Matching articles for "diclofenac"

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...
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 IntroductionHide 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 IntroductionHide Full Introduction

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

   
The Medical Letter on Drugs and Therapeutics • March 7, 2022;  (Issue 1645)
...
View the Comparison Table: Some Nonopioid Analgesics for Pain
Med Lett Drugs Ther. 2022 Mar 7;64(1645):e40-3 | Show Full IntroductionHide 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...
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 IntroductionHide 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...
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 IntroductionHide 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...
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 IntroductionHide 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-HT1F) 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 IntroductionHide 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 IntroductionHide 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...
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 IntroductionHide 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 IntroductionHide 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 IntroductionHide 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...
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 symptoms of GERD.
Med Lett Drugs Ther. 2018 Jan 15;60(1538):9-16 | Show Full IntroductionHide 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...
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 IntroductionHide Full Introduction

Ameluz for Actinic Keratoses

   
The Medical Letter on Drugs and Therapeutics • December 5, 2016;  (Issue 1509)
The FDA has approved a 10% nanoemulsion gel formulation of the porphyrin-based photosensitizer aminolevulinic acid hydrochloride (ALA; Ameluz – Biofrontera) for use in combination with a narrowband red...
The FDA has approved a 10% nanoemulsion gel formulation of the porphyrin-based photosensitizer aminolevulinic acid hydrochloride (ALA; Ameluz – Biofrontera) for use in combination with a narrowband red light photodynamic therapy (PDT) lamp (BF-RhodoLED) for treatment of actinic keratoses (AKs) of mild to moderate severity on the face and scalp. A 20% ALA solution (Levulan Kerastick) approved for use in combination with blue light PDT (BLU-U) has been available in the US since 2002.
Med Lett Drugs Ther. 2016 Dec 5;58(1509):155-6 | Show Full IntroductionHide 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 IntroductionHide 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 IntroductionHide 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 IntroductionHide 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...
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 IntroductionHide 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 IntroductionHide Full Introduction

In Brief: Low-Dose Indomethacin (Tivorbex) for Pain

   
The Medical Letter on Drugs and Therapeutics • July 21, 2014;  (Issue 1447)
The same pharmaceutical company (Iroko) that recently marketed low-dose diclofenac (Zorvolex) for treatment of mild to moderate acute pain1 has now received approval from the FDA to market a low-dose oral...
The same pharmaceutical company (Iroko) that recently marketed low-dose diclofenac (Zorvolex) for treatment of mild to moderate acute pain1 has now received approval from the FDA to market a low-dose oral formulation of indomethacin (Tivorbex) for the same indication. Tivorbex is available in 20- and 40-mg capsules; conventional immediate-release indomethacin capsules contain 25 mg and 50 mg of the drug.

The rationale for this new product is the same as the one offered for Zorvolex: the drug is formulated as submicron particles that increase surface area, leading to faster dissolution and absorption. According to the package insert, the time to reach peak serum concentrations (Tmax) was 1.67 hours with a 40-mg capsule of Tivorbex, compared to 2.02 hours with a standard 50-mg capsule of indomethacin.

The problem with Tivorbex is the same as the problem with Zorvolex: there are no studies comparing its efficacy to that of standard doses of indomethacin or to any other NSAID. In addition, indomethacin is generally considered one of the most potent NSAIDs and one of those most likely to cause GI bleeding, increase cardiovascular risk, and damage the kidneys. There is no good reason to use indomethacin in any dosage for treatment of mild to moderate pain.

  1. Low-dose diclofenac (Zorvolex) for pain. Med Lett Drugs Ther 2014; 56:19.


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Med Lett Drugs Ther. 2014 Jul 21;56(1447):64 | Show Full IntroductionHide 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 IntroductionHide 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 IntroductionHide 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...
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 IntroductionHide 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 IntroductionHide Full Introduction

Ingenol Mebutate (Picato) for Actinic Keratoses

   
The Medical Letter on Drugs and Therapeutics • April 30, 2012;  (Issue 1389)
The FDA has approved ingenol mebutate (Picato – Leo) for topical treatment of actinic keratoses (AKs). The new drug is derived from the sap of the Euphorbia peplus plant, a traditional folk remedy for...
The FDA has approved ingenol mebutate (Picato – Leo) for topical treatment of actinic keratoses (AKs). The new drug is derived from the sap of the Euphorbia peplus plant, a traditional folk remedy for warts and other skin lesions.
Med Lett Drugs Ther. 2012 Apr 30;54(1389):35-6 | Show Full IntroductionHide 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...
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 IntroductionHide 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...
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.
Treat Guidel Med Lett. 2009 May;7(81):37-46 | Show Full IntroductionHide 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 IntroductionHide Full Introduction

A Diclofenac Patch (Flector) for Pain

   
The Medical Letter on Drugs and Therapeutics • January 14, 2008;  (Issue 1277)
Diclofenac epolamine patch 1.3% (Flector Patch - Alpharma), a topical formulation of the nonsteroidal anti-inflammatory drug (NSAID) diclofenac, has been approved by the FDA for topical treatment of acute pain...
Diclofenac epolamine patch 1.3% (Flector Patch - Alpharma), a topical formulation of the nonsteroidal anti-inflammatory drug (NSAID) diclofenac, has been approved by the FDA for topical treatment of acute pain due to minor strains, sprains and contusions. It is the first topical NSAID patch approved in the US. A diclofenac patch has been used in Europe since 1993. Diclofenac sodium (Voltaren, and others) is available in the US as an oral tablet, in a 1% gel for treatment of osteoarthritis (to be reviewed in a future issue), in a 3% gel (Solaraze) for treatment of actinic keratoses, and in an ophthalmic formulation.
Med Lett Drugs Ther. 2008 Jan 14;50(1277):1-2 | Show Full IntroductionHide 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...
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 IntroductionHide 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...
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 IntroductionHide Full Introduction

Dangerous Drugs

   
The Medical Letter on Drugs and Therapeutics • December 6, 2004;  (Issue 1197)
At a US Senate hearing prompted by the withdrawal of Vioxx, an FDA officer cited 5 drugs as potentially dangerous. It may be useful to revisit Medical Letter reviews of these...
At a US Senate hearing prompted by the withdrawal of Vioxx, an FDA officer cited 5 drugs as potentially dangerous. It may be useful to revisit Medical Letter reviews of these drugs.
Med Lett Drugs Ther. 2004 Dec 6;46(1197):97 | Show Full IntroductionHide 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...
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 IntroductionHide 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 IntroductionHide 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)...
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 IntroductionHide 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...
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 IntroductionHide Full Introduction

Imiquimod (Aldara) for Actinic Keratoses

   
The Medical Letter on Drugs and Therapeutics • May 24, 2004;  (Issue 1183)
Imiquimod cream 5% (Aldara - 3M), an immune modifier previously approved for treatment of genital and perianal warts (Medical Letter 1997; 39:118), has now been approved by the FDA for treatment of actinic...
Imiquimod cream 5% (Aldara - 3M), an immune modifier previously approved for treatment of genital and perianal warts (Medical Letter 1997; 39:118), has now been approved by the FDA for treatment of actinic keratoses (AKs) on the face or scalp, and may also be approved soon for treatment of basal cell carcinoma. It produces apoptosis in malignant, but not normal, human keratinocytes (M Sch÷n et al, J Natl Cancer Inst 2003; 95:1138).
Med Lett Drugs Ther. 2004 May 24;46(1183):42-4 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 2003 Jun 8;45(1158):46-8 | Show Full IntroductionHide 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...
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 IntroductionHide Full Introduction

New Treatments for Actinic Keratoses

   
The Medical Letter on Drugs and Therapeutics • June 24, 2002;  (Issue 1133)
Several new treatments are now available for actinic keratoses (AKs), scaly pink papules commonly found on sun-exposed areas of the face, scalp, forearms and dorsal surface of the hands, particularly in the...
Several new treatments are now available for actinic keratoses (AKs), scaly pink papules commonly found on sun-exposed areas of the face, scalp, forearms and dorsal surface of the hands, particularly in the elderly. Some AKs regress spontaneously, but a few may progress to squamous cell carcinoma; the risk of progression has been estimated to be about 0.25% to 1% per year (EWB Jeffes III and EH Tang, Am J Clin Dermatol 2000; 1:167).
Med Lett Drugs Ther. 2002 Jun 24;44(1133):57-8 | Show Full IntroductionHide Full Introduction

Cardiovascular Safety of Cox-2 Inhibitors

   
The Medical Letter on Drugs and Therapeutics • November 12, 2001;  (Issue 1118)
Related Articles Since Publication Increasing use of rofecoxib (Vioxx) and celecoxib (Celebrex), both selective inhibitors of cyclooxygenase-2 (COX-2), for treatment of arthristis has been accompanied by...

Related Articles Since Publication

Increasing use of rofecoxib (Vioxx) and celecoxib (Celebrex), both selective inhibitors of cyclooxygenase-2 (COX-2), for treatment of arthristis has been accompanied by concerns that they may increase risk of thrombotic cardiovascular events.
Med Lett Drugs Ther. 2001 Nov 12;43(1118):99-100 | Show Full IntroductionHide 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...
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 IntroductionHide Full Introduction

Pantroprazole (Protonix)

   
The Medical Letter on Drugs and Therapeutics • July 24, 2000;  (Issue 1083)
Pantoprazole, the fourth benzimidazole proton pump inhibitor to become available in the United States, has been marketed for short-term oral treatment of erosive gastroesophageal reflux disease...
Pantoprazole, the fourth benzimidazole proton pump inhibitor to become available in the United States, has been marketed for short-term oral treatment of erosive gastroesophageal reflux disease (GERD).
Med Lett Drugs Ther. 2000 Jul 24;42(1083):65-6 | Show Full IntroductionHide 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...
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 IntroductionHide 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 IntroductionHide 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 IntroductionHide Full Introduction

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

Celecoxib for Arthritis

   
The Medical Letter on Drugs and Therapeutics • January 29, 1999;  (Issue 1045)
Celecoxib, a selective COX-2 inhibitor, has been approved by the FDA for treatment of osteoarthritis and rheumatoid...
Celecoxib, a selective COX-2 inhibitor, has been approved by the FDA for treatment of osteoarthritis and rheumatoid arthritis.
Med Lett Drugs Ther. 1999 Jan 29;41(1045):11-2 | Show Full IntroductionHide Full Introduction

New Drugs for Rheumatoid Arthritis

   
The Medical Letter on Drugs and Therapeutics • November 20, 1998;  (Issue 1040)
Leflunomide (Arava - Hoechst Marion Roussel), which inhibits pyrimidine synthesis, and etanercept (Enbrel - Immunex/Wyeth-Ayerst), which blocks the action of tumor necrosis factor (TNF), have been approved by...
Leflunomide (Arava - Hoechst Marion Roussel), which inhibits pyrimidine synthesis, and etanercept (Enbrel - Immunex/Wyeth-Ayerst), which blocks the action of tumor necrosis factor (TNF), have been approved by the FDA for treatment of rheumatoid arthritis. A third drug, infliximab (Remicade - Centocor), which also blocks TNF and has been used to treat rheumatoid arthritis, was approved earlier for treatment of Crohn's disease. Its use in Crohn's disease will be reviewed in a future issue.
Med Lett Drugs Ther. 1998 Nov 20;40(1040):110-2 | Show Full IntroductionHide 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...
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 IntroductionHide 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 IntroductionHide 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 IntroductionHide 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 IntroductionHide 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 IntroductionHide 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...
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 IntroductionHide Full Introduction

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.'
Med Lett Drugs Ther. 1988 Dec 2;30(780):109-11 | Show Full IntroductionHide Full Introduction