Matching articles for "cyclosporine"
Bimekizumab (Bimzelx) for Psoriasis
The Medical Letter on Drugs and Therapeutics • January 22, 2024; (Issue 1694)
The FDA has approved the injectable interleukin (IL)-17A/17F antagonist bimekizumab-bkzx (Bimzelx
– UCB) for treatment of moderate to severe plaque
psoriasis in adults who are candidates for...
The FDA has approved the injectable interleukin (IL)-17A/17F antagonist bimekizumab-bkzx (Bimzelx
– UCB) for treatment of moderate to severe plaque
psoriasis in adults who are candidates for systemic
treatment or phototherapy. Bimekizumab is the first
IL-17A/17F antagonist to be approved in the US. It
was approved in the European Union for the same
indication in 2021.
Three Drugs for Atopic Dermatitis (Adbry, Cibinqo, and Rinvoq)
The Medical Letter on Drugs and Therapeutics • April 3, 2023; (Issue 1673)
The subcutaneously injected interleukin-13 (IL-13)
antagonist tralokinumab-ldrm (Adbry – Leo) and
the oral Janus kinase (JAK) inhibitors abrocitinib
(Cibinqo – Pfizer) and upadacitinib (Rinvoq –...
The subcutaneously injected interleukin-13 (IL-13)
antagonist tralokinumab-ldrm (Adbry – Leo) and
the oral Janus kinase (JAK) inhibitors abrocitinib
(Cibinqo – Pfizer) and upadacitinib (Rinvoq – Abbvie)
have been approved by the FDA for treatment of
moderate to severe atopic dermatitis.
Deucravacitinib (Sotyktu) for Plaque Psoriasis
The Medical Letter on Drugs and Therapeutics • February 20, 2023; (Issue 1670)
The FDA has approved deucravacitinib (Sotyktu –
BMS), an oral tyrosine kinase 2 (TYK2) inhibitor, for
once-daily treatment of moderate to severe plaque
psoriasis in adults who are candidates for...
The FDA has approved deucravacitinib (Sotyktu –
BMS), an oral tyrosine kinase 2 (TYK2) inhibitor, for
once-daily treatment of moderate to severe plaque
psoriasis in adults who are candidates for systemic
therapy or phototherapy. Deucravacitinib is the first
selective TYK2 inhibitor to be approved in the US for
any indication.
Dupilumab (Dupixent) for Eosinophilic Esophagitis and Prurigo Nodularis
The Medical Letter on Drugs and Therapeutics • February 6, 2023; (Issue 1669)
The FDA has approved the subcutaneously
injected interleukin (IL)-4 receptor alpha antagonist
dupilumab (Dupixent – Sanofi/Regeneron)
for treatment of eosinophilic esophagitis (EoE)
in patients ≥12...
The FDA has approved the subcutaneously
injected interleukin (IL)-4 receptor alpha antagonist
dupilumab (Dupixent – Sanofi/Regeneron)
for treatment of eosinophilic esophagitis (EoE)
in patients ≥12 years old who weigh ≥40 kg and
treatment of prurigo nodularis in adults. Dupilumab
is the first drug to be approved in the US for each
of these indications. It is also FDA-approved for
treatment of atopic dermatitis, asthma, and chronic
rhinosinusitis with nasal polyposis.
Voclosporin (Lupkynis) for Lupus Nephritis
The Medical Letter on Drugs and Therapeutics • August 23, 2021; (Issue 1631)
Voclosporin (Lupkynis – Aurinia), an oral calcineurin
inhibitor, has been approved by the FDA for use
in combination with the antimetabolite immunosuppressant
mycophenolate mofetil (Cellcept,...
Voclosporin (Lupkynis – Aurinia), an oral calcineurin
inhibitor, has been approved by the FDA for use
in combination with the antimetabolite immunosuppressant
mycophenolate mofetil (Cellcept, and
generics) and a corticosteroid for treatment of adults
with active lupus nephritis. It is the first calcineurin
inhibitor to be approved in the US for this indication.
Tacrolimus (Prograf, and others) and cyclosporine
(Neoral, and others), the other available systemic
calcineurin inhibitors, are approved for prophylaxis of
organ rejection in transplant patients.
Drugs for Atopic Dermatitis
The Medical Letter on Drugs and Therapeutics • June 15, 2020; (Issue 1600)
Atopic dermatitis (AD; also known as eczema) is
frequently associated with other atopic disorders
such as allergic rhinitis, asthma, and food allergy. It
commonly presents in infancy and early childhood
and...
Atopic dermatitis (AD; also known as eczema) is
frequently associated with other atopic disorders
such as allergic rhinitis, asthma, and food allergy. It
commonly presents in infancy and early childhood
and has a relapsing course, often improving by
adolescence, but sometimes persisting into (or first
appearing in) adulthood or even old age.
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...
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 treatment
of psoriatic arthritis have recently been published.
Drugs for Psoriasis
The Medical Letter on Drugs and Therapeutics • June 17, 2019; (Issue 1574)
Mild to moderate psoriasis can be treated with topical
drugs or with phototherapy. Patients with moderate to
severe disease generally require systemic...
Mild to moderate psoriasis can be treated with topical
drugs or with phototherapy. Patients with moderate to
severe disease generally require systemic therapy.
Expanded Table: Some Drugs for Psoriasis (online only)
The Medical Letter on Drugs and Therapeutics • June 17, 2019; (Issue 1574)
...
View the Expanded Table: Some Drugs for Psoriasis
Risankizumab (Skyrizi) for Psoriasis
The Medical Letter on Drugs and Therapeutics • June 3, 2019; (Issue 1573)
The FDA has approved the interleukin (IL)-23
antagonist risankizumab-rzaa (Skyrizi – Abbvie) for
treatment of moderate to severe plaque psoriasis in
adults. Risankizumab is the third IL-23 antagonist...
The FDA has approved the interleukin (IL)-23
antagonist risankizumab-rzaa (Skyrizi – Abbvie) for
treatment of moderate to severe plaque psoriasis in
adults. Risankizumab is the third IL-23 antagonist to
be approved for this indication; guselkumab (Tremfya)
and tildrakizumab (Ilumya) were approved earlier.
Tildrakizumab (Ilumya) - Another IL-23 Antagonist for Psoriasis
The Medical Letter on Drugs and Therapeutics • January 14, 2019; (Issue 1563)
Tildrakizumab-asmn (Ilumya – Sun), an interleukin
(IL)-23 antagonist, has been approved by the FDA for
treatment of adults with moderate to severe plaque
psoriasis who are candidates for systemic therapy...
Tildrakizumab-asmn (Ilumya – Sun), an interleukin
(IL)-23 antagonist, has been approved by the FDA for
treatment of adults with moderate to severe plaque
psoriasis who are candidates for systemic therapy or
phototherapy. Tildrakizumab is the second selective
IL-23 antagonist to be approved for this indication;
guselkumab (Tremfya) was the first.
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...
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).
Drugs for Inflammatory Bowel Disease
The Medical Letter on Drugs and Therapeutics • July 2, 2018; (Issue 1550)
Management of both ulcerative colitis (UC) and Crohn's
disease (CD) is based on disease severity. Disease
location (proctitis, left-sided colitis, or extensive
colitis) also plays a role in drug selection....
Management of both ulcerative colitis (UC) and Crohn's
disease (CD) is based on disease severity. Disease
location (proctitis, left-sided colitis, or extensive
colitis) also plays a role in drug selection. Some
drugs for induction and maintenance of remission of
inflammatory bowel disease (IBD) are listed in Table 1.
Expanded Table: Some Drugs for Inflammatory Bowel Disease (online only)
The Medical Letter on Drugs and Therapeutics • July 2, 2018; (Issue 1550)
...
View Expanded Table: Some Drugs for Inflammatory Bowel Disease
Table: Drugs for Ulcerative Colitis (online only)
The Medical Letter on Drugs and Therapeutics • July 2, 2018; (Issue 1550)
...
View Table: Drugs for Ulcerative Colitis
Table: Safety of Drugs for IBD in Pregnancy (online only)
The Medical Letter on Drugs and Therapeutics • July 2, 2018; (Issue 1550)
...
View Table: Safety of Drugs for IBD in Pregnancy
Guselkumab (Tremfya) for Psoriasis
The Medical Letter on Drugs and Therapeutics • November 6, 2017; (Issue 1533)
The FDA has approved the interleukin (IL)-23 blocker
guselkumab (Tremfya – Janssen) for treatment of
moderate to severe plaque psoriasis in adults who
are candidates for systemic therapy or...
The FDA has approved the interleukin (IL)-23 blocker
guselkumab (Tremfya – Janssen) for treatment of
moderate to severe plaque psoriasis in adults who
are candidates for systemic therapy or phototherapy.
Guselkumab is the first selective IL-23 blocker to
become available in the US.
Brodalumab (Siliq) - Another IL-17A Antagonist for Psoriasis
The Medical Letter on Drugs and Therapeutics • July 17, 2017; (Issue 1525)
The FDA has approved brodalumab (Siliq – Valeant),
an injectable human interleukin (IL)-17A receptor
antagonist, for treatment of adults with moderate to
severe plaque psoriasis who have failed to...
The FDA has approved brodalumab (Siliq – Valeant),
an injectable human interleukin (IL)-17A receptor
antagonist, for treatment of adults with moderate to
severe plaque psoriasis who have failed to respond
to other systemic therapies. Brodalumab is the third
IL-17A antagonist to be approved in the US for this
indication; secukinumab (Cosentyx) and ixekizumab
(Taltz) were approved earlier.
Drugs for Allergic Disorders
The Medical Letter on Drugs and Therapeutics • May 8, 2017; (Issue 1520)
Allergic rhinitis can be classified as seasonal,
perennial, or episodic. It is often associated with
allergic conjunctivitis, rhinosinusitis, and asthma. H1-ANTIHISTAMINES — Oral – Oral...
Allergic rhinitis can be classified as seasonal,
perennial, or episodic. It is often associated with
allergic conjunctivitis, rhinosinusitis, and asthma.
H1-ANTIHISTAMINES — Oral – Oral second-generation H1-antihistamines are the preferred first-line treatment for relief of the itching, sneezing, and rhinorrhea that characterize mild-to-moderate allergic rhinitis. They are less effective for nasal congestion.
H1-ANTIHISTAMINES — Oral – Oral second-generation H1-antihistamines are the preferred first-line treatment for relief of the itching, sneezing, and rhinorrhea that characterize mild-to-moderate allergic rhinitis. They are less effective for nasal congestion.
Dupilumab (Dupixent) for Moderate to Severe Atopic Dermatitis
The Medical Letter on Drugs and Therapeutics • April 24, 2017; (Issue 1519)
The FDA has approved dupilumab (Dupixent – Sanofi/Regeneron), a subcutaneously-injected fully human
monoclonal antibody, for treatment of adults with
moderate to severe atopic dermatitis (eczema) that
has...
The FDA has approved dupilumab (Dupixent – Sanofi/Regeneron), a subcutaneously-injected fully human
monoclonal antibody, for treatment of adults with
moderate to severe atopic dermatitis (eczema) that
has not responded to topical therapies. It can be used
with or without topical corticosteroids.
Drugs for Psoriasis
The Medical Letter on Drugs and Therapeutics • June 8, 2015; (Issue 1470)
Mild to moderate psoriasis is generally treated with
topical corticosteroids. Vitamin D analogs and tazarotene
are topical alternatives that can be used in combination
with topical corticosteroids....
Mild to moderate psoriasis is generally treated with
topical corticosteroids. Vitamin D analogs and tazarotene
are topical alternatives that can be used in combination
with topical corticosteroids. Phototherapy and systemic
therapy, including biologic agents, are recommended for
patients with moderate to severe disease.
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.
Secukinumab (Cosentyx) for Psoriasis
The Medical Letter on Drugs and Therapeutics • March 30, 2015; (Issue 1465)
Secukinumab (Cosentyx – Novartis), an injectable
human interleukin (IL)-17A antagonist, has been
approved by the FDA for treatment of moderate to
severe plaque psoriasis in adult patients who...
Secukinumab (Cosentyx – Novartis), an injectable
human interleukin (IL)-17A antagonist, has been
approved by the FDA for treatment of moderate to
severe plaque psoriasis in adult patients who are
candidates for systemic therapy or phototherapy.
It is the first IL-17 inhibitor to be approved for any
indication in the US.
A 4-Drug Combination (Viekira Pak) for Hepatitis C
The Medical Letter on Drugs and Therapeutics • February 2, 2015; (Issue 1461)
The FDA has approved Viekira Pak (Abbvie), a fixed-dose
combination of two new direct-acting antiviral
agents (ombitasvir, paritaprevir) with the pharmacologic
enhancer ritonavir in one tablet, co-packaged...
The FDA has approved Viekira Pak (Abbvie), a fixed-dose
combination of two new direct-acting antiviral
agents (ombitasvir, paritaprevir) with the pharmacologic
enhancer ritonavir in one tablet, co-packaged with
a third new direct-acting antiviral agent (dasabuvir) in
a second tablet, for oral treatment of chronic hepatitis
C virus (HCV) genotype 1 infection. Genotype 1 is
responsible for 70-80% of HCV infections in the US.
Drugs for Inflammatory Bowel Disease
The Medical Letter on Drugs and Therapeutics • August 4, 2014; (Issue 1448)
Aminosalicylates are effective for induction and maintenance
of remission in mild to moderate ulcerative
colitis. They are not recommended for treatment of
Crohn's disease.
FORMULATIONS — Oral mesalamine...
Aminosalicylates are effective for induction and maintenance
of remission in mild to moderate ulcerative
colitis. They are not recommended for treatment of
Crohn's disease.
FORMULATIONS — Oral mesalamine is rapidly absorbed in the small intestine and most of the drug does not reach the colon. Pentasa releases mesalamine gradually throughout the gastrointestinal tract. Delzicol, Asacol HD, Lialda, and Apriso delay the release of the drug until it reaches the distal ileum and colon. Sulfasalazine (Azulfidine, and generics), balsalazide (Colazal, and others), and olsalazine (Dipentum) are prodrugs; mesalamine is azo-bonded to a second moiety and released in the colon following bacterial cleavage of the bond. Mesalamine is also available as an enema (Rowasa, and generics) and as a rectal suppository (Canasa).
FORMULATIONS — Oral mesalamine is rapidly absorbed in the small intestine and most of the drug does not reach the colon. Pentasa releases mesalamine gradually throughout the gastrointestinal tract. Delzicol, Asacol HD, Lialda, and Apriso delay the release of the drug until it reaches the distal ileum and colon. Sulfasalazine (Azulfidine, and generics), balsalazide (Colazal, and others), and olsalazine (Dipentum) are prodrugs; mesalamine is azo-bonded to a second moiety and released in the colon following bacterial cleavage of the bond. Mesalamine is also available as an enema (Rowasa, and generics) and as a rectal suppository (Canasa).
Golimumab (Simponi) for Ulcerative Colitis
The Medical Letter on Drugs and Therapeutics • March 31, 2014; (Issue 1439)
The FDA has approved golimumab (Simponi – Janssen),
a fully human monoclonal antibody specific for tumor necrosis
factor (TNF) alpha, for induction and maintenance
of remission in patients with moderate to...
The FDA has approved golimumab (Simponi – Janssen),
a fully human monoclonal antibody specific for tumor necrosis
factor (TNF) alpha, for induction and maintenance
of remission in patients with moderate to severe ulcerative
colitis who do not respond to or cannot tolerate other
therapies or who require continuous treatment with corticosteroids.
Golimumab was approved earlier for treatment
of rheumatoid arthritis, psoriatic arthritis, and ankylosing
spondylitis. It is the third TNF inhibitor to be approved for
use in ulcerative colitis.
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.
Drugs for Lipids
The Medical Letter on Drugs and Therapeutics • January 1, 2014; (Issue 137)
HMG-CoA reductase inhibitors (statins) inhibit
the enzyme that catalyzes the rate-limiting step in
cholesterol synthesis. The subsequent reduction in
hepatic cholesterol leads to increased expression of
LDL...
HMG-CoA reductase inhibitors (statins) inhibit
the enzyme that catalyzes the rate-limiting step in
cholesterol synthesis. The subsequent reduction in
hepatic cholesterol leads to increased expression of
LDL receptors, which in turn increases uptake and
clearance of LDL-C from the blood. Statins also lower
very low-density lipoprotein cholesterol (VLDL-C)
and triglycerides. Most statins increase high-density
lipoprotein cholesterol (HDL-C), but only modestly.
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...
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 symptoms.
Drugs for Acne, Rosacea and Psoriasis
The Medical Letter on Drugs and Therapeutics • January 1, 2013; (Issue 125)
The pathogenesis of acne is multifactorial: follicular
hyperkeratinization, bacteria, sebum production,
androgens, and inflammation all play a role. The gram-positive
microaerophilic bacteria...
The pathogenesis of acne is multifactorial: follicular
hyperkeratinization, bacteria, sebum production,
androgens, and inflammation all play a role. The gram-positive
microaerophilic bacteria Propionibacterium
acnes promote development of acne lesions by secreting
chemotactic factors that attract leukocytes to the
follicle, causing inflammation.
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.
Drugs for Inflammatory Bowel Disease
The Medical Letter on Drugs and Therapeutics • March 1, 2012; (Issue 115)
Inflammatory bowel disease (IBD) is generally classified
as either Crohn’s disease (CD) or ulcerative
colitis (UC). More detailed guidelines on their treatment
are available from the American College...
Inflammatory bowel disease (IBD) is generally classified
as either Crohn’s disease (CD) or ulcerative
colitis (UC). More detailed guidelines on their treatment
are available from the American College of
Gastroenterology.
Belatacept (Nulojix) for Prevention of Renal Transplant Rejection
The Medical Letter on Drugs and Therapeutics • December 12, 2011; (Issue 1379)
The FDA has approved belatacept (bel at´ a sept;
Nulojix – Bristol-Myers Squibb) for prevention of organ
rejection in adult patients receiving a kidney...
The FDA has approved belatacept (bel at´ a sept;
Nulojix – Bristol-Myers Squibb) for prevention of organ
rejection in adult patients receiving a kidney transplant.
New Simvastatin Dosing Recommendations
The Medical Letter on Drugs and Therapeutics • August 8, 2011; (Issue 1370)
The FDA has announced changes in the labeling of simvastatin to reduce the risk of myopathy. These changes include limiting the use of the 80-mg maximum dose to patients who have been taking it for 12 months or...
The FDA has announced changes in the labeling of simvastatin to reduce the risk of myopathy. These changes include limiting the use of the 80-mg maximum dose to patients who have been taking it for 12 months or more without evidence of myopathy and new recommendations for use of simvastatin with other drugs. Simvastatin is available alone (Zocor, and others) and in combination with ezetimibe (Vytorin) and with niacin (Simcor).
Addendum: Cost of Ustekinumab (Stelara)
The Medical Letter on Drugs and Therapeutics • March 8, 2010; (Issue 1333)
In the Medical Letter article on ustekinumab (Stelara) for psoriasis (2010; 52:7), footnote 2 in table 2 should have included a second sentence: $5595.60 is the cost of one 45-mg...
In the Medical Letter article on ustekinumab (Stelara) for psoriasis (2010; 52:7), footnote 2 in table 2 should have included a second sentence: $5595.60 is the cost of one 45-mg syringe.
Drugs for Allergic Disorders
The Medical Letter on Drugs and Therapeutics • February 1, 2010; (Issue 90)
Allergic rhinitis, allergic conjunctivitis, atopic dermatitis, urticaria, anaphylaxis and asthma (not included here; reviewed in Treatment Guidelines 2008; 6:83) are prevalent worldwide, especially in...
Allergic rhinitis, allergic conjunctivitis, atopic dermatitis, urticaria, anaphylaxis and asthma (not included here; reviewed in Treatment Guidelines 2008; 6:83) are prevalent worldwide, especially in industrialized countries. Pharmacologic treatment of these disorders continues to improve in efficacy and safety. In addition to using drugs to prevent and control these allergic diseases, patients should be instructed to avoid, if possible, specific allergens and/or environmental conditions that trigger or worsen their symptoms. Allergen-specific immunotherapy may be useful for treatment of allergic rhinitis and allergic conjunctivitis, and in preventing severe insect venom-triggered reactions.
Ustekinumab (Stelara) for Psoriasis
The Medical Letter on Drugs and Therapeutics • January 25, 2010; (Issue 1330)
The FDA has approved the use of ustekinumab (Stelara - Centocor Ortho Biotech), an interleukin antagonist given by subcutaneous (SC) injection for treatment of adults with moderate to severe plaque psoriasis....
The FDA has approved the use of ustekinumab (Stelara - Centocor Ortho Biotech), an interleukin antagonist given by subcutaneous (SC) injection for treatment of adults with moderate to severe plaque psoriasis. It is the first agent in its class for this indication; the other biologic agents for psoriasis are Tcell or tumor necrosis factor (TNF) inhibitors.
Drugs for Some Common Eye Disorders
The Medical Letter on Drugs and Therapeutics • January 1, 2010; (Issue 89)
Drugs for glaucoma, age-related macular degeneration, bacterial conjunctivitis, and dry eyes are reviewed here. Ophthalmic drugs can have local and systemic adverse effects. In addition, for some elderly...
Drugs for glaucoma, age-related macular degeneration, bacterial conjunctivitis, and dry eyes are reviewed here. Ophthalmic drugs can have local and systemic adverse effects. In addition, for some elderly patients, the complexity of self-administering numerous ophthalmic drugs may be the limiting factor in their ability to care for themselves. Drugs for the treatment of allergic conjunctivitis will be reviewed in a future issue of Treatment Guidelines on Drugs for Allergic Disorders.
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.
Aliskiren/Valsartan (Valturna) for Hypertension
The Medical Letter on Drugs and Therapeutics • November 30, 2009; (Issue 1326)
The FDA has approved the use of aliskiren (Tekturna), a direct renin inhibitor, with valsartan (Diovan), an angiotensin-receptor blocker (ARB), in a fixed-dose combination as Valturna (Novartis) for treatment...
The FDA has approved the use of aliskiren (Tekturna), a direct renin inhibitor, with valsartan (Diovan), an angiotensin-receptor blocker (ARB), in a fixed-dose combination as Valturna (Novartis) for treatment of hypertension in patients already taking both drugs or not adequately controlled on monotherapy, and as initial therapy in those likely to need multiple drugs to control their blood pressure.
Tolvaptan (Samsca) for Hyponatremia
The Medical Letter on Drugs and Therapeutics • November 30, 2009; (Issue 1326)
The FDA has approved the marketing of tolvaptan (Samsca - Otsuka), an oral vasopressin receptor antagonist, for treatment of hypervolemic or euvolemic hyponatremia due to congestive heart failure (CHF),...
The FDA has approved the marketing of tolvaptan (Samsca - Otsuka), an oral vasopressin receptor antagonist, for treatment of hypervolemic or euvolemic hyponatremia due to congestive heart failure (CHF), cirrhosis or the syndrome of inappropriate antidiuretic hormone secretion (SIADH). A similar drug, conivaptan (Vaprisol) is already available for intravenous (IV) treatment of euvolemic hyponatremia in hospitalized patients. Tolvaptan was approved by the FDA for both inpatient and outpatient use, but it should be started in a hospital.
Drugs for Inflammatory Bowel Disease
The Medical Letter on Drugs and Therapeutics • September 1, 2009; (Issue 85)
Inflammatory bowel disease (IBD) is either Crohn's disease or ulcerative colitis. Drug selection is guided by disease type (Crohn's versus ulcerative colitis), severity and location and whether the goal is...
Inflammatory bowel disease (IBD) is either Crohn's disease or ulcerative colitis. Drug selection is guided by disease type (Crohn's versus ulcerative colitis), severity and location and whether the goal is induction or maintenance of remission. Table 1 on page 66 lists the drugs used to treat IBD with their formulations and cost. Table 2 on page 68 lists the drugs of choice and their doses for different indications. Table 3 on page 71 lists the drugs' adverse effects and recommendations for monitoring. More detailed guidelines are available from the American College of Gastroenterology.
Fenofibric Acid (Trilipix)
The Medical Letter on Drugs and Therapeutics • May 4, 2009; (Issue 1311)
The FDA has approved the marketing of fenofibric acid (Trilipix - Abbott) to reduce triglycerides and increase HDL-C in patients with mixed dyslipidemia on optimal doses of a HMG-CoA reductase inhibitor...
The FDA has approved the marketing of fenofibric acid (Trilipix - Abbott) to reduce triglycerides and increase HDL-C in patients with mixed dyslipidemia on optimal doses of a HMG-CoA reductase inhibitor (statin) who have, or have risk factors for, coronary heart disease. It is the first fibrate approved by the FDA specifically for combined use with a statin. Trilipix is also approved as monotherapy for hypertriglyceridemia, hypercholesterolemia and low HDL-C. The patent for Tricor, Abbott's older formulation of fenofibrate, will expire in 2011.
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...
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 anti-inflammatory drugs (NSAIDs) and corticosteroids.
Silodosin (Rapaflo) for Benign Prostatic Hyperplasia
The Medical Letter on Drugs and Therapeutics • January 12, 2009; (Issue 1303)
Silodosin (Rapaflo - Watson Pharmaceuticals), an alpha1a-adrenoreceptor selective antagonist, has been approved by the FDA for treatment of benign prostatic hyperplasia (BPH). Some medications for BPH are...
Silodosin (Rapaflo - Watson Pharmaceuticals), an alpha1a-adrenoreceptor selective antagonist, has been approved by the FDA for treatment of benign prostatic hyperplasia (BPH). Some medications for BPH are listed in the table on page 4. Alpha1 blockers are commonly used with 5a-reductase inhibitors such as finasteride, which can shrink the size of the prostate, but may take months to do so.
Drugs for Acne, Rosacea and Psoriasis
The Medical Letter on Drugs and Therapeutics • November 1, 2008; (Issue 75)
The pathogenesis of acne is multifactorial: follicular hyperkeratinization, bacteria, sebum production, androgens and inflammation all play a role. The gram-positive microaerophilic bacteria Propionibacterium...
The pathogenesis of acne is multifactorial: follicular hyperkeratinization, bacteria, sebum production, androgens and inflammation all play a role. The gram-positive microaerophilic bacteria Propionibacterium acnes promote development of acne lesions by secreting chemotactic factors that attract leukocytes to the follicle, causing inflammation.
Drug Interactions with Simvastatin
The Medical Letter on Drugs and Therapeutics • October 20, 2008; (Issue 1297)
A recent letter to the editor of the Annals of Internal Medicine documented a single case of myopathy apparently due to an interaction between simvastatin (Zocor, and others) and green tea. Since it became...
A recent letter to the editor of the Annals of Internal Medicine documented a single case of myopathy apparently due to an interaction between simvastatin (Zocor, and others) and green tea. Since it became available generically, simvastatin has surpassed atorvastatin (Lipitor) as the best selling statin. As such, it is probably the most common cause of statin-induced myopathy, which is often a result of drug interactions.
Aliskiren/Hydrochlorothiazide (Tekturna HCT) for Hypertension
The Medical Letter on Drugs and Therapeutics • August 25, 2008; (Issue 1293)
Aliskiren (Tekturna - Novartis), the first direct renin inhibitor for treatment of hypertension, has been approved for use in a fixed-dose combination with the diuretic hydrochlorothiazide (Tekturna HCT -...
Aliskiren (Tekturna - Novartis), the first direct renin inhibitor for treatment of hypertension, has been approved for use in a fixed-dose combination with the diuretic hydrochlorothiazide (Tekturna HCT - Novartis). Many angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are also available in fixed-dose combinations with hydrochlorothiazide (HCTZ).
Drugs for Lipids
The Medical Letter on Drugs and Therapeutics • February 1, 2008; (Issue 66)
Drugs that lower low-density lipoprotein cholesterol (LDL-C) concentrations can prevent formation, slow progression and cause regression of atherosclerotic lesions. They should not be used as a substitute for...
Drugs that lower low-density lipoprotein cholesterol (LDL-C) concentrations can prevent formation, slow progression and cause regression of atherosclerotic lesions. They should not be used as a substitute for lifestyle changes; a combination of diet, exercise and lipid-lowering drugs is optimal for prevention of coronary disease. Lipid-regulating drugs must be taken indefinitely; when they are stopped, plasma lipoprotein levels return to pretreatment levels in 2-3 weeks.
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...
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 the Infectious Diseases Society of America (www.idsociety.org).
Drugs for Allergic Disorders
The Medical Letter on Drugs and Therapeutics • August 1, 2007; (Issue 60)
Allergic rhinitis, allergic conjunctivitis, atopic dermatitis, urticaria, anaphylaxis and asthma (reviewed in Treatment Guidelines 2005; 3:33 and not included here), are prevalent worldwide, especially in...
Allergic rhinitis, allergic conjunctivitis, atopic dermatitis, urticaria, anaphylaxis and asthma (reviewed in Treatment Guidelines 2005; 3:33 and not included here), are prevalent worldwide, especially in industrialized countries. Pharmacologic treatment of these disorders continues to improve in efficacy and safety. In addition to using drugs to prevent and control the symptoms of their allergic diseases, patients should also be instructed to avoid, if possible, specific allergens and/or environmental conditions that trigger or worsen their symptoms.
Drugs for Some Common Eye Disorders
The Medical Letter on Drugs and Therapeutics • January 1, 2007; (Issue 53)
Drugs for glaucoma, age-related macular degeneration, bacterial and allergic conjunctivitis, and dry eyes are reviewed here. Ophthalmic drugs can have local and systemic adverse effects. In addition, for some...
Drugs for glaucoma, age-related macular degeneration, bacterial and allergic conjunctivitis, and dry eyes are reviewed here. Ophthalmic drugs can have local and systemic adverse effects. In addition, for some elderly patients, the complexity of self-administering numerous ophthalmic drugs may be the limiting factor in their ability to care for themselves.
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...
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.
CYP3A and Drug Interactions
The Medical Letter on Drugs and Therapeutics • July 4, 2005; (Issue 1212)
Serious adverse interactions between drugs continue to be reported. Many of these are due to inhibition or induction of cytochrome P450 (CYP) enzymes, particularly CYP3A4. CYP3A is thought to be involved in the...
Serious adverse interactions between drugs continue to be reported. Many of these are due to inhibition or induction of cytochrome P450 (CYP) enzymes, particularly CYP3A4. CYP3A is thought to be involved in the metabolism of more than 50 percent of currently prescribed drugs.2 CYP3A4, which is more abundantly expressed than CYP3A5, accounts for most CYP3A activity in vivo.
Drugs for Acne, Rosacea and Psoriasis
The Medical Letter on Drugs and Therapeutics • July 1, 2005; (Issue 35)
The pathogenesis of acne is multifactorial: follicular hyperkeratinization, Propionibacterium acnes bacteria, sebum production, androgens and inflammation have all been implicated. P. acnes, a gram-positive...
The pathogenesis of acne is multifactorial: follicular hyperkeratinization, Propionibacterium acnes bacteria, sebum production, androgens and inflammation have all been implicated. P. acnes, a gram-positive microaerophilic bacterium, plays an important role in the development of acne lesions by secreting chemotactic factors that attract leukocytes to the follicle, causing inflammation.
Micafungin (Mycamine) for Fungal Infections
The Medical Letter on Drugs and Therapeutics • June 20, 2005; (Issue 1211)
Micafungin sodium (Mycamine - Astellas), the second echinocandin antifungal to become available in the US, has been approved by the FDA for intravenous treatment of esophageal candidiasis and prophylaxis of...
Micafungin sodium (Mycamine - Astellas), the second echinocandin antifungal to become available in the US, has been approved by the FDA for intravenous treatment of esophageal candidiasis and prophylaxis of invasive Candida infections in patients undergoing hematopoietic stem cell transplantation (HSCT).
Antifungal Drugs
The Medical Letter on Drugs and Therapeutics • February 1, 2005; (Issue 30)
The drugs of choice for treatment of some fungal infections are listed in the table that begins on page 8. Some of the indications and dosages recommended here have not been approved by the...
The drugs of choice for treatment of some fungal infections are listed in the table that begins on page 8. Some of the indications and dosages recommended here have not been approved by the FDA.
Safety of Aggressive Statin Therapy
The Medical Letter on Drugs and Therapeutics • November 22, 2004; (Issue 1196)
New guidelines from The National Cholesterol Education Program recommend, as a therapeutic option, lowering treatment goals for LDL cholesterol (LDL-C) from...
New guidelines from The National Cholesterol Education Program recommend, as a therapeutic option, lowering treatment goals for LDL cholesterol (LDL-C) from <100 mg/dL to <70 mg/dL for patients at very high risk for coronary heart disease and from 130 mg/dL to <100 mg/dL for those at moderately high risk. A likely consequence of these recommendations is increased use of statins and use of higher doses with a concomitant increase in adverse effects.
Tinidazole (Tindamax) - A New Anti-Protozoal Drug
The Medical Letter on Drugs and Therapeutics • August 30, 2004; (Issue 1190)
Tinidazole (Tindamax - Presutti Labs), an oral antiprotozoal drug similar to metronidazole (Flagyl, and others), has been approved by the FDA for treatment of trichomoniasis in adults and for treatment of...
Tinidazole (Tindamax - Presutti Labs), an oral antiprotozoal drug similar to metronidazole (Flagyl, and others), has been approved by the FDA for treatment of trichomoniasis in adults and for treatment of giardiasis, intestinal amebiasis and amebic liver abcess in adults and children more than 3 years old. Tinidazole has been widely used outside of the US for decades under the trade name Fasigyn (Pfizer).
New Indications for Modafinil (Provigil)
The Medical Letter on Drugs and Therapeutics • April 26, 2004; (Issue 1181)
Modafinil (Provigil - Cephalon; Alertec - Draxis in Canada), first approved by the FDA in 1999 for treatment of excessive daytime sleepiness associated with narcolepsy (Medical Letter 1999; 41:30), has now also...
Modafinil (Provigil - Cephalon; Alertec - Draxis in Canada), first approved by the FDA in 1999 for treatment of excessive daytime sleepiness associated with narcolepsy (Medical Letter 1999; 41:30), has now also been approved for treatment of patients with excessive sleepiness due to obstructive sleep apnea/hypopnea syndrome (OSAHS) or shift work sleep disorder (SWSD) (DSM-IV, text revision, Washington, DC: American Psychiatric Association, 2000, page 622).
Drug Interactions with Grapefruit Juice
The Medical Letter on Drugs and Therapeutics • January 5, 2004; (Issue 1173)
The ability of grapefruit juice to increase serum concentrations of drugs was first discovered during a study of the effect of ethanol on felodipine (Plendil) pharmacokinetics. Double-strength grapefruit juice...
The ability of grapefruit juice to increase serum concentrations of drugs was first discovered during a study of the effect of ethanol on felodipine (Plendil) pharmacokinetics. Double-strength grapefruit juice used to disguise the taste of ethanol resulted in higher than expected serum concentrations of felodipine (DG Bailey et al, Clin Invest Med 1989; 12:357).
Drugs for Allergic Disorders
The Medical Letter on Drugs and Therapeutics • November 1, 2003; (Issue 15)
Allergic rhinitis, allergic conjunctivitis, atopic dermatitis, urticaria and anaphylaxis, along with asthma (reviewed in Treatment Guidelines 2002; 1:7 and not included here), have increased in prevalence...
Allergic rhinitis, allergic conjunctivitis, atopic dermatitis, urticaria and anaphylaxis, along with asthma (reviewed in Treatment Guidelines 2002; 1:7 and not included here), have increased in prevalence during the past 30 years and are now epidemic worldwide, especially in industrialized countries. Many safe and effective drugs are currently available for prevention and relief of symptoms in these disorders, but pharmacological treatment alone may not be sufficient. Patients should also be instructed to avoid specific allergens or environmental conditions that trigger their symptoms. Allergen-specific immunotherapy, parenteral administration of gradually increasing doses of the allergen ("allergy shots"), has been effective in allergic rhinitis, allergic conjunctivitis and allergic asthma, and also in prevention of anaphylaxis triggered by stings from bees, yellow jackets, hornets and wasps. It has not been effective in food allergy, atopic dermatitis or urticaria.
Drug Interactions
The Medical Letter on Drugs and Therapeutics • June 8, 2003; (Issue 1158)
Changes caused by one drug in the absorption, distribution, metabolism or excretion of another may lead to a pharmacokinetic adverse drug interaction (DN Juurlink et al, JAMA 2003; 289:1652). Additive drug...
Changes caused by one drug in the absorption, distribution, metabolism or excretion of another may lead to a pharmacokinetic adverse drug interaction (DN Juurlink et al, JAMA 2003; 289:1652). Additive drug interactions, such as vasodilation caused by both sildenafil (Viagra) and nitrates, can also have adverse effects.
Alefacept (Amevive) For Treatment of Psoriasis
The Medical Letter on Drugs and Therapeutics • April 14, 2003; (Issue 1154)
Alefacept (a le' fa sept; Amevive - Biogen) has been approved by the FDA for parenteral treatment of adults with moderate to severe chronic plaque...
Alefacept (a le' fa sept; Amevive - Biogen) has been approved by the FDA for parenteral treatment of adults with moderate to severe chronic plaque psoriasis.
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...
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.
Generic drugs
The Medical Letter on Drugs and Therapeutics • October 14, 2002; (Issue 1141)
When patents expire on brand-name drugs and generic formulations become available, patients and managed care organizations may express a preference for the lower-cost generics. Are they equivalent to the...
When patents expire on brand-name drugs and generic formulations become available, patients and managed care organizations may express a preference for the lower-cost generics. Are they equivalent to the brand-name product?
Topical Pimecrolimus (Elidel) for treatment of atopic dermatitis
The Medical Letter on Drugs and Therapeutics • May 27, 2002; (Issue 1131)
Pimecrolimus 1% cream (pim e kroe' limus; SDZ ASM 981; Elidel - Novartis) has been approved by the FDA for short-term and intermittent long-term treatment of mild to moderate atopic dermatitis in...
Pimecrolimus 1% cream (pim e kroe' limus; SDZ ASM 981; Elidel - Novartis) has been approved by the FDA for short-term and intermittent long-term treatment of mild to moderate atopic dermatitis in non-immunocompromised patients at least 2 years old.
Topical Tacrolimus For Treatment of Atopic Dermatitis
The Medical Letter on Drugs and Therapeutics • April 16, 2001; (Issue 1102)
Tacrolimus ointment (Protopic) has been approved by the FDA in 0.03% and 0.1% formulations for treatment of atopic dermatitis. Tacrolimus is used systemically (Prograf) to prevent rejection of organ...
Tacrolimus ointment (Protopic) has been approved by the FDA in 0.03% and 0.1% formulations for treatment of atopic dermatitis. Tacrolimus is used systemically (Prograf) to prevent rejection of organ transplants.
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...
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.
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...
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.
Drug Interactions with St. John's Wort
The Medical Letter on Drugs and Therapeutics • June 26, 2000; (Issue 1081)
Even though its effectiveness has not been established, many patients take St. John's Wort (Hypericum perforatum), an over-the-counter herbal extract, to treat symptoms of depression, often without the...
Even though its effectiveness has not been established, many patients take St. John's Wort (Hypericum perforatum), an over-the-counter herbal extract, to treat symptoms of depression, often without the knowledge of their physicians. Recent reports indicate that St. John's wort interacts adversely with a number of drugs.
Sirolimus (Rapamune) for Transplant Rejection
The Medical Letter on Drugs and Therapeutics • February 7, 2000; (Issue 1071)
Sirolimus, whlch is structurally related to tacrolimus, has been approved by the FDA for prevention of acute renal transplant rejection. The manufacturer recommends that sirolimus be taken with cyclosporine and...
Sirolimus, whlch is structurally related to tacrolimus, has been approved by the FDA for prevention of acute renal transplant rejection. The manufacturer recommends that sirolimus be taken with cyclosporine and corticosteroids.
Quinupristin/Dalfopristin
The Medical Letter on Drugs and Therapeutics • November 19, 1999; (Issue 1066)
Quinupristin and dalfopristin, two streptogramin antibacterials marketed in a 30:70 combination as Synercid, have received accelerated approval from the FDA for intravenous treatment of bacteremia and...
Quinupristin and dalfopristin, two streptogramin antibacterials marketed in a 30:70 combination as Synercid, have received accelerated approval from the FDA for intravenous treatment of bacteremia and life-threatening infection....
Drug Interactions
The Medical Letter on Drugs and Therapeutics • July 2, 1999; (Issue 1056)
Reports of adverse interactions between drugs continue to accumulate. Recently, the FDA has expanded the recommendations on drug interactions found in the package inserts of new...
Reports of adverse interactions between drugs continue to accumulate. Recently, the FDA has expanded the recommendations on drug interactions found in the package inserts of new drugs.
Generic drugs
The Medical Letter on Drugs and Therapeutics • May 21, 1999; (Issue 1053)
When patents expire on brand-name drugs, generic formulations become available that often cost much less. Some physicians, however, hesitate to prescribe the less expensive drug because of concerns about the...
When patents expire on brand-name drugs, generic formulations become available that often cost much less. Some physicians, however, hesitate to prescribe the less expensive drug because of concerns about the quality of generic formulations.
Modafinil for Narcolepsy
The Medical Letter on Drugs and Therapeutics • March 26, 1999; (Issue 1049)
Modafinil (Provigil), a benzhydryl sulfinylacetamide non-amphetamine stimulant that has been used in Europe since 1995, has now been approved by the FDA for treatment of excessive daytime sleepiness associated...
Modafinil (Provigil), a benzhydryl sulfinylacetamide non-amphetamine stimulant that has been used in Europe since 1995, has now been approved by the FDA for treatment of excessive daytime sleepiness associated with narcolepsy.
New Monoclonal Antibodies to Prevent Transplant Rejection
The Medical Letter on Drugs and Therapeutics • September 25, 1998; (Issue 1036)
Basiliximab (Simulect - Novartis) and daclizumab (Zenapax - Roche), two mouse/human monoclonal antibodies that block the interleukin-2 (IL-2) receptor on Tlymphocytes, have been approved by the FDA for use in...
Basiliximab (Simulect - Novartis) and daclizumab (Zenapax - Roche), two mouse/human monoclonal antibodies that block the interleukin-2 (IL-2) receptor on Tlymphocytes, have been approved by the FDA for use in the prevention of acute renal transplant rejection. Both drugs are used with cyclosporine (Sandimmune; Neoral) and corticosteroids. An all-murine anti-CD3 monoclonal antibody, muromonab-CD3 (Orthoclone OKT3), has been available in the USA for many years for treatment of transplant rejection, and has also been used with some success for prophylaxis (MI Wilde and KL Goa, Drugs, 51:865, 1996).
Fenofibrate for Hypertriglyceridemia
The Medical Letter on Drugs and Therapeutics • July 3, 1998; (Issue 1030)
Micronized fenofibrate (Tricor - Abbott), a fibric acid derivative structurally similar to clofibrate (Atromid-S, and others) and gemfibrozil (Lopid, and others), has been approved by the FDA for treatment of...
Micronized fenofibrate (Tricor - Abbott), a fibric acid derivative structurally similar to clofibrate (Atromid-S, and others) and gemfibrozil (Lopid, and others), has been approved by the FDA for treatment of hypertriglyceridemia. Increased serum triglyceride concentrations have been associated with an increased risk of coronary heart disease (J Jeppesen et al, Circulation, 97:1029, 1998).
Cerivastatin for Hypercholesterolemia
The Medical Letter on Drugs and Therapeutics • January 16, 1998; (Issue 1018)
Cerivastatin (Baycol - Bayer), a new HMG-CoA reductase inhibitor (or "statin"), has been approved by the FDA for treatment of hypercholesterolemia. Cerivastatin is the sodium salt of a synthetic fluorophenyl...
Cerivastatin (Baycol - Bayer), a new HMG-CoA reductase inhibitor (or "statin"), has been approved by the FDA for treatment of hypercholesterolemia. Cerivastatin is the sodium salt of a synthetic fluorophenyl pyridinyl-substituted heptanoic acid.
Mibefradil--A New Calcium-Channel Blocker
The Medical Letter on Drugs and Therapeutics • November 7, 1997; (Issue 1013)
Mibefradil dihydrochloride (Posicor - Roche), a chemically distinct nondihydropyridine calcium-channel blocker, has been approved by the US Food and Drug Administration (FDA) and is being heavily promoted as...
Mibefradil dihydrochloride (Posicor - Roche), a chemically distinct nondihydropyridine calcium-channel blocker, has been approved by the US Food and Drug Administration (FDA) and is being heavily promoted as the first T-type calcium-channel blocker for treatment of hypertension and chronic stable angina.
Systemic Antifungal Drugs
The Medical Letter on Drugs and Therapeutics • September 12, 1997; (Issue 1009)
The drugs of choice for treatment of deep fungal infections are listed in the table below. Some of the indications and dosages recommended here have not been approved by the...
The drugs of choice for treatment of deep fungal infections are listed in the table below. Some of the indications and dosages recommended here have not been approved by the FDA.
Atorvastatin - A New Lipid-lowering Drug
The Medical Letter on Drugs and Therapeutics • March 28, 1997; (Issue 997)
Atorvastatin (Lipitor - Parke-Davis), an HMG-CoA reductase inhibitor (or 'statin'), was recently approved by the US Food and Drug Administration for treatment of primary hypercholesterolemia and mixed...
Atorvastatin (Lipitor - Parke-Davis), an HMG-CoA reductase inhibitor (or 'statin'), was recently approved by the US Food and Drug Administration for treatment of primary hypercholesterolemia and mixed dyslipidemia. A single stereoisomer of a pyrrole derivative, the new drug is chemically different from other statins.
Zafirlukast for Asthma
The Medical Letter on Drugs and Therapeutics • December 20, 1996; (Issue 990)
Zafirlukast (za fir loo kast; Accolate - Zeneca), the first leukotriene receptor anta-gonist approved by the US Food and Drug Administration, is now being heavily promoted for oral maintenance treatment of...
Zafirlukast (za fir loo kast; Accolate - Zeneca), the first leukotriene receptor anta-gonist approved by the US Food and Drug Administration, is now being heavily promoted for oral maintenance treatment of chronic asthma in patients more than 12 years old. It is not recommended for treatment of acute asthma.
Terbinafine for Onychomycosis
The Medical Letter on Drugs and Therapeutics • August 16, 1996; (Issue 981)
Terbinafine (Lamisil - Sandoz), an allylamine synthetic antifungal, previously available in the USA in a topical formulation (Medical Letter, 35:76, 1993) has now been marketed for oral use in the treatment...
Terbinafine (Lamisil - Sandoz), an allylamine synthetic antifungal, previously available in the USA in a topical formulation (Medical Letter, 35:76, 1993) has now been marketed for oral use in the treatment of fungal nail infections caused by dermatophytes. Oral terbinafine has been available in Europe since 1992.
Choice of Lipid-Lowering Drugs
The Medical Letter on Drugs and Therapeutics • August 2, 1996; (Issue 980)
Drugs that lower elevated plasma cholesterol concentrations can prevent formation, slow progression and cause regression of atherosclerotic lesions, and may also improve coronary vasodilatation (JW Jukema et...
Drugs that lower elevated plasma cholesterol concentrations can prevent formation, slow progression and cause regression of atherosclerotic lesions, and may also improve coronary vasodilatation (JW Jukema et al, circulation, 91:2528, 1995: CB Treasure er al, N Engl J Med, 332:481, 1995; TJ Anderson et al, N Engl J Med, 332:488, 1995). All these drugs must be continued indefinitely; when htey are stopped, plasma cholesterol concentrations generally return to pretreatment levels.
Systemic Antifungal Drugs
The Medical Letter on Drugs and Therapeutics • February 2, 1996; (Issue 967)
The drugs of choice for treatment of deep fungal infections are listed in the table on page 101. Some of the indications and dosages recommended here have not been approved by the US Food and Drug...
The drugs of choice for treatment of deep fungal infections are listed in the table on page 101. Some of the indications and dosages recommended here have not been approved by the US Food and Drug Administration. More detailed guidelines are available from the Infectious Diseases Society of America (J Sobel et al, Clin Infect Dis, volume 30, April 2000).
Itraconazole for Onychomycosis
The Medical Letter on Drugs and Therapeutics • January 19, 1996; (Issue 966)
Itraconazole (Sporanox - Janssen), an oral antifungal triazole that has been available in the USA since 1992 for treatment of deep fungal infections (Medical Letter, 35:7, 1993), is now being marketed for...
Itraconazole (Sporanox - Janssen), an oral antifungal triazole that has been available in the USA since 1992 for treatment of deep fungal infections (Medical Letter, 35:7, 1993), is now being marketed for treatment of dermatophyte infections of the toenails, with or without fingernail involvement.
Mycophenolate Mofetil - A New Immunosuppressant for Organ Transplantation
The Medical Letter on Drugs and Therapeutics • September 29, 1995; (Issue 958)
Mycophenolate mofetil (CellCept - Roche) has been approved by the US Food and Drug Administration for oral use in preventing organ rejection in patients receiving allogeneic renal transplants. It is being...
Mycophenolate mofetil (CellCept - Roche) has been approved by the US Food and Drug Administration for oral use in preventing organ rejection in patients receiving allogeneic renal transplants. It is being promoted as an improvement over azathioprine (Imuran) for concurrent use with cyclosporine (Sandimmune; Neoral) and corticosteroids.
Grapefruit Juice Interactions With Drugs
The Medical Letter on Drugs and Therapeutics • August 18, 1995; (Issue 955)
In a study of the interaction between alcohol and the calcium-channel blocker felodipine (Plendil), the grapefruit juice vehicle for the alcohol appeared to increase felodipine plasma concentrations....
In a study of the interaction between alcohol and the calcium-channel blocker felodipine (Plendil), the grapefruit juice vehicle for the alcohol appeared to increase felodipine plasma concentrations. Subsequent studies have found that grapefruit juice increases plasma concentrations of several calcium-channel blockers and of some other drugs as well (DG Bailey et al, Clin Pharmacokinet, 26:91, 1994).
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.
Calcipotriene for Psoriasis
The Medical Letter on Drugs and Therapeutics • August 5, 1994; (Issue 928)
Calcipotriene ointment 0.005% (calcipotriol; Dovonex - Westwood Squibb), a synthetic vitamin D 3 analog previously available in Europe and Canada, has now been approved by the US Food and Drug Administration...
Calcipotriene ointment 0.005% (calcipotriol; Dovonex - Westwood Squibb), a synthetic vitamin D 3 analog previously available in Europe and Canada, has now been approved by the US Food and Drug Administration (FDA) for treatment of moderate plaque psoriasis, the most common form of the disease.
Captopril for Diabetic Nephropathy
The Medical Letter on Drugs and Therapeutics • May 27, 1994; (Issue 923)
Captopril (Capoten - Bristol-Myers Squibb), an angiotensin-converting enzyme (ACE) inhibitor previously available for treatment of hypertension, has now been approved by the US Food and Drug Administration...
Captopril (Capoten - Bristol-Myers Squibb), an angiotensin-converting enzyme (ACE) inhibitor previously available for treatment of hypertension, has now been approved by the US Food and Drug Administration (FDA) for treatment of diabetic nephropathy in patients with insulin-dependent diabetes mellitus (IDDM). Diabetic nephropathy is the most common cause of end-stage renal disease in the United States.
Choice of Cholesterol-Lowering Drugs
The Medical Letter on Drugs and Therapeutics • March 5, 1993; (Issue 891)
Lowering elevated serum cholesterol concentrations can slow progression and sometimes cause regression of atherosclerotic lesions. Most authorities advise patients with high cholesterol concentrations to eat...
Lowering elevated serum cholesterol concentrations can slow progression and sometimes cause regression of atherosclerotic lesions. Most authorities advise patients with high cholesterol concentrations to eat less fat and less cholesterol and, when appropriate, to lose weight. If these measures do not lower serum lipids sufficiently, drugs are frequently added to the regimen. When drugs are discontinued, serum cholesterol concentrations generally return to pretreatment levels.
Itraconazole
The Medical Letter on Drugs and Therapeutics • January 22, 1993; (Issue 888)
Itraconazole (Sporanox - Janssen), an antifungal triazole, has been approved by the US Food and Drug Administration (FDA) for oral treatment of histoplasmosis and blastomycosis. These two endemic mycoses...
Itraconazole (Sporanox - Janssen), an antifungal triazole, has been approved by the US Food and Drug Administration (FDA) for oral treatment of histoplasmosis and blastomycosis. These two endemic mycoses occur both in normal hosts and in immunocompromised patients, such as those with AIDS (RW Bradsher, Clin Infect Dis, 14:S82, 1992; LJ Wheat, Clin Infect Dis, 14:S91, 1992).
Bone Marrow Transplants for Malignant Diseases
The Medical Letter on Drugs and Therapeutics • August 21, 1992; (Issue 877)
Intensive chemotherapy, with or without total body radiation, followed by bone marrow transplantation is now widely used in the treatment of malignant diseases. The drugs and radiation needed to try to...
Intensive chemotherapy, with or without total body radiation, followed by bone marrow transplantation is now widely used in the treatment of malignant diseases. The drugs and radiation needed to try to eradicate the malignancy unavoidably destroy the bone marrow; intravenous infusion of bone marrow cells restores the marrow by repopulating it. Diseases for which bone marrow transplantation has been used include the leukemias and lymphomas, breast cancer, neuroblastoma, ovarian cancer, germ cell tumors, melanoma, multiple myeloma, and malignant gliomas (NC Gorin, Am J Clin On-col, 14 suppl 1:S5, 1991; Medical Letter, 33:39, 1991; G Gahrton et al, N Engl J Med, 325:1267, 1991).
Ticlopidine
The Medical Letter on Drugs and Therapeutics • July 10, 1992; (Issue 874)
hydrochloride (Ticlid - Syntex), a platelet aggregation inhibitor that has been available in Europe for more than a decade, was recently approved by the U.S. Food and Drug Administration to decrease the risk...
hydrochloride (Ticlid - Syntex), a platelet aggregation inhibitor that has been available in Europe for more than a decade, was recently approved by the U.S. Food and Drug Administration to decrease the risk of thrombotic stroke in men and women who have had premonitory signs of stroke or have had a completed thrombotic stroke. The manufacturer is promoting the drug for patients intolerant to aspirin or with conditions for which aspirin has not been approved (previous thrombotic stroke; transient ischemic attacks in women). The drug has also been used for prevention of myocardial infarction.
Pravastatin, Simvastatin, and Lovastatin For Serum Cholesterol Concentrations
The Medical Letter on Drugs and Therapeutics • June 12, 1992; (Issue 872)
Pravastatin - Bristol-Myers Squibb) and simvastatin (Zocor -Merck), two new inhibitors of cholesterol synthesis similar to lovastatin (Mevacor - Merck), have now been marketed in the USA for treatment of...
Pravastatin - Bristol-Myers Squibb) and simvastatin (Zocor -Merck), two new inhibitors of cholesterol synthesis similar to lovastatin (Mevacor - Merck), have now been marketed in the USA for treatment of hypercholesterolemia. Lovastatin (Medical Letter, 29:99, 1987) is the most frequently prescribed of all cholesterol-lowering drugs in the USA. Pravastatin and simvastatin were previously reviewed in The Medical Letter when they became available in Canada (volume 33, page 18, 1991).
Drugs For Treatment Of Fungal Infections
The Medical Letter on Drugs and Therapeutics • February 21, 1992; (Issue 864)
The incidence of opportunistic fungal infections continues to increase, particularly in patients who have AIDS, are taking immunosuppressive drugs, or are in intensive care units. Intravenous (IV) amphotericin...
The incidence of opportunistic fungal infections continues to increase, particularly in patients who have AIDS, are taking immunosuppressive drugs, or are in intensive care units. Intravenous (IV) amphotericin B (Fungizone, and others), sometimes given with flucytosine (Ancobon), is the drug of choice for initial treatment of most rapidly progressive, acutely life-threatening fungal infections; for less severe infections, fluconazole (Diflucan, ketoconazole (Nizoral), or itraconazole (Sporanox - an investigational drug in the (USA) may also be effective, can be taken orally, and are much better tolerated. The treatment of superficial fungal infections is not discussed here.
FK 506 - An Investigational Immunosuppressant
The Medical Letter on Drugs and Therapeutics • October 4, 1991; (Issue 854)
FK 506 (Fujisawa), an immunosuppressant similar in activity to cyclosporine (Sandimmune - Medical Letter 25:77, 1983), is currently under investigation in the USA, Europe, and Japan for prevention of organ...
FK 506 (Fujisawa), an immunosuppressant similar in activity to cyclosporine (Sandimmune - Medical Letter 25:77, 1983), is currently under investigation in the USA, Europe, and Japan for prevention of organ transplant rejection.
Intravenous Ciprofloxacin
The Medical Letter on Drugs and Therapeutics • August 9, 1991; (Issue 850)
Ciprofloxacin, previously available orally (Cipro - Medical Letter, 30:11, 1988) and for ophthalmic use (Ciloxan - Medical Letter, 33:52, May 31, 1991), is now the first fluoroquinolone antibiotic to become...
Ciprofloxacin, previously available orally (Cipro - Medical Letter, 30:11, 1988) and for ophthalmic use (Ciloxan - Medical Letter, 33:52, May 31, 1991), is now the first fluoroquinolone antibiotic to become available in the USA in an intravenous (IV) formulation. Cipro I.V. (Miles) is being promoted as an alternative to third-generation cephalosporins, aminoglycosides, and other drugs used for treatment of serious infections.
Pravastatin And Simvastatin for Hypercholesterolemia
The Medical Letter on Drugs and Therapeutics • March 8, 1991; (Issue 839)
Pravastatin (Pravachol - Bristol-Myers Squibb) and simvastatin (Zocor - Merck), two new inhibitors of cholesterol synthesis similar to lovastatin (Mevacor - Merck), have been marketed in Canada and several...
Pravastatin (Pravachol - Bristol-Myers Squibb) and simvastatin (Zocor - Merck), two new inhibitors of cholesterol synthesis similar to lovastatin (Mevacor - Merck), have been marketed in Canada and several European countries and may soon be available in the USA for treatment of high plasma cholesterol concentrations. Drugs already marketed here for this indication were recently reviewed in The Medical Letter (Volume 33, page 1, January 11, 1991).
Choice Of Cholesterol-Lowering Drugs
The Medical Letter on Drugs and Therapeutics • January 11, 1991; (Issue 835)
Recent reports indicate that lowering elevated serum cholesterol concentrations not only decreases mortality from coronary artery disease, but may cause regression of atherosclerotic lesions (JP Kane et al,...
Recent reports indicate that lowering elevated serum cholesterol concentrations not only decreases mortality from coronary artery disease, but may cause regression of atherosclerotic lesions (JP Kane et al, JAMA, 264:3007, Dec 19, 1990). Most authorities advise patients with high cholesterol concentrations to eat less saturated and total fat and lose weight. If these measures do not lower serum lipids, drugs are frequently added to the regimen. When drugs are discontinued, serum cholesterol concentrations generally return to pretreatment levels.
Drugs for Treatment of Fungal Infections
The Medical Letter on Drugs and Therapeutics • June 15, 1990; (Issue 820)
...
Fluconazole
The Medical Letter on Drugs and Therapeutics • May 18, 1990; (Issue 818)
Fluconazole (Diflucan - Roerig), an antifungal azole, was recently approved by the US Food and Drug Administration for oral and intravenous (IV) treatment of cryptococcal meningitis and various forms of...
Fluconazole (Diflucan - Roerig), an antifungal azole, was recently approved by the US Food and Drug Administration for oral and intravenous (IV) treatment of cryptococcal meningitis and various forms of candidiasis. Both cryptococcal meningitis and candidiasis occur frequently in patients with AIDS, organ transplants, or cancer.
Octreotide - A Synthetic Somatostatin
The Medical Letter on Drugs and Therapeutics • July 14, 1989; (Issue 796)
Octreotide acetate (Sandostatin - Sandoz), a synthetic octapeptide that mimics the actions of somatostatin, was recently approved by the US Food and Drug Administration for symptomatic treatment of patients...
Octreotide acetate (Sandostatin - Sandoz), a synthetic octapeptide that mimics the actions of somatostatin, was recently approved by the US Food and Drug Administration for symptomatic treatment of patients with metastatic carcinoid or VIPomas (vasoactive intestinal peptide-secreting tumors).
Nicardipine - A New Calcium-Entry Blocker
The Medical Letter on Drugs and Therapeutics • May 5, 1989; (Issue 791)
Nicardipine (Cardene - Syntex), a dihydropyridine calcium-entry blocker structurally related to nifedipine (Procardia; Adalat), was recently approved by the US Food and Drug Administration for oral treatment...
Nicardipine (Cardene - Syntex), a dihydropyridine calcium-entry blocker structurally related to nifedipine (Procardia; Adalat), was recently approved by the US Food and Drug Administration for oral treatment of angina and hypertension. Advertisements for the drug claim that nicardipine is more vasoselective; than other calcium-channel blockers and does not depress myocardial contractility.
Diclofenac
The Medical Letter on Drugs and Therapeutics • December 2, 1988; (Issue 780)
Diclofenac sodium (Voltaren - Geigy), a nonsteroidal anti-inflammatory drug (NSAID) available in some countries since 1974, was recently introduced in the USA for treatment of rheumatoid arthritis,...
Diclofenac sodium (Voltaren - Geigy), a nonsteroidal anti-inflammatory drug (NSAID) available in some countries since 1974, was recently introduced in the USA for treatment of rheumatoid arthritis, osteoarthritis and ankylosing spondylitis. It is being promoted as 'The number one prescribed antiarthritic in the world.'
Choice of Cholesterol-Lowering Drugs
The Medical Letter on Drugs and Therapeutics • September 9, 1988; (Issue 774)
The recent surge of interest in lowering serum cholesterol concentrations has led to vigorous promotion of various hypocholesterolemic drugs in the USA. Since the risk of coronary heart disease is increased in...
The recent surge of interest in lowering serum cholesterol concentrations has led to vigorous promotion of various hypocholesterolemic drugs in the USA. Since the risk of coronary heart disease is increased in patients with high serum cholesterol concentrations, most authorities advise such patients to eat less fat and try to lose weight (The Expert Panel, Arch Intern Med, 148:36, 1988). When these measures fail, cholesterol-lowering drugs are frequently recommended.
Drugs For Treatment of Deep Fungal Infections
The Medical Letter on Drugs and Therapeutics • March 11, 1988; (Issue 761)
The incidence of opportunistic deep fungal infections continues to increase, particularly among patients who have AIDS, are taking immunosuppressive drugs, or are in intensive care...
The incidence of opportunistic deep fungal infections continues to increase, particularly among patients who have AIDS, are taking immunosuppressive drugs, or are in intensive care units.