Matching articles for "carbamazepine"

Comparison Table: Some Oral Antiseizure Medications (online only)

   
The Medical Letter on Drugs and Therapeutics • August 5, 2024;  (Issue 1708)
...
View the Comparison Table: Some Oral Antiseizure Medications
Med Lett Drugs Ther. 2024 Aug 5;66(1708):e133-40 | Show Full IntroductionHide Full Introduction

Drugs for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • August 5, 2024;  (Issue 1708)
When used for the appropriate seizure type, antiseizure medications (ASMs) are roughly equivalent in efficacy. In addition to the seizure type, the choice of drug is usually based on factors such as ease of...
When used for the appropriate seizure type, antiseizure medications (ASMs) are roughly equivalent in efficacy. In addition to the seizure type, the choice of drug is usually based on factors such as ease of use, spectrum of activity, adverse effects, interactions with other drugs, presence of comorbid conditions, suitability for elderly persons and those with childbearing potential, and cost. Treatment should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures persist, expert clinicians generally try at least one and sometimes a second alternative drug as monotherapy before considering use of two drugs at the same time.
Med Lett Drugs Ther. 2024 Aug 5;66(1708):121-8 | Show Full IntroductionHide Full Introduction

Iloperidone (Fanapt) — A New Indication for Bipolar Disorder

   
The Medical Letter on Drugs and Therapeutics • July 22, 2024;  (Issue 1707)
The oral second-generation antipsychotic drug iloperidone (Fanapt – Vanda) has been approved by the FDA for acute treatment of manic or mixed episodes associated with bipolar I disorder in adults. First...
The oral second-generation antipsychotic drug iloperidone (Fanapt – Vanda) has been approved by the FDA for acute treatment of manic or mixed episodes associated with bipolar I disorder in adults. First approved in 2009 for treatment of schizophrenia, iloperidone is the eighth second-generation antipsychotic to be approved for acute treatment of manic or mixed episodes of bipolar I disorder (see Table 1).
Med Lett Drugs Ther. 2024 Jul 22;66(1707):115-6 | Show Full IntroductionHide Full Introduction

Gepirone (Exxua) for Depression

   
The Medical Letter on Drugs and Therapeutics • June 24, 2024;  (Issue 1705)
The FDA has approved an oral extended-release formulation of gepirone (Exxua – Fabre-Kramer), a selective 5-HT1A receptor agonist, for treatment of major depressive disorder (MDD) in adults. Gepirone was...
The FDA has approved an oral extended-release formulation of gepirone (Exxua – Fabre-Kramer), a selective 5-HT1A receptor agonist, for treatment of major depressive disorder (MDD) in adults. Gepirone was originally developed decades ago for treatment of anxiety and depression, but it was not approved by the FDA for such use. Gepirone is structurally related to buspirone, which is FDA-approved for treatment of anxiety.
Med Lett Drugs Ther. 2024 Jun 24;66(1705):97-9 | Show Full IntroductionHide Full Introduction

Drugs for Bipolar Disorder

   
The Medical Letter on Drugs and Therapeutics • April 1, 2024;  (Issue 1699)
Bipolar disorder is characterized by episodes of mania, hypomania, and depression. Recurrences of manic or (more frequently) depressive symptoms are common. About 15-20% of patients with bipolar disorder...
Bipolar disorder is characterized by episodes of mania, hypomania, and depression. Recurrences of manic or (more frequently) depressive symptoms are common. About 15-20% of patients with bipolar disorder die by suicide.
Med Lett Drugs Ther. 2024 Apr 1;66(1699):49-54 | 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

Cenobamate (Xcopri) for Focal Seizures

   
The Medical Letter on Drugs and Therapeutics • August 24, 2020;  (Issue 1605)
The FDA has approved cenobamate (Xcopri – SK Life Science) for oral treatment of partial-onset (focal) seizures in...
The FDA has approved cenobamate (Xcopri – SK Life Science) for oral treatment of partial-onset (focal) seizures in adults.
Med Lett Drugs Ther. 2020 Aug 24;62(1605):134-6 | 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

Drugs for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • July 31, 2017;  (Issue 1526)
Treatment of epilepsy should begin with a single antiepileptic drug (AED), increasing its dosage gradually until seizures are controlled or adverse effects become intolerable. If seizures...
Treatment of epilepsy should begin with a single antiepileptic drug (AED), increasing its dosage gradually until seizures are controlled or adverse effects become intolerable. If seizures persist, specialists generally recommend trying at least one and sometimes a second alternative drug as monotherapy before considering use of two drugs concurrently. When used for the appropriate seizure type, AEDs are roughly equivalent in efficacy. Drug choice is usually based on factors such as ease of use, adverse effects, drug interactions, presence of comorbidities, and cost.
Med Lett Drugs Ther. 2017 Jul 31;59(1526):121-30 | Show Full IntroductionHide Full Introduction

Comparison Table: Some Oral Antiepileptic Drugs (online only)

   
The Medical Letter on Drugs and Therapeutics • July 31, 2017;  (Issue 1526)
...
View the Comparison Table: Some Oral Antiepileptic Drugs
Med Lett Drugs Ther. 2017 Jul 31;59(1526):e130-6 | Show Full IntroductionHide Full Introduction

Drugs for Bipolar Disorder

   
The Medical Letter on Drugs and Therapeutics • August 15, 2016;  (Issue 1501)
Bipolar disorder is characterized by intermittent episodes of mania and/or depression. Even with maintenance treatment, recurrences of manic or (more frequently) depressive episodes are common. Some of the...
Bipolar disorder is characterized by intermittent episodes of mania and/or depression. Even with maintenance treatment, recurrences of manic or (more frequently) depressive episodes are common. Some of the drugs and dosages recommended here have not been approved by the FDA for use in bipolar disorder.
Med Lett Drugs Ther. 2016 Aug 15;58(1501):103-6 | Show Full IntroductionHide Full Introduction

Drugs for Hypothyroidism

   
The Medical Letter on Drugs and Therapeutics • October 26, 2015;  (Issue 1480)
Primary hypothyroidism is usually the result of Hashimoto's thyroiditis, thyroidectomy, or radioactive iodine therapy. Treatment of hypothyroidism with replacement doses of thyroid hormone is...
Primary hypothyroidism is usually the result of Hashimoto's thyroiditis, thyroidectomy, or radioactive iodine therapy. Treatment of hypothyroidism with replacement doses of thyroid hormone is usually lifelong. Levothyroxine is the drug of choice.
Med Lett Drugs Ther. 2015 Oct 26;57(1480):147-50 | Show Full IntroductionHide Full Introduction

Treatment of Atrial Fibrillation

   
The Medical Letter on Drugs and Therapeutics • July 7, 2014;  (Issue 1446)
The treatment of atrial fibrillation includes anticoagulation, rate control, and rhythm control. New US guidelines for the management of atrial fibrillation have recently been...
The treatment of atrial fibrillation includes anticoagulation, rate control, and rhythm control. New US guidelines for the management of atrial fibrillation have recently been published.
Med Lett Drugs Ther. 2014 Jul 7;56(1446):53-8 | Show Full IntroductionHide Full Introduction

Perampanel (Fycompa) for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • February 3, 2014;  (Issue 1435)
Perampanel (per am’ pa nel; Fycompa – Eisai), a first-in-class noncompetitive AMPA receptor antagonist, has been approved by the FDA for adjunctive treatment of partial-onset seizures in patients ≥12...
Perampanel (per am’ pa nel; Fycompa – Eisai), a first-in-class noncompetitive AMPA receptor antagonist, has been approved by the FDA for adjunctive treatment of partial-onset seizures in patients ≥12 years old. New drugs for epilepsy are often initially approved by the FDA as adjunctive treatment for partial seizures.
Med Lett Drugs Ther. 2014 Feb 3;56(1435):9-10 | Show Full IntroductionHide Full Introduction

Drugs for Psychiatric Disorders

   
The Medical Letter on Drugs and Therapeutics • June 1, 2013;  (Issue 130)
Drugs are not the only treatment for psychiatric illness. Psychotherapy remains an important component in the management of these disorders, and cognitive behavioral therapy (CBT) can be used for many...
Drugs are not the only treatment for psychiatric illness. Psychotherapy remains an important component in the management of these disorders, and cognitive behavioral therapy (CBT) can be used for many of them as well. Electroconvulsive therapy (ECT) has a long history of efficacy and safety when drugs are ineffective or cannot be used.
Treat Guidel Med Lett. 2013 Jun;11(130):53-64 | 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 Epilepsy

   
The Medical Letter on Drugs and Therapeutics • February 1, 2013;  (Issue 126)
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures persist, expert clinicians...
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures persist, expert clinicians generally prescribe at least one and sometimes a second alternative drug as monotherapy before considering use of two drugs at the same time. When used for the appropriate seizure type, antiepileptic drugs are roughly equivalent in efficacy. The choice of drug is usually based on factors such as ease of use, adverse effects, interactions with other drugs, presence of comorbid conditions and cost.
Treat Guidel Med Lett. 2013 Feb;11(126):9-18 | Show Full IntroductionHide Full Introduction

Ezogabine (Potiga) for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • August 20, 2012;  (Issue 1397)
The FDA has approved ezogabine (ee-ZOE-ga-been; Potiga – GSK/Valeant) for oral adjunctive treatment of partial-onset seizures in adults. Ezogabine is available in Europe as retigabine...
The FDA has approved ezogabine (ee-ZOE-ga-been; Potiga – GSK/Valeant) for oral adjunctive treatment of partial-onset seizures in adults. Ezogabine is available in Europe as retigabine (Trobalt).
Med Lett Drugs Ther. 2012 Aug 20;54(1397):65-7 | Show Full IntroductionHide Full Introduction

Drugs for Treatment of ADHD

   
The Medical Letter on Drugs and Therapeutics • May 1, 2011;  (Issue 105)
Attention-deficit/hyperactivity disorder (ADHD) is a disruptive behavior disorder that occurs in about 5% of school-age children, most often in boys, and frequently persists into young...
Attention-deficit/hyperactivity disorder (ADHD) is a disruptive behavior disorder that occurs in about 5% of school-age children, most often in boys, and frequently persists into young adulthood.
Treat Guidel Med Lett. 2011 May;9(105):23-8 | Show Full IntroductionHide Full Introduction

Drugs for Depression and Bipolar Disorder

   
The Medical Letter on Drugs and Therapeutics • May 1, 2010;  (Issue 93)
Drugs are not the only treatment for mood disorders. Psychotherapy remains an important component in the management of these disorders, and electroconvulsive therapy (ECT) has a long history of efficacy and...
Drugs are not the only treatment for mood disorders. Psychotherapy remains an important component in the management of these disorders, and electroconvulsive therapy (ECT) has a long history of efficacy and safety when drugs are ineffective, poorly tolerated or cannot be used. Some drugs are recommended here for indications that have not been approved by the FDA.
Treat Guidel Med Lett. 2010 May;8(93):35-42 | 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

Vigabatrin (Sabril) for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • February 22, 2010;  (Issue 1332)
The FDA has approved vigabatrin (vye gá ba trin; Sabril – Lundbeck) for oral use as add-on therapy for complex partial seizures in adults who are refractory to several antiepileptic drugs and as monotherapy...
The FDA has approved vigabatrin (vye gá ba trin; Sabril – Lundbeck) for oral use as add-on therapy for complex partial seizures in adults who are refractory to several antiepileptic drugs and as monotherapy for infantile spasms. Vigabatrin has been available in other countries for many years. Because of its potential for retinal toxicity, it will be available in the US only through a restricted distribution program called SHARE (Support, Help and Resources for Epilepsy). Prescribers and pharmacists distributing the drug must register, and patients must undergo visual field testing.
Med Lett Drugs Ther. 2010 Feb 22;52(1332):14-6 | Show Full IntroductionHide Full Introduction

Antifungal Drugs

   
The Medical Letter on Drugs and Therapeutics • December 1, 2009;  (Issue 88)
The drugs of choice for treatment of some fungal infections are listed. Some of the indications and dosages recommended here have not been approved by the FDA. More detailed guidelines are available online from...
The drugs of choice for treatment of some fungal infections are listed. Some of the indications and dosages recommended here have not been approved by the FDA. More detailed guidelines are available online from the Infectious Diseases Society of America (www.idsociety.org).
Treat Guidel Med Lett. 2009 Dec;7(88):95-102 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 2009 Nov 30;51(1326):95-6 | Show Full IntroductionHide Full Introduction

Dronedarone (Multaq) for Atrial Fibrillation

   
The Medical Letter on Drugs and Therapeutics • October 5, 2009;  (Issue 1322)
Dronedarone (Multaq - Sanofi-Aventis) has been approved by the FDA for oral treatment of atrial fibrillation and flutter. Amiodarone (Cordarone, and others) is the most effective drug for this indication, but...
Dronedarone (Multaq - Sanofi-Aventis) has been approved by the FDA for oral treatment of atrial fibrillation and flutter. Amiodarone (Cordarone, and others) is the most effective drug for this indication, but has considerable toxicity.
Med Lett Drugs Ther. 2009 Oct 5;51(1322):78-80 | Show Full IntroductionHide Full Introduction

Drugs for Thyroid Disorders

   
The Medical Letter on Drugs and Therapeutics • August 1, 2009;  (Issue 84)
Primary hypothyroidism is usually the result of Hashimoto's thyroiditis, thyroidectomy for hyperthyroidism, goiter or cancer, or radioactive iodine therapy for...
Primary hypothyroidism is usually the result of Hashimoto's thyroiditis, thyroidectomy for hyperthyroidism, goiter or cancer, or radioactive iodine therapy for hyperthyroidism.
Treat Guidel Med Lett. 2009 Aug;7(84):57-64 | Show Full IntroductionHide Full Introduction

Lacosamide for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • June 29, 2009;  (Issue 1315)
The FDA has approved lacosamide (Vimpat - UCB Pharma) for oral or intravenous (IV) use as add-on therapy in adults with partial-onset...
The FDA has approved lacosamide (Vimpat - UCB Pharma) for oral or intravenous (IV) use as add-on therapy in adults with partial-onset seizures.
Med Lett Drugs Ther. 2009 Jun 29;51(1315):50-2 | Show Full IntroductionHide Full Introduction

Rufinamide (Banzel) for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • March 9, 2009;  (Issue 1307)
Rufinamide (Banzel - Eisai), a triazole derivative structurally unrelated to other marketed antiepileptic drugs (AEDs), has been approved by the FDA for treatment of seizures associated with Lennox-Gastaut...
Rufinamide (Banzel - Eisai), a triazole derivative structurally unrelated to other marketed antiepileptic drugs (AEDs), has been approved by the FDA for treatment of seizures associated with Lennox-Gastaut syndrome (LGS) in patients ≥4 years old.
Med Lett Drugs Ther. 2009 Mar 9;51(1307):18-20 | Show Full IntroductionHide Full Introduction

Correction: Bendamustine (Treanda) for CLL and NHL

   
The Medical Letter on Drugs and Therapeutics • December 1, 2008;  (Issue 1300)
(Med Lett Drugs Ther 2008; 50:91) In the Clinical Studies section, the complete response rate with chlorambucil for CLL was 2% (not...
(Med Lett Drugs Ther 2008; 50:91) In the Clinical Studies section, the complete response rate with chlorambucil for CLL was 2% (not 24%).
Med Lett Drugs Ther. 2008 Dec 1;50(1300):96 | Show Full IntroductionHide Full Introduction

Bendamustine (Treanda) for CLL and NHL

   
The Medical Letter on Drugs and Therapeutics • November 17, 2008;  (Issue 1299)
Bendamustine HCl (Treanda - Cephalon), an unusual DNA-alkylating agent that has been used in Europe for many years to treat lymphoma, has now been approved by the FDA for treatment of chronic lymphocytic...
Bendamustine HCl (Treanda - Cephalon), an unusual DNA-alkylating agent that has been used in Europe for many years to treat lymphoma, has now been approved by the FDA for treatment of chronic lymphocytic leukemia (CLL) and non-Hodgkin's lymphoma (NHL).
Med Lett Drugs Ther. 2008 Nov 17;50(1299):91-2 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 2008 Oct 20;50(1297):83-4 | Show Full IntroductionHide Full Introduction

Drugs for Tobacco Dependence

   
The Medical Letter on Drugs and Therapeutics • September 1, 2008;  (Issue 73)
Peptic ulcers caused by treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) are mainly gastric ulcers. The greater the number of office visits and the longer the counseling time, the higher the smoking...
Peptic ulcers caused by treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) are mainly gastric ulcers. The greater the number of office visits and the longer the counseling time, the higher the smoking cessation rates have been.
Treat Guidel Med Lett. 2008 Sep;6(73):61-5 | Show Full IntroductionHide Full Introduction

Addendum: Warfarin-Acetaminophen Interaction

   
The Medical Letter on Drugs and Therapeutics • June 16, 2008;  (Issue 1288)
A reader expressed disappointment that our recent listing of “Some Warfarin Drug Interactions”1 did not include acetaminophen. Perhaps it should have. Acetaminophen can increase the anticoagulant effect of...
A reader expressed disappointment that our recent listing of “Some Warfarin Drug Interactions”1 did not include acetaminophen. Perhaps it should have. Acetaminophen can increase the anticoagulant effect of warfarin, particularly with continued use, but it does so inconsistently. The mechanism of this interaction has not been established, but may be related to an acetaminophen metabolite inhibiting vitamin K-epoxide reductase, the target for warfarin’s anticoagulant effect.2

Patient susceptibility varies, possibly on a genetic basis; occasional use of acetaminophen generally has little or no effect on the international normalized ratio (INR) in patients on chronic warfarin therapy, but in some, even a few grams of the drug may cause a dramatic increase in INR. One study in healthy subjects found no effect of acetaminophen 4 g per day for 2 weeks, while another study in patients with the same acetaminophen dose for the same period of time found a moderate increase in INR.3,4 It might be prudent to monitor INR in patients on chronic warfarin therapy more closely than usual when they take more than 2 g per day of acetaminophen for more than a few days.

1. Pharmacogenetic-based dosing of warfarin. Med Lett Drugs Ther 2008; 50:39.
2. HH Thijssen et al. Paracetamol (acetaminophen) warfarin interaction: NAPQI, the toxic metabolite of paracetamol, is an inhibitor of enzymes in the vitamin K cycle. Thromb Haemost 2004; 92:797.
3. D Kwan et al. The effects of acetaminophen on pharmacokinetics and pharmacodynamics of warfarin. J Clin Pharmacol 1999; 39:68.
4. I Mahe et al. Paracetamol: A haemorrhagic risk factor in patients on warfarin. Br J Clin Pharmacol 2005; 59:371.

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Med Lett Drugs Ther. 2008 Jun 16;50(1288):45 | Show Full IntroductionHide Full Introduction

Drugs for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • June 1, 2008;  (Issue 70)
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures continue and further dosage increases...
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures continue and further dosage increases appear inadvisable because of adverse effects, most Medical Letter consultants generally prescribe at least one and sometimes a second alternative drug as monotherapy before considering use of two drugs at the same time. Most antiepileptic drugs initially approved by the FDA only as adjunctive therapy for partial seizures may also be effective for other types of seizures and as monotherapy. Studies suggest that when used for the appropriate seizure type, antiepileptic drugs are roughly equivalent in efficacy. The choice of a drug is usually based on factors such as ease of use, adverse effects and cost.
Treat Guidel Med Lett. 2008 Jun;6(70):37-46 | Show Full IntroductionHide Full Introduction

Pharmacogenetic-Based Dosing of Warfarin

   
The Medical Letter on Drugs and Therapeutics • May 19, 2008;  (Issue 1286)
Warfarin sodium (Coumadin, and others) and other coumarin anticoagulants prevent thrombosis, but patient response is highly variable and overanticoagulation can lead to hemorrhage. Genotyping patients for...
Warfarin sodium (Coumadin, and others) and other coumarin anticoagulants prevent thrombosis, but patient response is highly variable and overanticoagulation can lead to hemorrhage. Genotyping patients for single nucleotide polymorphisms (SNPs) that affect coumarin metabolism and sensitivity may help clinicians estimate the therapeutic warfarin dose. The FDA has added a note to warfarin labeling recommending lowrange doses for patients with such genetic variations. Commercial tests for these variants are now available and cost about $500 per test.
Med Lett Drugs Ther. 2008 May 19;50(1286):39-40 | Show Full IntroductionHide Full Introduction

In Brief: Genetic Test for Carbamazepine-Induced Stevens-Johnson Syndrome

   
The Medical Letter on Drugs and Therapeutics • April 21, 2008;  (Issue 1284)
Genetic Test for Carbamazepine-Induced Stevens-Johnson Syndrome Carbamazepine (Tegretol, Carbatrol, Equetro, and others), which is now used to treat not only epilepsy but also trigeminal neuralgia and manic...
Genetic Test for Carbamazepine-Induced Stevens-Johnson Syndrome Carbamazepine (Tegretol, Carbatrol, Equetro, and others), which is now used to treat not only epilepsy but also trigeminal neuralgia and manic episodes in patients with bipolar disorder,1 is a known cause of Stevens-Johnson syndrome (SJS). The incidence of carbamazepine-induced SJS in countries with mainly white populations is 1 to 6 per 10,000 new users of the drug, but Asian patients have a 10-fold higher incidence of this reaction. An association has been found between the human leukocyte antigen (HLA)-B*1502 allele and carbamazepine-induced SJS in a Chinese population.2 This allele occurs almost exclusively in Asians.3,4 The FDA is now recommending that Asian patients be tested for genetic susceptibility to carbamazepine-induced SJS before starting the drug. The genetic test should be available in most clinical chemistry labs.

1. Extended-release carbamazepine (Equetro) for bipolar disorder. Med Lett Drugs Ther 2005; 47:27.
2. WH Chung et al. Medical genetics: a marker for Stevens- Johnson syndrome. Nature 2004; 428:486.
3. C Lonjou et al. A marker for Stevens-Johnson syndrome. . . : ethnicity matters. Pharmacogenomics J 2006; 6:265.
4. A Alfirevic et al. HLA-B locus in Caucasian patients with carbamazepine hypersensitivity. Pharmacogenomics 2006; 7:813.

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Med Lett Drugs Ther. 2008 Apr 21;50(1284):29 | Show Full IntroductionHide Full Introduction

Antifungal Drugs

   
The Medical Letter on Drugs and Therapeutics • January 1, 2008;  (Issue 65)
The drugs of choice for treatment of some fungal infections are listed in the tables. Some of the indications and dosages recommended here have not been approved by the FDA. Other guidelines are available from...
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).
Treat Guidel Med Lett. 2008 Jan;6(65):1-8 | Show Full IntroductionHide Full Introduction

Drugs for Psychiatric Disorders

   
The Medical Letter on Drugs and Therapeutics • June 1, 2006;  (Issue 46)
Drugs are not the only treatment for psychiatric illness. Psychotherapy remains an important component in the management of these disorders, and cognitive behavioral therapy (CBT) is used for many of them as...
Drugs are not the only treatment for psychiatric illness. Psychotherapy remains an important component in the management of these disorders, and cognitive behavioral therapy (CBT) is used for many of them as well. Electroconvulsive therapy (ECT) has a long history of efficacy and safety when drugs are ineffective or cannot be used.
Treat Guidel Med Lett. 2006 Jun;4(46):35-46 | Show Full IntroductionHide Full Introduction

Drugs for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • November 1, 2005;  (Issue 39)
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures continue and further dosage increases...
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures continue and further dosage increases appear inadvisable because of adverse effects, most Medical Letter consultants generally prescribe at least one and sometimes a second alternative drug as monotherapy before considering use of two drugs at the same time. Most antiepileptic drugs initially approved by the FDA only as adjunctive therapy for partial seizures may also be effective for other types of seizures and as monotherapy.
Treat Guidel Med Lett. 2005 Nov;3(39):75-82 | Show Full IntroductionHide Full Introduction

Pregabalin (Lyrica) for Neuropathic Pain and Epilepsy

   
The Medical Letter on Drugs and Therapeutics • September 12, 2005;  (Issue 1217)
Pregabalin (Lyrica - Pfizer), a structural analog of gamma-aminobutyric acid (GABA) similar to gabapentin (Neurontin - Pfizer, and others), which recently became available generically, has been approved by the...
Pregabalin (Lyrica - Pfizer), a structural analog of gamma-aminobutyric acid (GABA) similar to gabapentin (Neurontin - Pfizer, and others), which recently became available generically, has been approved by the FDA for treatment of neuropathic pain associated with postherpetic neuralgia (PHN) and diabetic peripheral neuropathy (DPN), and for adjunctive treatment of partial onset seizures in adults with epilepsy.
Med Lett Drugs Ther. 2005 Sep 12;47(1217):75-6 | Show Full IntroductionHide Full Introduction

Duloxetine (Cymbalta) for Diabetic Neuropathic Pain

   
The Medical Letter on Drugs and Therapeutics • August 15, 2005;  (Issue 1215)
Duloxetine hydrochloride (Cymbalta - Lilly), a selective serotonin and norepinephrine reuptake inhibitor (SNRI) available for treatment of depression, has also been approved by the FDA for treatment of...
Duloxetine hydrochloride (Cymbalta - Lilly), a selective serotonin and norepinephrine reuptake inhibitor (SNRI) available for treatment of depression, has also been approved by the FDA for treatment of neuropathic pain associated with diabetic peripheral neuropathy (DPN). Duloxetine is one of two drugs approved specifically for management of neuropathic pain due to diabetes; the other, pregabalin (Lyrica - Pfizer), will be marketed soon and will be reviewed in the next issue of The Medical Letter.
Med Lett Drugs Ther. 2005 Aug 15;47(1215):67-8 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 2005 Jul 4;47(1212):54-5 | Show Full IntroductionHide Full Introduction

Erlotinib (Tarceva) for Advanced Non-Small Cell Lung Cancer

   
The Medical Letter on Drugs and Therapeutics • March 28, 2005;  (Issue 1205)
Erlotinib (Tarceva) is the second oral epidermal growth factor receptor (EGFR) inhibitor to become available in the US for treatment of advanced refractory NSCLC. In clinical trials, erlotinib produced a...
Erlotinib (Tarceva) is the second oral epidermal growth factor receptor (EGFR) inhibitor to become available in the US for treatment of advanced refractory NSCLC. In clinical trials, erlotinib produced a response rate of only 8.9%, but increased median survival from 4.7 to 6.7 months. Patients who had never smoked and those with EGFR-positive tumors survived longer. Erlotinib is generally well tolerated; diarrhea and rash are the most common adverse effects.
Med Lett Drugs Ther. 2005 Mar 28;47(1205):25-6 | Show Full IntroductionHide Full Introduction

Extended-Release Carbamazepine (Equetro) for Bipolar Disorder

   
The Medical Letter on Drugs and Therapeutics • March 28, 2005;  (Issue 1205)
An extended-release formulation of carbamazepine, available since 1997 for treatment of epilepsy, has now been approved under a new name, Equetro, for acute mania and mixed episodes of bipolar disorder....
An extended-release formulation of carbamazepine, available since 1997 for treatment of epilepsy, has now been approved under a new name, Equetro, for acute mania and mixed episodes of bipolar disorder. Although the drug was effective in some patients for up to 6 months, it has not been approved for maintenance treatment. Carbamazepine has not been shown to be more effective than lithium or valproate, and it can cause serious adverse effects.
Med Lett Drugs Ther. 2005 Mar 28;47(1205):27-8 | Show Full IntroductionHide Full Introduction

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.
Treat Guidel Med Lett. 2005 Feb;3(30):7-14 | Show Full IntroductionHide Full Introduction

Topiramate (Topamax) for Prevention of Migraine

   
The Medical Letter on Drugs and Therapeutics • January 31, 2005;  (Issue 1201)
Patients with frequent, severe or disabling migraine headaches may benefit from taking a drug to prevent the attacks. Beta-blockers traditionally have been the prophylactic treatment of choice, but in recent...
Patients with frequent, severe or disabling migraine headaches may benefit from taking a drug to prevent the attacks. Beta-blockers traditionally have been the prophylactic treatment of choice, but in recent years some antiepileptic drugs such as valproate (Depakote, and others) and topiramate (Topamax) have also been used for this indication. Valproate was approved by the FDA for such use in 1996. Now topiramate has also been approved.
Med Lett Drugs Ther. 2005 Jan 31;47(1201):9-10 | Show Full IntroductionHide Full Introduction

Alprazolam (Xanax, and others) Revisited

   
The Medical Letter on Drugs and Therapeutics • January 17, 2005;  (Issue 1200)
Alprazolam, a short-acting benzodiazepine, is one of the most widely prescribed drugs in the US. It is approved by the FDA for treatment of anxiety and panic disorder. An extended-release formulation, Xanax XR,...
Alprazolam, a short-acting benzodiazepine, is one of the most widely prescribed drugs in the US. It is approved by the FDA for treatment of anxiety and panic disorder. An extended-release formulation, Xanax XR, which can be taken once a day, recently became available for panic disorder.
Med Lett Drugs Ther. 2005 Jan 17;47(1200):5-7 | Show Full IntroductionHide Full Introduction

Telithromycin (Ketek) for Respiratory Infections

   
The Medical Letter on Drugs and Therapeutics • August 16, 2004;  (Issue 1189)
Telithromycin (Ketek - Aventis) has been approved by the FDA for oral treatment of mild to moderate community-acquired pneumonia, acute exacerbations of chronic bronchitis and acute bacterial sinusitis in...
Telithromycin (Ketek - Aventis) has been approved by the FDA for oral treatment of mild to moderate community-acquired pneumonia, acute exacerbations of chronic bronchitis and acute bacterial sinusitis in patients age 18 and older. The drug is the first in a new class of antibiotics, the ketolides, derived from the macrolide erythromycin. Telithromycin has been marketed in Europe since 2001.
Med Lett Drugs Ther. 2004 Aug 16;46(1189):66-8 | 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

Gabapentin (Neurontin) for Chronic Pain

   
The Medical Letter on Drugs and Therapeutics • April 12, 2004;  (Issue 1180)
Gabapentin (Neurontin - Pfizer), which has been available in the US since 1994, is approved by the FDA only for treatment of partial epilepsy and postherpetic neuralgia, but is widely used off-label for a...
Gabapentin (Neurontin - Pfizer), which has been available in the US since 1994, is approved by the FDA only for treatment of partial epilepsy and postherpetic neuralgia, but is widely used off-label for a number of other indications, especially neuropathic pain syndromes. According to one report, among Medicaid recipients in Florida receiving gabapentin, 71% of prescriptions were for chronic pain and 8% for seizures and neuralgia ("The Pink Sheet" February 2, 2004; 66:30).
Med Lett Drugs Ther. 2004 Apr 12;46(1180):29-31 | Show Full IntroductionHide Full Introduction

Olanzapine/Fluoxetine (Symbyax) for Bipolar Depression

   
The Medical Letter on Drugs and Therapeutics • March 15, 2004;  (Issue 1178)
The fixed-dose combination of olanzapine and fluoxetine (Symbyax - Lilly) has been approved by the FDA for treatment of depressive episodes associated with bipolar disorder. Olanzapine alone (Zyprexa), which is...
The fixed-dose combination of olanzapine and fluoxetine (Symbyax - Lilly) has been approved by the FDA for treatment of depressive episodes associated with bipolar disorder. Olanzapine alone (Zyprexa), which is mainly used as an antipsychotic (Medical Letter 2003; 45:102), is FDA-approved for treatment of acute manic episodes and for maintenance treatment of bipolar disorder. Fluoxetine alone (Prozac, and others), which is mainly used as an antidepressant (Medical Letter 2003; 45:93), has no specific approval for use in bipolar disorder.
Med Lett Drugs Ther. 2004 Mar 15;46(1178):23-4 | Show Full IntroductionHide Full Introduction

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).
Med Lett Drugs Ther. 2004 Jan 5;46(1173):2-4 | Show Full IntroductionHide Full Introduction

Drugs for Psychiatric Disorders

   
The Medical Letter on Drugs and Therapeutics • July 1, 2003;  (Issue 11)
The number of drugs marketed for psychiatric indications has increased sharply in recent years. The recommendations in this article are based on the results of controlled trials and on the experience and...
The number of drugs marketed for psychiatric indications has increased sharply in recent years. The recommendations in this article are based on the results of controlled trials and on the experience and opinions of Medical Letter consultants. Interactions with other drugs can be found in The Medical Letter Handbook of Adverse Drug Interactions, 2003.
Treat Guidel Med Lett. 2003 Jul;1(11):69-76 | 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

Xanax XR for Panic Disorder

   
The Medical Letter on Drugs and Therapeutics • May 26, 2003;  (Issue 1157)
The FDA has approved an extended-release (XR) formulation of the benzodiazepine alprazolam (Xanax XR - Pfizer) for treatment of panic disorder, with or without agoraphobia. The new formulation is intended to...
The FDA has approved an extended-release (XR) formulation of the benzodiazepine alprazolam (Xanax XR - Pfizer) for treatment of panic disorder, with or without agoraphobia. The new formulation is intended to reduce the need for frequent dosing and problems of interdose anxiety. This review describes the effectiveness of the extended-release formulation, as well as sections on dependence, abuse and withdrawal, adverse effects, and drug interactions. The review concludes with an overall assessment of the drug's efficacy and cost.
Med Lett Drugs Ther. 2003 May 26;45(1157):43-4 | Show Full IntroductionHide Full Introduction

Drugs for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • May 1, 2003;  (Issue 9)
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures continue and further dosage increases...
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures continue and further dosage increases appear inadvisable because of adverse effects, most Medical Letter consultants generally prescribe at least one and sometimes a second alternative drug as monotherapy before considering use of two drugs at the same time. Most antiepileptic drugs initially approved by the FDA only for adjunctive therapy are probably also effective as monotherapy. Many of the drugs used to treat epilepsy interact with each other (see table beginning on page 63) and with other drugs; for interactions with other drugs, see The Medical Letter Handbook of Adverse Drug Interactions, 2003. The treatment of status epilepticus is not included here.
Treat Guidel Med Lett. 2003 May;1(9):57-64 | Show Full IntroductionHide Full Introduction

Aripiprazole (Abilify) for Schizophrenia

   
The Medical Letter on Drugs and Therapeutics • February 17, 2003;  (Issue 1150)
Aripiprazole (Abilify - Bristol-Myers Squibb/Otsuka), a quinolinone derivative, has been approved by the FDA for treatment of...
Aripiprazole (Abilify - Bristol-Myers Squibb/Otsuka), a quinolinone derivative, has been approved by the FDA for treatment of schizophrenia.
Med Lett Drugs Ther. 2003 Feb 17;45(1150):15-6 | Show Full IntroductionHide Full Introduction

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?
Med Lett Drugs Ther. 2002 Oct 14;44(1141):89-90 | Show Full IntroductionHide Full Introduction

Valproate and Other Anticonvulsants For Psychiatric Disorders

   
The Medical Letter on Drugs and Therapeutics • December 11, 2000;  (Issue 1094)
Anticonvulsants are now widely used for treatment of psychiatric illnesses, particularly bipolar disorder. Lithium is the standard drug for treatment of bipolar disorder, but it can cause severe toxicity, serum...
Anticonvulsants are now widely used for treatment of psychiatric illnesses, particularly bipolar disorder. Lithium is the standard drug for treatment of bipolar disorder, but it can cause severe toxicity, serum concentrations must be monitored, and it is not effective in some patients.
Med Lett Drugs Ther. 2000 Dec 11;42(1094):114-5 | Show Full IntroductionHide Full Introduction

Zonisamide (Zonegran) For Epilepsy

   
The Medical Letter on Drugs and Therapeutics • October 2, 2000;  (Issue 1089)
Zonisamide (Zonegran - Elan Pharma), a sulfonamide chemically unrelated to other antiepileptic drugs, has been approved by the FDA for adjunctive use in adults with partial seizures. Zonisamide has been...
Zonisamide (Zonegran - Elan Pharma), a sulfonamide chemically unrelated to other antiepileptic drugs, has been approved by the FDA for adjunctive use in adults with partial seizures. Zonisamide has been available in Japan for more than 10 years.
Med Lett Drugs Ther. 2000 Oct 2;42(1089):94-5 | 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

Two New Drugs for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • April 17, 2000;  (Issue 1076)
Oxcarbazepine, which is chemically similar to carbamazepine, and levetiracetam, a pyrrolidine acetamide chemically unrelated to other antiepileptic drugs, are the sixth and seventh drugs approved by the US Food...
Oxcarbazepine, which is chemically similar to carbamazepine, and levetiracetam, a pyrrolidine acetamide chemically unrelated to other antiepileptic drugs, are the sixth and seventh drugs approved by the US Food and Drug Administration in the last five years for oral use in partial seizures.
Med Lett Drugs Ther. 2000 Apr 17;42(1076):33-5 | 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

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.
Med Lett Drugs Ther. 1999 May 21;41(1053):47-8 | Show Full IntroductionHide Full Introduction

Citalopram for Depression

   
The Medical Letter on Drugs and Therapeutics • December 4, 1998;  (Issue 1041)
Citalopram hydrobromide (Celexa - Forest/Parke-Davis), a selective serotonin reuptake inhibitor (SSRI) available in Europe since 1989, has now been approved by the US Food and Drug Administration (FDA) for...
Citalopram hydrobromide (Celexa - Forest/Parke-Davis), a selective serotonin reuptake inhibitor (SSRI) available in Europe since 1989, has now been approved by the US Food and Drug Administration (FDA) for treatment of depression. It is being advertised as having a 'favorable side-effect profile.'
Med Lett Drugs Ther. 1998 Dec 4;40(1041):113-4 | 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

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.
Med Lett Drugs Ther. 1997 Sep 12;39(1009):86-8 | Show Full IntroductionHide Full Introduction

Bupropion (Zyban) for Smoking Cessation

   
The Medical Letter on Drugs and Therapeutics • August 15, 1997;  (Issue 1007)
Bupropion hydrochloride, currently available as an antidepressant (Wellbutrin - Medical Letter, 31:97, 1989; Wellbutrin SR), is now being marketed in a sustainedrelease formulation as Zyban (Glaxo Wellcome)...
Bupropion hydrochloride, currently available as an antidepressant (Wellbutrin - Medical Letter, 31:97, 1989; Wellbutrin SR), is now being marketed in a sustainedrelease formulation as Zyban (Glaxo Wellcome) for use as an aid in smoking cessation.
Med Lett Drugs Ther. 1997 Aug 15;39(1007):77-8 | Show Full IntroductionHide Full Introduction

Topiramate for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • May 23, 1997;  (Issue 1001)
Topiramate (Topamax - Ortho-McNeil) has been approved by the US Food and Drug Administration (FDA) for oral use as an adjunct to other drugs in adult patients with partial seizures. Since this diagnostic...
Topiramate (Topamax - Ortho-McNeil) has been approved by the US Food and Drug Administration (FDA) for oral use as an adjunct to other drugs in adult patients with partial seizures. Since this diagnostic category includes the largest number of patients with refractory epilepsy, new drugs with antiepileptic activity are usually tried first for this indication. Topiramate (toe pyre' a mate) is a structurally unique agent chemically related to the D-enantiomer of fructose.
Med Lett Drugs Ther. 1997 May 23;39(1001):51-2 | Show Full IntroductionHide Full Introduction

Drugs for Psychiatric Disorders

   
The Medical Letter on Drugs and Therapeutics • April 11, 1997;  (Issue 998)
The number of new drugs marketed for psychiatric indications has increased sharply in recent years. The recommendations in this article are based on the results of controlled trials and on the experience and...
The number of new drugs marketed for psychiatric indications has increased sharply in recent years. The recommendations in this article are based on the results of controlled trials and on the experience and opinions of Medical Letter consultants. Interactions with other drugs can be found in The Medical Letter Handbook of Adverse Drug Interactions, 1997.
Med Lett Drugs Ther. 1997 Apr 11;39(998):33-40 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 1996 Dec 20;38(990):111-2 | Show Full IntroductionHide Full Introduction

Drugs Past Their Expiration Date

   
The Medical Letter on Drugs and Therapeutics • July 19, 1996;  (Issue 979)
Physicians and pharmacists are often asked if patients can use drugs after their expiration date. Pharmaceutical companies, because of legal restrictions and liability concerns, will not sanction such use and...
Physicians and pharmacists are often asked if patients can use drugs after their expiration date. Pharmaceutical companies, because of legal restrictions and liability concerns, will not sanction such use and may not even comment on the safety or effectiveness of using their products beyond the date on the label.
Med Lett Drugs Ther. 1996 Jul 19;38(979):65-6 | Show Full IntroductionHide Full Introduction

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).
Med Lett Drugs Ther. 1996 Feb 2;38(967):10-2 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 1996 Jan 19;38(966):5-6 | Show Full IntroductionHide Full Introduction

Lamotrigine For Epilepsy

   
The Medical Letter on Drugs and Therapeutics • March 17, 1995;  (Issue 944)
Lamotrigine (la mo tri jeen; Lamictal - Burroughs Wellcome), a phenyltriazine derivative, has been approved by the US Food and Drug Administration for use in addition to other antiepileptic drugs in adults...
Lamotrigine (la mo tri jeen; Lamictal - Burroughs Wellcome), a phenyltriazine derivative, has been approved by the US Food and Drug Administration for use in addition to other antiepileptic drugs in adults with partial seizures. Since this diagnostic category includes the largest number of patients with intractable epilepsy, new drugs with antiepileptic activity are usually tried first for this indication. Lamotrigine was first marketed abroad in 1990 and is now available in more than 50 other countries.
Med Lett Drugs Ther. 1995 Mar 17;37(944):21-3 | Show Full IntroductionHide Full Introduction

Fluvoxamine for Obsessive-Compulsive Disorder

   
The Medical Letter on Drugs and Therapeutics • February 17, 1995;  (Issue 942)
Fluvoxamine (Luvox - Solvay), a selective serotonin reuptake inhibitor (SSRI), has been approved for treatment of obsessive-compulsive disorder (OCD) by the US Food and Drug Administration. Fluoxetine...
Fluvoxamine (Luvox - Solvay), a selective serotonin reuptake inhibitor (SSRI), has been approved for treatment of obsessive-compulsive disorder (OCD) by the US Food and Drug Administration. Fluoxetine (Prozac), another SSRI antidepressant, and clomipramine (Anafranil), a tricyclic antidepressant that also inhibits serotonin reuptake, are the only other drugs available for this indication in the USA. Antidepressants that do not inhibit serotonin reuptake have not been effective for treatment of this condition.
Med Lett Drugs Ther. 1995 Feb 17;37(942):13-4 | Show Full IntroductionHide Full Introduction

Valproate for Bipolar Disorder

   
The Medical Letter on Drugs and Therapeutics • August 19, 1994;  (Issue 929)
Although lithium (Eskalith, and others) is the standard treatment for bipolar (manic-depressive) disorder, 20% to 40% of patients do not respond adequately or cannot tolerate its adverse effects (Medical...
Although lithium (Eskalith, and others) is the standard treatment for bipolar (manic-depressive) disorder, 20% to 40% of patients do not respond adequately or cannot tolerate its adverse effects (Medical Letter, 33:43, 1991). Results of recent studies suggest that valproate (Depakene - valproic acid; Depakote - divalproex sodium), a widely used anticonvulsant (Medical Letter, 31:1, 1989), might be an effective alternative. Other anticonvulsants, particularly carbamazepine (Tegretol, and others), have also been used as second-line drugs for treatment of mania and other psychiatric disorders (C Van Valkenburg et al, Drugs, 44:326, 1992; PE Keck, Jr et al, J Neuropsychiatry Clin Neurosci, 4:395, 1992).
Med Lett Drugs Ther. 1994 Aug 19;36(929):74-5 | Show Full IntroductionHide Full Introduction

LAAM - Long-Acting Methadone for Treatment of Heroin Addiction

   
The Medical Letter on Drugs and Therapeutics • June 10, 1994;  (Issue 924)
Methadone, an opioid agonist that can be taken orally, has been used for maintenance treatment for many years in the USA (DM Novick et al, Drug Alcohol Depend, 33:235, 1993). Last year, the US Food and Drug...
Methadone, an opioid agonist that can be taken orally, has been used for maintenance treatment for many years in the USA (DM Novick et al, Drug Alcohol Depend, 33:235, 1993). Last year, the US Food and Drug Administration approved the distribution and use of L-alpha-acetyl-methadol (LAAM; ORLAAM - Bio Development Corporation, McLean, VA), a long-acting congener of methadone. LAAM, like methadone, will be available for this indication only through federal and state-regulated treatment programs.
Med Lett Drugs Ther. 1994 Jun 10;36(924):52 | Show Full IntroductionHide Full Introduction

Gabapentin - A New Anticonvulsant

   
The Medical Letter on Drugs and Therapeutics • April 29, 1994;  (Issue 921)
Gabapentin (Neurontin - Parke-Davis), a cyclohexane acetic acid derivative, has been approved by the US Food and Drug Administration for use in addition to other antiepileptic drugs in patients with partial...
Gabapentin (Neurontin - Parke-Davis), a cyclohexane acetic acid derivative, has been approved by the US Food and Drug Administration for use in addition to other antiepileptic drugs in patients with partial (focal) seizures with or without secondary generalization. Since this diagnostic category includes the largest number of patients with intractable epilepsy, new drugs with antiepileptic activity are generally tried first for this indication.
Med Lett Drugs Ther. 1994 Apr 29;36(921):39-40 | Show Full IntroductionHide Full Introduction

Felbamate

   
The Medical Letter on Drugs and Therapeutics • November 26, 1993;  (Issue 910)
Felbamate (Felbatol - Wallace Laboratories), a phenyl dicarbamate structurally similar to meprobamate (Equanil, and others), was recently approved by the US Food and Drug Administration for use alone or with...
Felbamate (Felbatol - Wallace Laboratories), a phenyl dicarbamate structurally similar to meprobamate (Equanil, and others), was recently approved by the US Food and Drug Administration for use alone or with other drugs in adults with partial seizures with or without secondary generalization. It was also approved for use in addition to other drugs in children with the multiple types of seizures associated with the Lennox-Gastaut syndrome, a severe epileptic encephalopathy.
Med Lett Drugs Ther. 1993 Nov 26;35(910):107-8 | Show Full IntroductionHide Full Introduction

Clozapine

   
The Medical Letter on Drugs and Therapeutics • February 19, 1993;  (Issue 890)
Clozapine (Clozaril - Sandoz), an antipsychotic drug, was first marketed in the USA three years ago (Medical Letter, 32:3, 1990). Because of its hematological toxicity, the US Food and Drug Administration...
Clozapine (Clozaril - Sandoz), an antipsychotic drug, was first marketed in the USA three years ago (Medical Letter, 32:3, 1990). Because of its hematological toxicity, the US Food and Drug Administration approved the drug only for patients with schizophrenia who cannot tolerate or do not respond to standard antipsychotic drugs.
Med Lett Drugs Ther. 1993 Feb 19;35(890):16-8 | Show Full IntroductionHide Full Introduction

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).
Med Lett Drugs Ther. 1993 Jan 22;35(888):7-9 | Show Full IntroductionHide Full Introduction

Drugs for Pain

   
The Medical Letter on Drugs and Therapeutics • January 8, 1993;  (Issue 887)
Three types of analgesic drugs are available in the USA: first, aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; second, opioids; and third, drugs not usually thought of as...
Three types of analgesic drugs are available in the USA: first, aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; second, opioids; and third, drugs not usually thought of as analgesics, which act as adjuvants when given with NSAIDs or opioids, or have analgesic activity of their own in some types of pain. (American Pain Society, Principles of analgesic Use, 3rd ed, Skokie, illinois: American pain society, 1992).
Med Lett Drugs Ther. 1993 Jan 8;35(887):1-6 | Show Full IntroductionHide Full Introduction

Doxacurium

   
The Medical Letter on Drugs and Therapeutics • July 26, 1991;  (Issue 849)
Doxacurium (Nuromax - Burroughs Wellcome), a new, long-acting, nondepolarizing neuromuscular blocking agent, is now available in the USA for use as a skeletal muscle relaxant during general anesthesia and for...
Doxacurium (Nuromax - Burroughs Wellcome), a new, long-acting, nondepolarizing neuromuscular blocking agent, is now available in the USA for use as a skeletal muscle relaxant during general anesthesia and for endotracheal intubation. Although small decreases in heart rate and mean arterial pressure occur in some patients who receive doxacurium, clinical studies have found no adverse cardiovascular effects in patients with heart disease receiving up to three times the usual effective dose (CM Stoops et al, Anesthesiology, 69:365, 1988; DJ Murray et al, Anesthesiology, 69:472, 1988; RS Emmott et al, Br J Anaesth, 65:480, 1990). As with pipecuronium, which it closely resembles in activity, the duration of block is prolonged in patients with renal failure (JN Cashman et al, Br J Anaesth, 64:186, 1990; DR Cook et al, Anesth Analg, 72:145, 1991).
Med Lett Drugs Ther. 1991 Jul 26;33(849):73-4 | Show Full IntroductionHide Full Introduction

A Subdermal Progestin Implant For Long-Term Contraception

   
The Medical Letter on Drugs and Therapeutics • March 8, 1991;  (Issue 839)
The Norplant System (Wyeth-Ayerst) for subdermal delivery of the synthetic progestin levonorgestrel was recently approved by the US Food and Drug Administration for use as a long-term...
The Norplant System (Wyeth-Ayerst) for subdermal delivery of the synthetic progestin levonorgestrel was recently approved by the US Food and Drug Administration for use as a long-term contraceptive.
Med Lett Drugs Ther. 1991 Mar 8;33(839):17-8 | 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

Fluoxetine (Prozac) Revisited

   
The Medical Letter on Drugs and Therapeutics • September 7, 1990;  (Issue 826)
In the short time since fluoxetine (Prozac - Lilly) first became available in the USA (Medical Letter, 30:45, 1988), it has become the most frequently prescribed of all antidepressants. Some recent reports,...
In the short time since fluoxetine (Prozac - Lilly) first became available in the USA (Medical Letter, 30:45, 1988), it has become the most frequently prescribed of all antidepressants. Some recent reports, however, have questioned its safety.
Med Lett Drugs Ther. 1990 Sep 7;32(826):83-4 | Show Full IntroductionHide Full Introduction

Adenosine

   
The Medical Letter on Drugs and Therapeutics • June 29, 1990;  (Issue 821)
Adenosine (Adenocard - Fujisawa), an endogenous purine nucleoside, was recently approved by the US Food and Drug Administration for intravenous treatment of paroxysmal supraventricular tachycardia, including...
Adenosine (Adenocard - Fujisawa), an endogenous purine nucleoside, was recently approved by the US Food and Drug Administration for intravenous treatment of paroxysmal supraventricular tachycardia, including Wolff-Parkinson-White (WPW) syndrome. Adenosine is not approved for and has not been effective in treating atrial flutter, atrial fibrillation, or ventricular tachycardias.
Med Lett Drugs Ther. 1990 Jun 29;32(821):63 | Show Full IntroductionHide Full Introduction

Bupropion For Depression

   
The Medical Letter on Drugs and Therapeutics • November 3, 1989;  (Issue 804)
Bupropion (Wellbutrin - Burroughs Wellcome) was recently marketed in the USA for treatment of depression. First approved by the Food and Drug Administration in late 1985, the drug was withdrawn from the...
Bupropion (Wellbutrin - Burroughs Wellcome) was recently marketed in the USA for treatment of depression. First approved by the Food and Drug Administration in late 1985, the drug was withdrawn from the market in early 1986 because of a high incidence of seizures in one study.
Med Lett Drugs Ther. 1989 Nov 3;31(804):97-8 | Show Full IntroductionHide Full Introduction