingual spray formulation of fentanyl (Subsys – Insys) for management of breakthrough pain in adult cancer patients who are receiving and are tolerant to opioid therapy (taking ≥60 mg/day of oral morphine or the equivalent). Fentanyl is already available in the US for intravenous, intrathecal, epidural, transdermal and transmucosal use.

Med Lett Drugs Ther. 2012 May 14;54(1390):39-40 | Show Full Introduction Hide Full Introduction

Off-Label Use of Ketorolac for Athletic Injuries

The Medical Letter on Drugs and Therapeutics • May 14, 2012; (Issue 1390)

Recent reports indicate that intramuscular (IM) injection of the nonsteroidal anti-inflammatory drug (NSAID) ketorolac (Toradol, and others), sometimes directly into injured muscles, has become a...

Recent reports indicate that intramuscular (IM) injection of the nonsteroidal anti-inflammatory drug (NSAID) ketorolac (Toradol, and others), sometimes directly into injured muscles, has become a common practice in US locker rooms.

Med Lett Drugs Ther. 2012 May 14;54(1390):37 | Show Full Introduction Hide Full Introduction

Drugs for Rheumatoid Arthritis

The Medical Letter on Drugs and Therapeutics • May 1, 2012; (Issue 117)

Disease-modifying anti-rheumatic drugs (DMARDs) are now used early in the treatment of rheumatoid arthritis (RA) to achieve clinical remission, prevent irreversible damage to joints, and minimize...

Disease-modifying anti-rheumatic drugs (DMARDs) are now used early in the treatment of rheumatoid arthritis (RA) to achieve clinical remission, prevent irreversible damage to joints, and minimize toxicity associated with nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. DMARDs (Table 1) generally do not have an immediate analgesic effect, but over time can control symptoms and have been shown to delay and possibly stop progression of the disease. NSAIDs have immediate analgesic and antiinflammatory effects, but may not affect the disease process. Oral corticosteroids can relieve joint symptoms and control systemic manifestations, but their chronic use can cause many complications. Judicious use of intra-articular corticosteroids can rapidly decrease inflammation in acute joints with few, if any, adverse effects.

Treat Guidel Med Lett. 2012 May;10(117):37-44 | Show Full Introduction Hide Full Introduction

Bupivacaine Liposome Injection (Exparel) for Postsurgical Pain

The Medical Letter on Drugs and Therapeutics • April 2, 2012; (Issue 1387)

The FDA has approved a new formulation (Exparel – Pacira) of the local anesthetic bupivacaine (Marcaine, and others) for use in the management of postsurgical pain in...

The FDA has approved a new formulation (Exparel – Pacira) of the local anesthetic bupivacaine (Marcaine, and others) for use in the management of postsurgical pain in adults.

Med Lett Drugs Ther. 2012 Apr 2;54(1387):26-7 | Show Full Introduction Hide Full Introduction

Intranasal Ketorolac (Sprix)

The Medical Letter on Drugs and Therapeutics • January 23, 2012; (Issue 1382)

An intranasal formulation of ketorolac tromethamine (Sprix – Lutipold) has been approved by the FDA for short-term (up to 5 days) treatment of moderate to moderately severe pain in adults. It is the first...

An intranasal formulation of ketorolac tromethamine (Sprix – Lutipold) has been approved by the FDA for short-term (up to 5 days) treatment of moderate to moderately severe pain in adults. It is the first nonsteroidal anti-inflammatory drug (NSAID) to become available in an intranasal formulation. Ketorolac tromethamine is also available in oral, ophthalmic and injectable formulations.

Med Lett Drugs Ther. 2012 Jan 23;54(1382):7-8 | Show Full Introduction Hide Full Introduction

A Fixed-Dose Combination of Ibuprofen and Famotidine (Duexis)

The Medical Letter on Drugs and Therapeutics • October 31, 2011; (Issue 1376)

The FDA has approved Duexis (Horizon), a fixed-dose combination of the nonsteroidal anti-inflammatory drug (NSAID) ibuprofen and the H2-receptor antagonist (H2RA) famotidine, for symptomatic relief of...

The FDA has approved Duexis (Horizon), a fixed-dose combination of the nonsteroidal anti-inflammatory drug (NSAID) ibuprofen and the H2-receptor antagonist (H2RA) famotidine, for symptomatic relief of osteoarthritis and rheumatoid arthritis and to decrease the risk of developing gastric and duodenal ulcers in patients at risk for NSAID-associated ulcers. Vimovo, a combination of the NSAID naproxen and the proton pump inhibitor (PPI) esomeprazole, is also approved by the FDA for prevention of NSAID-associated gastric ulcers.

Med Lett Drugs Ther. 2011 Oct 31;53(1376):85-6 | Show Full Introduction Hide Full Introduction

Drugs for Peptic Ulcer Disease and GERD

The Medical Letter on Drugs and Therapeutics • September 1, 2011; (Issue 109)

Peptic ulcer disease (PUD) is usually caused by nonsteroidal anti-inflammatory drugs (NSAIDs) or by infection with Helicobacter pylori. Gastroesophageal reflux disease (GERD) can be caused by...

Peptic ulcer disease (PUD) is usually caused by nonsteroidal anti-inflammatory drugs (NSAIDs) or by infection with Helicobacter pylori. Gastroesophageal reflux disease (GERD) can be caused by transient lower esophageal sphincter relaxation, reduced lower esophageal sphincter tone, hiatal hernia, delayed gastric emptying or hormonal changes due to pregnancy. Acid suppressive therapy is the cornerstone of management for both PUD and GERD.

Treat Guidel Med Lett. 2011 Sep;9(109):55-60 | Show Full Introduction Hide Full Introduction

In Brief: Does Acetaminophen Increase Blood Pressure?

The Medical Letter on Drugs and Therapeutics • April 18, 2011; (Issue 1362)

A recent article in Circulation reported that acetaminophen (Tylenol, and others; paracetamol outside the US) increased blood pressure in patients with coronary artery disease. This conclusion was based on a...

A recent article in Circulation reported that acetaminophen (Tylenol, and others; paracetamol outside the US) increased blood pressure in patients with coronary artery disease. This conclusion was based on a randomized, placebo-controlled crossover trial in 33 patients; acetaminophen 1 g three times daily for 2 weeks was associated with statistically significant increases in blood pressure of 2.9 mmHg systolic and 2.2 mmHg diastolic.1

NSAIDs can increase blood pressure; the mechanism is thought to be inhibition of cyclooxygenase leading to decreased renal prostaglandin activity. Acetaminophen also inhibits cyclooxygenase (primarily COX-2) and decreases prostaglandin activity.2

The small increases in blood pressure reported with acetaminophen would probably be inconsequential in low-risk patients, but might be a concern for those with cardiovascular disease. Like most drugs, acetaminophen should be used in the lowest effective doses for the shortest possible time. Mild to moderate pain due to osteoarthritis or headache generally responds to a dose of 650 mg.3

1. I Sudano et al. Acetaminophen increases blood pressure in patients with coronary artery disease. Circulation 2010; 122:1789.

2. B Hinz et al. Acetaminophen (paracetamol) is a selective cyclooxygenase-2 inhibitor in man. FASEB J 2008; 22:383.

3. Drugs for pain. Treat Guidel Med Lett 2010; 8:25.

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Med Lett Drugs Ther. 2011 Apr 18;53(1362):29 | Show Full Introduction Hide Full Introduction

Drugs for Migraine

The Medical Letter on Drugs and Therapeutics • February 1, 2011; (Issue 102)

Drugs for treatment of migraine are listed in Table 2 on page 9. Drugs for prevention of migraine are listed in Table 3 on page 10. Treatment of migraine in the emergency room, which may involve use of...

Treat Guidel Med Lett. 2011 Feb;9(102):7-12 | Show Full Introduction Hide Full Introduction

Naproxen/Esomeprazole (Vimovo)

The Medical Letter on Drugs and Therapeutics • September 20, 2010; (Issue 1347)

The FDA has approved the marketing of Vimovo (AstraZeneca), a fixed-dose combination of the nonsteroidal anti-inflammatory drug (NSAID) naproxen and the proton pump inhibitor (PPI) esomeprazole,...

The FDA has approved the marketing of Vimovo (AstraZeneca), a fixed-dose combination of the nonsteroidal anti-inflammatory drug (NSAID) naproxen and the proton pump inhibitor (PPI) esomeprazole, for symptomatic relief of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis and to decrease the risk of developing gastric ulcers in patients at risk for NSAID-associated ulcers.

Med Lett Drugs Ther. 2010 Sep 20;52(1347):74-5 | Show Full Introduction Hide Full Introduction

Drugs for Pain

The Medical Letter on Drugs and Therapeutics • April 1, 2010; (Issue 92)

Pain can be acute or chronic. Chronic pain has been broadly classified into two types: nociceptive and neuropathic. Nociceptive pain can be treated with nonopioid analgesics or opioids. Neuropathic pain is less responsive to opioids; adjuvant medicines such as antidepressants and anticonvulsants are often used to treat neuropathic pain. Combining different types of analgesics may provide an additive analgesic effect without increasing adverse effects.

Treat Guidel Med Lett. 2010 Apr;8(92):25-34 | Show Full Introduction Hide Full Introduction

Primary Prevention of Ulcers in Patients Taking Aspirin or NSAIDs

The Medical Letter on Drugs and Therapeutics • March 8, 2010; (Issue 1333)

Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) are common causes of peptic ulcer disease. Patients infected with Helicobacter pylori who take aspirin or another NSAID have an especially high...

Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) are common causes of peptic ulcer disease. Patients infected with Helicobacter pylori who take aspirin or another NSAID have an especially high risk. Drugs that have been tried for prevention of ulcers in patients taking NSAIDs including H₂-receptor antagonists, proton pump inhibitors (PPIs), aluminum- or magnesium-containing antacids, the prostaglandin misoprostol (Cytotec, and others), and antibiotics to eradicate H. pylori.

Click here to view the free full article.

Med Lett Drugs Ther. 2010 Mar 8;52(1333):17-9 | Show Full Introduction Hide Full Introduction

Colchicine and Other Drugs for Gout

The Medical Letter on Drugs and Therapeutics • November 30, 2009; (Issue 1326)

Until the recent introduction of febuxostat (Uloric), no new drugs had been marketed for treatment of gout in the past 40 years. Colchicine, which has been available for decades as an unapproved drug, has now...

Until the recent introduction of febuxostat (Uloric), no new drugs had been marketed for treatment of gout in the past 40 years. Colchicine, which has been available for decades as an unapproved drug, has now been approved by the FDA (Colcrys) for treatment and prophylaxis of gout flares. It was approved earlier only in combination with probenecid (Colbenemid, and others). The goals of gout treatment are three-fold: treating acute disease, preventing flares and reducing uric acid stores.

Med Lett Drugs Ther. 2009 Nov 30;51(1326):93-4 | Show Full Introduction Hide Full Introduction

Prasugrel (Effient) vs. Clopidogrel (Plavix)

The Medical Letter on Drugs and Therapeutics • September 7, 2009; (Issue 1320)

The FDA has approved prasugrel (Effient - Lilly/Daiichi Sankyo), an oral antiplatelet drug, for use with aspirin to reduce the rate of thrombotic cardiovascular events in patients with acute coronary syndromes...

The FDA has approved prasugrel (Effient - Lilly/Daiichi Sankyo), an oral antiplatelet drug, for use with aspirin to reduce the rate of thrombotic cardiovascular events in patients with acute coronary syndromes (ACS) being managed with percutaneous coronary intervention (PCI). It will compete with clopidogrel (Plavix) for such use.

Med Lett Drugs Ther. 2009 Sep 7;51(1320):69-70 | Show Full Introduction Hide Full Introduction

Febuxostat (Uloric) for Chronic Treatment of Gout

The Medical Letter on Drugs and Therapeutics • May 18, 2009; (Issue 1312)

Febuxostat (Uloric - Takeda), a xanthine oxidase inhibitor, has been approved by the FDA for chronic management of hyperuricemia in patients with gout. It is the first drug marketed for treatment of gout in 40...

Febuxostat (Uloric - Takeda), a xanthine oxidase inhibitor, has been approved by the FDA for chronic management of hyperuricemia in patients with gout. It is the first drug marketed for treatment of gout in 40 years. Febuxostat is structurally unrelated to allopurinol, the only other commercially available inhibitor of xanthine oxidase. Xanthine oxidase inhibitors decrease serum urate concentrations by decreasing urate synthesis.

Med Lett Drugs Ther. 2009 May 18;51(1312):37-8 | Show Full Introduction Hide Full Introduction

Drugs for Rheumatoid Arthritis

The Medical Letter on Drugs and Therapeutics • May 1, 2009; (Issue 81)

Disease-modifying anti-rheumatic drugs (DMARDs) are now used early in the treatment of rheumatoid arthritis (RA) to prevent irreversible damage to joints and minimize toxicities associated with nonsteroidal...

Treat Guidel Med Lett. 2009 May;7(81):37-46 | Show Full Introduction Hide Full Introduction

Drugs That May Cause Psychiatric Symptoms

The Medical Letter on Drugs and Therapeutics • December 15, 2008; (Issue 1301)

Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment could also be due to the underlying illness, previously unrecognized psychopathology, or psychosocial factors. The withdrawal of some drugs can cause symptoms such as anxiety, psychosis, delirium, agitation or depression.

Click here to view the free full article.

Med Lett Drugs Ther. 2008 Dec 15;50(1301):100-3 | Show Full Introduction Hide Full Introduction

Treatment of Peptic Ulcers and GERD

The Medical Letter on Drugs and Therapeutics • August 1, 2008; (Issue 72)

Peptic ulcers caused by treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) are mainly gastric ulcers. Most duodenal and other gastric ulcers are caused by the gram-negative bacillus Helicobacter pylori. Gastroesophageal reflux disease (GERD) is caused by gastric acid reflux into the esophagus. Drugs that suppress gastric acid production are the primary treatment for GERD and peptic ulcers.

Treat Guidel Med Lett. 2008 Aug;6(72):55-60 | Show Full Introduction Hide Full Introduction

Diclofenac Gel For Osteoarthritis

The Medical Letter on Drugs and Therapeutics • April 21, 2008; (Issue 1284)

The nonsteroidal anti-inflammatory drug (NSAID) diclofenac, has been approved by the FDA in a 1% topical gel formulation (Voltaren Gel - Endo) for treatment of osteoarthritis (OA). A 3% topical diclofenac gel...

The nonsteroidal anti-inflammatory drug (NSAID) diclofenac, has been approved by the FDA in a 1% topical gel formulation (Voltaren Gel - Endo) for treatment of osteoarthritis (OA). A 3% topical diclofenac gel (Solaraze) is currently approved for treatment of actinic keratoses, but not for topical use on joints. No other topical NSAIDs are approved by the FDA for OA. A diclofenac patch (Flector) was recently approved by the FDA for treatment of pain due to minor strains, sprains and contusions.

Med Lett Drugs Ther. 2008 Apr 21;50(1284):31-2 | Show Full Introduction Hide Full Introduction

Drugs for Migraine

The Medical Letter on Drugs and Therapeutics • March 1, 2008; (Issue 67)

Some drugs for treatment of migraine attacks are listed in table 2 on page 18. Drugs for prevention of migraine are listed in table 3 on page 20. Treatment of migraine in the emergency room, which may involve...

Treat Guidel Med Lett. 2008 Mar;6(67):17-22 | Show Full Introduction Hide Full Introduction

Antifungal Drugs

The Medical Letter on Drugs and Therapeutics • January 1, 2008; (Issue 65)

The drugs of choice for treatment of some fungal infections are listed in the tables. Some of the indications and dosages recommended here have not been approved by the FDA. Other guidelines are available from...

Treat Guidel Med Lett. 2008 Jan;6(65):1-8 | Show Full Introduction Hide Full Introduction

Drugs for Pain

The Medical Letter on Drugs and Therapeutics • April 1, 2007; (Issue 56)

Pain can be acute or chronic. Chronic pain has been broadly classified into two types: nociceptive and neuropathic. Nociceptive pain is generally treated with nonopioid analgesics and opioids. Antidepressants and anticonvulsants have been used to treat neuropathic pain. Combining two different types of analgesics may nprovide an additive analgesic effect without increasing adverse effects.

Treat Guidel Med Lett. 2007 Apr;5(56):23-32 | Show Full Introduction Hide Full Introduction

A Combination of Oxycodone and Ibuprofen (Combunox) for Pain

The Medical Letter on Drugs and Therapeutics • January 2, 2006; (Issue 1225)

A fixed-dose combination of oxycodone 5 mg and ibuprofen 400 mg (Combunox - Forest Laboratories) is now available and is being heavily advertised for short-term treatment of moderate to severe acute...

A fixed-dose combination of oxycodone 5 mg and ibuprofen 400 mg (Combunox - Forest Laboratories) is now available and is being heavily advertised for short-term treatment of moderate to severe acute pain.

Med Lett Drugs Ther. 2006 Jan 2;48(1225):3-4 | Show Full Introduction Hide Full Introduction

Drugs for Rheumatoid Arthritis

The Medical Letter on Drugs and Therapeutics • December 1, 2005; (Issue 40)

To prevent irreversible damage to joints and minimize toxicities associated with nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, disease modifying anti-rheumatic drugs (DMARDs) are now used early in the treatment of rheumatoid arthritis (RA). The DMARDs listed in the table on page 84 have no immediate analgesic effects, but can control symptoms and have been shown to delay and possibly stop progression of the disease. The NSAIDs listed in the table on page 88 have analgesic and anti-inflammatory effects, but may not affect the disease process. Oral corticosteroids can rapidly relieve joint symptoms and control systemic manifestations, but their chronic use is associated with many complications.

Treat Guidel Med Lett. 2005 Dec;3(40):83-90 | Show Full Introduction Hide Full Introduction

Addendum: Tramadol as an NSAID Alternative

The Medical Letter on Drugs and Therapeutics • February 14, 2005; (Issue 1202)

In our January 17 issue, a short article on NSAID alternatives mentioned that tramadol (Ultram, and others), a weak opioid analgesic, could be helpful for some patients. A few readers have commented that we...

In our January 17 issue, a short article on NSAID alternatives mentioned that tramadol (Ultram, and others), a weak opioid analgesic, could be helpful for some patients. A few readers have commented that we should have said something about its drawbacks. The need for slow titration in dosage limits the drug's use for treatment of acute pain. Seizures have been reported with tramadol; patients taking an antidepressant or an antipsychotic drug may be at increased risk. Tramadol is not a controlled substance, but psychological and physical dependence have occurred.

Med Lett Drugs Ther. 2005 Feb 14;47(1202):16 | Show Full Introduction Hide Full Introduction

NSAID Alternatives

The Medical Letter on Drugs and Therapeutics • January 17, 2005; (Issue 1200)

Patients taking nonsteroidal anti-inflammatory drugs (NSAIDs) may be asking their health care providers if they should continue, and some may be asking for alternatives. For most patients taking nonspecific NSAIDs, it would be reasonable to continue. For those who are taking the COX-2 selective celecoxib (Celebrex) because they cannot tolerate the gastrointestinal (GI) effects of nonspecific NSAIDs, it seems reasonable to continue at doses no higher than 100 mg b.i.d. or 200 mg once daily; at these dosages cardiovascular risk has been no higher than with placebo. All NSAIDs, including COX-2 inhibitors, can decrease renal blood flow and cause fluid retention, hypertension and renal failure, especially in the elderly and in patients who take diuretics. The unpublished study that led to an FDA alert on an increased cardiovascular risk with naproxen (Naprosyn, and others) was conducted in patients older than 70. See NSAID addendum

Med Lett Drugs Ther. 2005 Jan 17;47(1200):8 | Show Full Introduction Hide Full Introduction

COX-2 Alternatives and GI Protection

The Medical Letter on Drugs and Therapeutics • November 8, 2004; (Issue 1195)

With the removal of Vioxx from the market and concerns about cardiovascular toxicity with other selective COX-2 inhibitors, patients are looking for safe alternatives, and manufacturers of other drugs are looking for additional market share. The COX-2 inhibitors first became popular because they have less upper GI toxicity than older less selective NSAIDs, at least in the short term, in patients not taking aspirin.

Med Lett Drugs Ther. 2004 Nov 8;46(1195):91-2 | Show Full Introduction Hide Full Introduction

What About Celebrex?

The Medical Letter on Drugs and Therapeutics • October 25, 2004; (Issue 1194)

Rofecoxib (Vioxx - Merck) has been withdrawn from the market due to an increased risk of cardiovascular complications associated with its long-term use. The question remains whether all selective COX-2...

Rofecoxib (Vioxx - Merck) has been withdrawn from the market due to an increased risk of cardiovascular complications associated with its long-term use. The question remains whether all selective COX-2 inhibitors carry the same risk. Full-page advertisements in newspapers for celecoxib (Celebrex - Pfizer), the most widely used COX-2 inhibitor, assure the public that it does not.

Med Lett Drugs Ther. 2004 Oct 25;46(1194):87-8 | Show Full Introduction Hide Full Introduction

Drugs for Migraine

The Medical Letter on Drugs and Therapeutics • September 1, 2004; (Issue 25)

Drugs for treatment of migraine attacks are listed in the table on page 64. All of the oral drugs are most effective if taken early in an attack when the pain is mild (H Christoph-Diener et al, Neurology 2004; 63:520). Drugs for prevention of migraine are listed in the table on page 65. Treatment of migraine in the emergency room, which may involve use of intravenous drugs, is not included here.

Treat Guidel Med Lett. 2004 Sep;2(25):63-6 | Show Full Introduction Hide Full Introduction

Do NSAIDs Interfere with the Cardioprotective Effects of Aspirin?

The Medical Letter on Drugs and Therapeutics • August 2, 2004; (Issue 1188)

Low-dose aspirin is widely used as an antiplatelet drug to reduce the risk of cardiovascular disease (Medical Letter 2000; 42:18). Recent reports suggest that the nonsteroidal anti-inflammatory drug (NSAID) ibuprofen (Motrin, and others) may decrease the efficacy of aspirin for this indication. The manufacturer of Tylenol is capitalizing on these reports by advertising that aspirin-taking patients who need pain relief should use acetaminophen instead of ibuprofen.

Med Lett Drugs Ther. 2004 Aug 2;46(1188):61-2 | Show Full Introduction Hide Full Introduction

Drugs for Pain

The Medical Letter on Drugs and Therapeutics • July 1, 2004; (Issue 23)

Three types of analgesic drugs are available: non-opioids, including aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; opioids; and adjuvant drugs that are not usually thought of as analgesics, such as antidepressants, which can act as adjuvants when given with NSAIDs or opioids, or have analgesic activity of their own in some types of pain. Combining two different types of analgesics may provide an additive analgesic effect without necessarily increasing adverse effects.

Treat Guidel Med Lett. 2004 Jul;2(23):47-54 | Show Full Introduction Hide Full Introduction

Prevention and Treatment of Sunburn

The Medical Letter on Drugs and Therapeutics • June 7, 2004; (Issue 1184)

Solar ultraviolet (UV) light capable of injuring the skin is classified by wavelength into UVA I (340-400 nm), UVA II (320-340 nm) and UVB (290-320 nm). UVB is responsible for most of the erythema of sunburn. UVA has been implicated in the development of phototoxicity and photoaging. The FDA permits sunscreen manufacturers to claim broad-spectrum protection if their products block at least part of UVA II in addition to UVB.

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Med Lett Drugs Ther. 2004 Jun 7;46(1184):45-6 | Show Full Introduction Hide Full Introduction

Gabapentin (Neurontin) for Chronic Pain

The Medical Letter on Drugs and Therapeutics • April 12, 2004; (Issue 1180)

Gabapentin (Neurontin - Pfizer), which has been available in the US since 1994, is approved by the FDA only for treatment of partial epilepsy and postherpetic neuralgia, but is widely used off-label for a...

Gabapentin (Neurontin - Pfizer), which has been available in the US since 1994, is approved by the FDA only for treatment of partial epilepsy and postherpetic neuralgia, but is widely used off-label for a number of other indications, especially neuropathic pain syndromes. According to one report, among Medicaid recipients in Florida receiving gabapentin, 71% of prescriptions were for chronic pain and 8% for seizures and neuralgia ("The Pink Sheet" February 2, 2004; 66:30).

Med Lett Drugs Ther. 2004 Apr 12;46(1180):29-31 | Show Full Introduction Hide Full Introduction

Drugs for Peptic Ulcers

The Medical Letter on Drugs and Therapeutics • February 1, 2004; (Issue 18)

Most peptic ulcers not caused by nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with infection of the gastric mucosa by the gram-negative bacilli Helicobacter pylori. The majority of NSAID-related...

Most peptic ulcers not caused by nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with infection of the gastric mucosa by the gram-negative bacilli Helicobacter pylori. The majority of NSAID-related ulcers are gastric. H. pylori infection causes both duodenal and gastric ulcers. Eradication of H. pylori promotes healing and markedly decreases recurrence of both duodenal and gastric ulcers (A Shiotamni and DY Graham, Med Clin North Am 2002; 86:1447; FKL Chan and WK Leung, Lancet 2002; 360:933). The first step in the management of peptic ulcers is the diagnosis and treatment of H. pylori.

Treat Guidel Med Lett. 2004 Feb;2(18):7-12 | Show Full Introduction Hide Full Introduction

Drugs for Rheumatoid Arthritis

The Medical Letter on Drugs and Therapeutics • January 1, 2003; (Issue 5)

Many different drugs are now used to treat rheumatoid arthritis. Nonsteroidal anti-inflammatory drugs (NSAIDs), listed in the table on page 26, have analgesic and anti-inflammatory effects, but may not affect the disease process. Corticosteroids can provide rapid relief of joint symptoms and control of systemic manifestations, but chronic use is associated with many complications. The "disease-modifying" anti-rheumatic drugs (DMARDs), listed on page 29, have no immediate analgesic effects, but can control symptoms and may delay progression of the disease (American College of Rheumatology Subcommittee on Rheumatoid Arthritis Guidelines, Arthritis Rheum 2002; 46:328). Interactions of anti-rheumatic drugs with other drugs are listed in The Medical Letter Handbook of Adverse Drug Interactions, 2003.

Treat Guidel Med Lett. 2003 Jan;1(5):25-32 | Show Full Introduction Hide Full Introduction

Drugs That May Cause Psychiatric Symptoms

The Medical Letter on Drugs and Therapeutics • July 8, 2002; (Issue 1134)

Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment may also be due to the underlying illness, previously unrecognized psychopathology, or psychosocial factors. The withdrawal of some drugs can cause symptoms such as anxiety, psychosis, delirium, agitation or depression.

Med Lett Drugs Ther. 2002 Jul 8;44(1134):59-62 | Show Full Introduction Hide Full Introduction

Valdecoxib (Bextra) - a New Cyclooxygenase-2 Inhibitor

The Medical Letter on Drugs and Therapeutics • April 29, 2002; (Issue 1129)

Valdecoxib (Bextra - Pharmacia/Pfizer), a selective cyclooxygenase (COX-2) inhibitor similar to celecoxib (Celebrex) and rofecoxib (Vioxx), was recently approved by the FDA for treatment of osteoarthritis,...

Valdecoxib (Bextra - Pharmacia/Pfizer), a selective cyclooxygenase (COX-2) inhibitor similar to celecoxib (Celebrex) and rofecoxib (Vioxx), was recently approved by the FDA for treatment of osteoarthritis, rheumatoid arthritis and primary dysmenorrhea.

Med Lett Drugs Ther. 2002 Apr 29;44(1129):39-41 | Show Full Introduction Hide Full Introduction

Drugs that may cause Cognitive Disorders in the Elderly

The Medical Letter on Drugs and Therapeutics • November 27, 2000; (Issue 1093)

Older patients are especially susceptible to drug-induced cognitive impairment. They are more likely to be taking multiple drugs, to have higher blood levels of those drugs because of renal or hepatic dysfunction, and to have pre-existing cognitive problems that make it difficult to detect the role of drugs causing new symptoms or making old ones worse.

Med Lett Drugs Ther. 2000 Nov 27;42(1093):111-2 | Show Full Introduction Hide Full Introduction

Drugs for Pain: A Clarification

The Medical Letter on Drugs and Therapeutics • September 18, 2000; (Issue 1087)

Selective COX-2 Inhibitors and Bleeding Risk: An Additional Note - The Medical Letter article on Drugs for Pain (August 21, 2000) stated that the selective COX-2 inhibitors celecoxib (Celebrex) and rofecoxib...

Selective COX-2 Inhibitors and Bleeding Risk: An Additional Note - The Medical Letter article on Drugs for Pain (August 21, 2000) stated that the selective COX-2 inhibitors celecoxib (Celebrex) and rofecoxib (Vioxx) do not inhibit platelet aggregation or bleeding time. Perhaps we should have added, as we did in discussing use of these drugs in rheumatoid arthritis (July 10, 2000), that both celecoxib and rofecoxib, if given with warfarin (Coumadin, and others), increase INR and prothrombin time values and may increase the risk of bleeding.

Med Lett Drugs Ther. 2000 Sep 18;42(1087):83-92 | Show Full Introduction Hide Full Introduction

Drugs for Pain

The Medical Letter on Drugs and Therapeutics • August 21, 2000; (Issue 1085)

Three types of analgesic drugs are available: first, non-opioids, including aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; second, opioids; and third, drugs not usually thought of as analgesics, which act as adjuvants when given with NSAIDs or opioids, or have analgesic activity of their own in some types of pain. Non-opioids can be given concurrently with opioids for an additive analgesic effect.

Med Lett Drugs Ther. 2000 Aug 21;42(1085):73-8 | Show Full Introduction Hide Full Introduction

Drugs For Rheumatoid Arthritis

The Medical Letter on Drugs and Therapeutics • July 10, 2000; (Issue 1082)

Many different drugs are now used to treat rheumatoid arthritis. Nonsteroidal anti-inflammatory drugs (NSAIDs) have analgesic and anti-inflammatory effects, but may not affect the disease process. The "disease-modifying anti-rheumatic"drugs (DMARDs) have no immediate analgesic effects, but can control symptoms and may delay progression of the disease.

Med Lett Drugs Ther. 2000 Jul 10;42(1082):57-64 | Show Full Introduction Hide Full Introduction

Meloxicam (Mobic) for Osteoarthritis

The Medical Letter on Drugs and Therapeutics • May 29, 2000; (Issue 1079)

Meloxicam, a nonsteroidal anti-inflammatory drug (NSAID) with some cyclooxygenase-2 (COX-2) selectivity in vitro, has been approved by the FDA for treatment of...

Meloxicam, a nonsteroidal anti-inflammatory drug (NSAID) with some cyclooxygenase-2 (COX-2) selectivity in vitro, has been approved by the FDA for treatment of osteoarthritis.

Med Lett Drugs Ther. 2000 May 29;42(1079):47-8 | Show Full Introduction Hide Full Introduction

New Drugs for Allergic Conjunctivitis

The Medical Letter on Drugs and Therapeutics • May 1, 2000; (Issue 1077)

Ophthalmic formulations of ketotifen fumarate (Zaditor), pemirolast potassium (Alamast) and nedocromil sodium (Alocril) have recently been approved by the FDA for use in adults and children with itching of the...

Med Lett Drugs Ther. 2000 May 1;42(1077):39-40 | Show Full Introduction Hide Full Introduction

Rofecoxib for Osteoarthritis and Pain

The Medical Letter on Drugs and Therapeutics • July 2, 1999; (Issue 1056)

Rofecoxib, a selective COX-2 inhibitor, has been approved by the FDA for treatment of osteoarthritis, acute pain and menstrual...

Rofecoxib, a selective COX-2 inhibitor, has been approved by the FDA for treatment of osteoarthritis, acute pain and menstrual pain.

Med Lett Drugs Ther. 1999 Jul 2;41(1056):59-62 | Show Full Introduction Hide Full Introduction

New "Triptans" and Other Drugs for Migraine

The Medical Letter on Drugs and Therapeutics • October 9, 1998; (Issue 1037)

Three new 5-HT1 receptors agonissts ('triptans') have been marketed recently for treatment of migraine. Some drugs for prevention of migraine are listed in the table on page 99. Treatment of migraine in the...

Med Lett Drugs Ther. 1998 Oct 9;40(1037):97-100 | Show Full Introduction Hide Full Introduction

Drugs for Pain

The Medical Letter on Drugs and Therapeutics • August 14, 1998; (Issue 1033)

Three types of analgesic drugs are available: first, non-opioids, including aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; second, opioids; and third, some drugs not usually thought of as analgesics, which act as adjuvants when given with NSAIDs or opioids, or have analgesic activity of their own in some types of pain.

Med Lett Drugs Ther. 1998 Aug 14;40(1033):79-84 | Show Full Introduction Hide Full Introduction

Clopidogrel for Reduction of Atherosclerotic Events

The Medical Letter on Drugs and Therapeutics • June 5, 1998; (Issue 1028)

Clopidogrel bisulfate (Plavix - Bristol-Myers Squibb/Sanofi), a new thienopyridine antiplatelet agent similar to ticlopidine (Ticlid - Medical Letter, 34:65, 1992), has been approved by the US Food and Drug...

Clopidogrel bisulfate (Plavix - Bristol-Myers Squibb/Sanofi), a new thienopyridine antiplatelet agent similar to ticlopidine (Ticlid - Medical Letter, 34:65, 1992), has been approved by the US Food and Drug Administration (FDA) for secondary prevention of myocardial infarction, stroke and other vascular events.

Med Lett Drugs Ther. 1998 Jun 5;40(1028):59-60 | Show Full Introduction Hide Full Introduction

Bromfenac for Analgesia

The Medical Letter on Drugs and Therapeutics • October 10, 1997; (Issue 1011)

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...

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.

Med Lett Drugs Ther. 1997 Oct 10;39(1011):93-4 | Show Full Introduction Hide Full Introduction

Drugs for Migraine

The Medical Letter on Drugs and Therapeutics • March 3, 1995; (Issue 943)

Drugs are used both to prevent and treat migraine symptoms. The effectiveness of such use can be difficult to evaluate, even with double-blind controlled trials, because migraine is episodic, response to placebo is frequent, and patients vary in response to a given agent (KMA Welch, N Engl J Med, 329:1476, 1993; SD Silberstein and RB Lipton, Neurology, 44 suppl 7:S6, Oct 1994).

Med Lett Drugs Ther. 1995 Mar 3;37(943):17-20 | Show Full Introduction Hide Full Introduction

Tacrolimus FK506 Organ Transplants

The Medical Letter on Drugs and Therapeutics • September 16, 1994; (Issue 931)

Tacrolimus (Prograf - Fujisawa), previously called FK506 (Medical Letter, 33:94, 1991), has been approved by the US Food and Drug Administration for primary prevention of organ rejection in patients receiving...

Tacrolimus (Prograf - Fujisawa), previously called FK506 (Medical Letter, 33:94, 1991), has been approved by the US Food and Drug Administration for primary prevention of organ rejection in patients receiving liver transplants. The drug has also been used as rescue therapy for organ graft rejection unresponsive to cyclosporine (Sandimmune) and other immunosuppressive drugs.

Med Lett Drugs Ther. 1994 Sep 16;36(931):82-3 | Show Full Introduction Hide Full Introduction

Ketorolac for Seasonal Allergic Conjunctivitis

The Medical Letter on Drugs and Therapeutics • September 17, 1993; (Issue 905)

Ketorolac (kee' toe role ak) tromethamine 0.5%, a nonsteroidal anti-inflammatory drug (NSAID) previously available for parenteral and oral administration (Toradol - Medical Letter, 32:79, 1990), has now been...

Ketorolac (kee' toe role ak) tromethamine 0.5%, a nonsteroidal anti-inflammatory drug (NSAID) previously available for parenteral and oral administration (Toradol - Medical Letter, 32:79, 1990), has now been approved for ophthalmic use (Acular - Allergan, Fisons) to relieve itching in seasonal allergic conjunctivitis. NSAIDs decrease prostaglandin concentrations in the eye, which theoretically might contribute to a decrease in itching. Several other NSAIDs are available for ophthalmic use in the USA, but none is marketed for this indication. Flurbiprofen (Ocufen) and suprofen (Profenal) are promoted for use in ophthalmic surgery to prevent miosis. Diclofenac (Voltaren) is available in an ophthalmic solution for treatment of post-operative inflammation after cataract extraction.

Med Lett Drugs Ther. 1993 Sep 17;35(905):88-9 | Show Full Introduction Hide Full Introduction

Oxaprozin for Arthritis

The Medical Letter on Drugs and Therapeutics • February 19, 1993; (Issue 890)

Oxaprozin (Daypro -Searle), a propionic acid-derivative nonsteroidal anti-inflammatory drug (NSAID), has been approved by the US Food and Drug Administration for once-daily treatment of rheumatoid arthritis...

Oxaprozin (Daypro -Searle), a propionic acid-derivative nonsteroidal anti-inflammatory drug (NSAID), has been approved by the US Food and Drug Administration for once-daily treatment of rheumatoid arthritis and osteoarthritis. Some of the NSAIDs previously marketed in the USA are listed in the table on page 16. Ibuprofen, naproxen, fenoprofen, ketoprofen, and flurbiprofen are also propionic acid derivatives. Piroxicam and nabumetone (Medical Letter, 34:38, 1992) are also approved for once-daily use, and indomethacin is available in an extended-release formulation that can be taken once a day.

Med Lett Drugs Ther. 1993 Feb 19;35(890):15-6 | Show Full Introduction Hide Full Introduction

Drugs for Pain

The Medical Letter on Drugs and Therapeutics • January 8, 1993; (Issue 887)

Three types of analgesic drugs are available in the USA: first, aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; second, opioids; and third, drugs not usually thought of as analgesics, which act as adjuvants when given with NSAIDs or opioids, or have analgesic activity of their own in some types of pain. (American Pain Society, Principles of analgesic Use, 3rd ed, Skokie, illinois: American pain society, 1992).

Med Lett Drugs Ther. 1993 Jan 8;35(887):1-6 | Show Full Introduction Hide Full Introduction

Sumatriptan for Migraine

The Medical Letter on Drugs and Therapeutics • October 2, 1992; (Issue 880)

Sumatriptan (soo ma trip' tan; Imitrex - Glaxo), a serotonin (5-HT) agonist, is now available in Canada and may soon be available in the USA for oral or parenteral treatment of migraine headache. The...

Sumatriptan (soo ma trip' tan; Imitrex - Glaxo), a serotonin (5-HT) agonist, is now available in Canada and may soon be available in the USA for oral or parenteral treatment of migraine headache. The parenteral formulation is designed for patients to inject themselves subcutaneously. Sumatriptan is not recommended for prophylactic use.

Med Lett Drugs Ther. 1992 Oct 2;34(880):91-3 | Show Full Introduction Hide Full Introduction

Nabumetone - A New Nsaid

The Medical Letter on Drugs and Therapeutics • April 17, 1992; (Issue 868)

Nabumetone (Relafen - SmithKline Beecham), a new nonsteroidal anti-inflammatory drug (NSAID), has been approved by the US Food and Drug Administration for treatment of rheumatoid arthritis and osteoarthritis....

Nabumetone (Relafen - SmithKline Beecham), a new nonsteroidal anti-inflammatory drug (NSAID), has been approved by the US Food and Drug Administration for treatment of rheumatoid arthritis and osteoarthritis. The drug has been available in the United Kingdom since 1987. The manufacturer claims that nabumetone is as effective as other NSAIDs and causes a relatively low incidence of peptic ulcers.

Med Lett Drugs Ther. 1992 Apr 17;34(868):38-40 | Show Full Introduction Hide Full Introduction

Drugs For Treatment of Peptic Ulcers

The Medical Letter on Drugs and Therapeutics • November 29, 1991; (Issue 858)

Drugs that accelerate healing and prevent relapse or reurrence of peptic ulcers act either by decreasing gastric acidity or by enhancing mucosal defense mechanisms. Risk factors that may cause breakdown of mucosal defenses include the use of aspirinor other nonsteroidal anti-inflammatory drugs (NSAIDs) and the presence of Helicobacter pylori bacterial in the gastric antrum (AH Soll, Engl J Med, 322:909, 1990; WL Peterson, N Engl J Med, 324:1043, 1991).

Med Lett Drugs Ther. 1991 Nov 29;33(858):111-4 | Show Full Introduction Hide Full Introduction

Etodolac

The Medical Letter on Drugs and Therapeutics • August 23, 1991; (Issue 851)

Etodolac (Lodine - Wyeth-Ayerst), a nonsteroidal anti-inflammatory drug (NSAID) available in Europe for several years, was recently approved by the U.S. Food and Drug Administration for use in osteoarthritis...

Etodolac (Lodine - Wyeth-Ayerst), a nonsteroidal anti-inflammatory drug (NSAID) available in Europe for several years, was recently approved by the U.S. Food and Drug Administration for use in osteoarthritis and as a general-purpose analgesic. It has not been approved for treatment of rheumatoid arthritis.

Med Lett Drugs Ther. 1991 Aug 23;33(851):79-80 | Show Full Introduction Hide Full Introduction

Drugs That Cause Pulmonary Toxicity

The Medical Letter on Drugs and Therapeutics • September 21, 1990; (Issue 827)

Some commonly used systemic drugs that may cause pulmonary toxicity are listed in the table below. These adverse effects may sometimes be difficult to distinguish from the underlying disease (JAD Cooper, Jr et al, Am Rev Respir Dis, 133:321, 488, 1986). Pulmonary effects that are part of a generalized reaction or are indirect effects of drugs - on respiratory muscles, for example, or on the immune system - are not included here.

Med Lett Drugs Ther. 1990 Sep 21;32(827):88-90 | Show Full Introduction Hide Full Introduction

Ketorolac Tromethamine

The Medical Letter on Drugs and Therapeutics • August 24, 1990; (Issue 825)

Ketorolac (kee'; toe role ak) tromethamine (Toradol), manufactured by Syntex but also marketed by Roche, is the first parenteral nonsteroidal anti-inflammatory drug (NSAID) to become available for analgesic...

Ketorolac (kee'; toe role ak) tromethamine (Toradol), manufactured by Syntex but also marketed by Roche, is the first parenteral nonsteroidal anti-inflammatory drug (NSAID) to become available for analgesic use in the USA. Parenteral indomethacin (Indocin I.V.) has been marketed here since 1985, but only for treatment of patent ductus arteriosus in newborn infants. Other parenteral NSAIDs are available in other parts of the world, but low potency, poor aqueous solubility, and substantial tissue irritation on injection have limited their usefulness. Ketorolac has been approved by the US Food and Drug Administration for intramuscular (IM) treatment of moderate to severe pain.

Med Lett Drugs Ther. 1990 Aug 24;32(825):79-80 | Show Full Introduction Hide Full Introduction

Ibuprofen vs. Acetaminophen in Children

The Medical Letter on Drugs and Therapeutics • December 15, 1989; (Issue 807)

Since the implication of aspirin in Reye's syndrome, acetaminophen (Tylenol; and others) has become the standard drug for symptomatic treatment of fever and pain in children. Ibuprofen, a nonsteroidal...

Since the implication of aspirin in Reye's syndrome, acetaminophen (Tylenol; and others) has become the standard drug for symptomatic treatment of fever and pain in children. Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID) available for many years in tables (Mortin; Advil; and others), has now become available in a suspension. The suspension will be sold by presecription for treatment of fever or arthritis in children.

Med Lett Drugs Ther. 1989 Dec 15;31(807):109-10 | Show Full Introduction Hide Full Introduction

Drugs for Rheumatoid Arthritis

The Medical Letter on Drugs and Therapeutics • June 30, 1989; (Issue 795)

Many different drugs are now used to treat rheumatoid arthritis. Aspirin and other nonsteroidal antiinflammatory drugs (NSAIDs), such as ibuprofen (Motrin; and others), Naproxen (Naprosyn; and others) and, most...

Many different drugs are now used to treat rheumatoid arthritis. Aspirin and other nonsteroidal antiinflammatory drugs (NSAIDs), such as ibuprofen (Motrin; and others), Naproxen (Naprosyn; and others) and, most recently, diclofenac (Voltaren - Medical Letter, 30:110, 1988), have immediate analgesic and anti-inflammatory effects, and they are relatively safe. The second-line of drugs used for treatment of rheumatoid arthritis include hydroxychloroquine, gold, penicillamine, azathioprine, sulfasalazine and methotrezate. These agents, which have no immediate analgesic effects, can control symptoms and may possibly delay progression of the disease, but they can also cause severe adverse effects. NSAIDs are usually taken concurrently with the slower acting second-line drugs, which may take months to produce a therapeutic response. but may not affect the disease process.

Med Lett Drugs Ther. 1989 Jun 30;31(795):61-4 | Show Full Introduction Hide Full Introduction

Flurbiprofen

The Medical Letter on Drugs and Therapeutics • April 7, 1989; (Issue 789)

Flurbiprofen (Ansaid - Upjohn), a nonsteroidal anti-inflammatory drug (NSAID) available in some countries since 1977, was recently approved by the US Food and Drug Administration for treatment of rheumatoid...

Flurbiprofen (Ansaid - Upjohn), a nonsteroidal anti-inflammatory drug (NSAID) available in some countries since 1977, was recently approved by the US Food and Drug Administration for treatment of rheumatoid arthritis and osteoarthritis. Flurbiprofen is a fluorinated phenylalkanoic acid derivative structurally related to ibuprofen (Motrin;and others).

Med Lett Drugs Ther. 1989 Apr 7;31(789):31-2 | Show Full Introduction Hide Full Introduction

Misoprostol

The Medical Letter on Drugs and Therapeutics • March 10, 1989; (Issue 787)

Misoprostol (Cytotec - Searle), a synthetic methyl analog of prostaglandin E1, was recently approved by the US Food and Drug Administration for prevention of gastric ulcers in high-risk patients taking...

Misoprostol (Cytotec - Searle), a synthetic methyl analog of prostaglandin E1, was recently approved by the US Food and Drug Administration for prevention of gastric ulcers in high-risk patients taking nonsteroidal anti-inflammatory drugs (NSAIDs). In other countries, the drug is also marketed for treatment of idiopathic peptic ulcers unrelated to NSAIDs.

Med Lett Drugs Ther. 1989 Mar 10;31(787):21-2 | Show Full Introduction Hide Full Introduction