This page contains all corrections published in recent Medical Letter publications (newsletter, handbooks, software).
Treatment of Atrial Fibrillation
The Medical Letter • Volume 66, January 8, 2024
Addendum: The Interruption of Anticoagulation section of our article on Treatment of Atrial Fibrillation cited the recommendations of the American College of Chest Physicians on perioperative management of antithrombotic therapy (JD Douketis et al. Chest 2022; 162:e207). A reader suggested that our general statement …
View the complete addendum.
In Brief: Over-the-Counter Narcan Nasal Spray
The Medical Letter • Volume 65, May 1, 2023
Addendum: Since the publication of our articles entitled Drugs for Opioid Use Disorder and In Brief: Over-the-Counter Narcan Nasal Spray earlier this year, Narcan (Emergent), a nasal spray that delivers 4 mg of the opioid antagonist naloxone, has become available for sale over the counter (OTC). According to the manufacturer …
View the complete addendum.
Choice of Contraceptives
The Medical Letter • Volume 65, May 15, 2023
Revisions:
In the Diaphragm with Spermicide section in Table 1, failure rate for typical use is 17% (not 7% as originally stated).
In the “Progestin-Only Oral Contraceptives” section, Opill contains 0.075 mg of norgestrel (not 0.75 mg as originally stated).
View the updated online version of this article.
Drugs for Anxiety Disorders
The Medical Letter • Volume 65, August 7, 2023
Addendum: A nephrologist and longtime reader of The Medical Letter wrote us to say that our recent article entitled Drugs for Anxiety Disorders should have said more about the need for dosage adjustment of gabapentin (Neurontin, and others) and pregabalin (Lyrica, and others) in patients …
View the complete addendum.
Drugs for Opioid Use Disorder
The Medical Letter • Volume 65, September 4, 2023
Addendum: Since the publication of our articles entitled Drugs for Opioid Use Disorder and In Brief: Over-the-Counter Narcan Nasal Spray earlier this year, Narcan (Emergent), a nasal spray that delivers 4 mg of the opioid antagonist naloxone, has become available for sale over the counter (OTC). According to the manufacturer …
View the complete addendum.
COVID-19 Update: New Pfizer and Moderna Vaccine Formulations for 2023-2024
The Medical Letter • Volume 65, October 16, 2023
Correction: In our article in issue 1687 on the updated 2023-2024 COVID-19 vaccines from Pfizer and Moderna (Med Lett Drugs Ther 2023; 65:161), the doses and formulations of the Pfizer vaccine were incorrect. A revised table has been posted in the online version of the article.
View the updated online version of this article.
Antiviral Drugs for Influenza for 2023-2024
The Medical Letter • Volume 65, November 13, 2023
Addendum: In the printed version of our article entitled Antiviral Drugs for Influenza for 2023-2024 in issue 1689 (Med Lett Drugs Ther 2023; 65:177), the clinical studies section should have included a meta-analysis of 15 randomized trials in 6295 outpatient adolescents and adults with influenza that found that use of oseltamivir did not reduce the risk of hospitalization in the overall population or in those ≥65 years old compared to placebo or standard of care. It has been added in the online version of the article.
View the updated online version of this article.
Drugs for Depression
The Medical Letter • Volume 65, December 11, 2023
Addendum 2/5/2024: In our article on Drugs for Depression, we should have included tardive dyskinesia (TD) in our list of adverse effects of second-generation antipsychotic (SGA) drugs. TD, which is more commonly associated with first-generation antipsychotics, can also occur in patients taking an SGA…
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Addendum 4/1/2024: Our December 11, 2023 article on Drugs for Depression included a single sentence on the safety of bupropion use during pregnancy: “The safety of bupropion during pregnancy has not been established; data from a bupropion pregnancy registry suggested a possible increase in cardiac malformations.” A reader asked us to provide more information. …
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Drugs for GERD and Peptic Ulcer Disease
The Medical Letter • Volume 64, April 4, 2022
Addendum: A reader commented that our recent article on Drugs for GERD and Peptic Ulcer Disease did not include enough information on dexlansoprazole (Dexilant, and generics), a proton pump inhibitor (PPI) claimed to provide “all-day and all-night relief from heartburn”. Dexlansoprazole recently became available generically, but it is much more expensive than other generic PPIs. …
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Prevention and Treatment of Monkeypox
The Medical Letter • Volume 64, September 5, 2022
Revision: In the Prevention section, “smallpox” was removed in the first paragraph, last sentence of The Vaccines section when describing the vaccinia virus; it was also removed in Table 2, 3rd column of Vaccine virus.
View the updated online version of this article.
Nalmefene Returns for Reversal of Opioid Overdose
The Medical Letter • Volume 64, September 5, 2022
Revision: In Table 2, footnote 3, the last sentence about a challenge dosage has been changed from 0.1 mg/kg to 0.1 mg/70 kg (“70” was missing).
View the updated online version of this article.
Drugs for Type 2 Diabetes
The Medical Letter • Volume 64, November 14, 2022
Revision: The GLP-1 agonist lixisenatide (Adlyxin) is no longer available in the US. Soliqua, the fixed-dose combination of lixisenatide and insulin glargine, is still available.
View the updated online version of this article.
Opioids for Pain
The Medical Letter • Volume 64, December 12, 2022
Revision: In the Pregnancy paragraph, the last sentence has been revised from “Pregnant women who are physically dependent on opioids should receive buprenorphine or methadone.” to “Pregnant women with opioid use disorder should receive buprenorphine or methadone for maintenance treatment.”
View the updated online version of this article.
FDA Authorizes Pfizer-BioNTech COVID-19 Vaccine
The Medical Letter • Volume 63, January 11, 2021
Revisions: On March 3, 2021, the CDC changed the “contraindication” to use of a mRNA COVID-19 vaccine in patients with polysorbate allergy to a “precaution”: https://bit.ly/38i7CIH. The last paragraph of the Adverse Effects section has been updated to reflect this. 6/15/21: The Storage and Administration section has been updated.
View the updated online version of this article.
FDA Authorizes Moderna COVID-19 Vaccine
The Medical Letter • Volume 63, January 25, 2021
Revisions: On March 3, 2021, the CDC changed the “contraindication” to use of a mRNA COVID-19 vaccine in patients with polysorbate allergy to a “precaution”: https://bit.ly/38i7CIH. The last paragraph of the Adverse Effects section has been updated to reflect this. 4/5/21: The Storage and Administration section has been updated.
View the updated online version of this article.
Drugs for Parkinson’s Disease
The Medical Letter • Volume 63, February 22, 2021
Revision: Canadian-English Edition: In Table 1, the price of Duodopa has been changed to reflect the monthly cost (the price previously listed was the daily cost).
View the updated online version of this article.
An EUA for Bamlanivimab and Etesevimab for COVID-19
The Medical Letter • Volume 63, April 5, 2021
Revisions:
1/6/2022: The Variants paragraph has been updated.
9/23/2021: As of September 2, 2021, distribution of bamlanivimab and etesevimab has resumed in all US jurisdictions (https://bit.ly/3AynAdr).
7/1/2021: On June 25, 2021, federal distribution of bamlanivimab and etesevimab was suspended because an increasing percentage of COVID-19 cases in the US are being caused by SARS-CoV-2 variants that are resistant to the drugs (https://bit.ly/3dsDH2I).
View the updated online version of this article.
Semaglutide (Ozempic) for Weight Loss
The Medical Letter • Volume 63, April 5, 2021
Revision: The Clinical Studies section and Table 2 have been updated to reflect data from a new study (STEP 4) that was released after press.
View the updated online version of this article.
Drugs for Chronic Heart Failure
The Medical Letter • Volume 63, June 14, 2021
Revision: The 2nd paragraph of the ivabradine section has been reworded.
View the updated online version of this article.
An EUA for Sotrovimab for Treatment of COVID-19
The Medical Letter • Volume 63, June 28, 2021
Revisions:
7/1/2021: The Availability paragraph has been revised.
1/6/2022: The Variants paragraph has been updated.
View the updated online version of this article.
Aducanumab (Aduhelm) for Alzheimer’s Disease
The Medical Letter • Volume 63, July 12, 2021
Addendum: In June 2021, the FDA approved the IV amyloid beta-directed monoclonal antibody aducanumab (Aduhelm) for treatment of Alzheimer’s disease. The approval did not restrict use of the drug to patients with mild cognitive impairment or mild dementia, which was the population enrolled in the clinical trials. Now, Biogen, with the permission of the FDA…
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Casirivimab and Imdevimab (REGEN-COV) for Post-Exposure Prophylaxis of COVID-19
The Medical Letter • Volume 63, August 23, 2021
Revision: The Variants paragraph has been revised.
View the updated online version of this article.
Bamlanivimab and Etesevimab for Post-Exposure Prophylaxis of COVID-19
The Medical Letter • Volume 63, October 18, 2021
Revision: The Variants paragraph has been revised.
View the updated online version of this article.
Drospirenone (Slynd) – A New Progestin-Only Oral Contraceptive
The Medical Letter • Volume 62, February 10, 2020
Revision: In the Drug Interactions section, the last sentence was added to warn about an increased risk of hyperkalemia when drospirenone and spironolactone are used concurrently.
Addendum: In our article on Slynd (Med Lett Drugs Ther 2020; 62:18), the drospirenone-only oral contraceptive, we mentioned that drospirenone has antiandrogenic activity that could improve acne and antimineralocorticoid activity that could cause hyperkalemia. We should have added that concurrent use of drospirenone with other drugs that increase potassium levels, such as the anti-androgen aldosterone receptor antagonist spironolactone (Aldactone, and generics), which is often used off-label for treatment of acne, can increase the risk of hyperkalemia.
View the updated online version of this article.
Brolucizumab (Beovu) for Age-Related Macular Degeneration
The Medical Letter • Volume 62, February 10, 2020
Addendum: We reviewed brolucizumab (Beovu – Novartis) for treatment of neovascular (wet) age-related macular degeneration in our February 10 issue. On February 23, the American Society of Retina Specialists reported that 14 patients who received the drug have developed retinal vasculitis…
View the complete addendum.
Drugs for Osteoarthritis
The Medical Letter • Volume 62, April 20, 2020
Revision: In the turmeric paragraph, information on a recent trial has been added.
View the updated online version of this article.
Durysta – A Bimatoprost Implant for Glaucoma
The Medical Letter • Volume 62, July 27, 2020
Revision: In the 2nd sentence of the Clinical Studies section, bimatoprost implants were administered at day 1, week 16, and week 32 (not week 24 as originally stated).
View the updated online version of this article.
Drugs for Menopausal Symptoms
The Medical Letter • Volume 62, August 10, 2020
Correction: In Table 1, Estring‘s formulation and dosage was changed to 7.5 mcg/day (not 75 mcg/day).
View the updated online version of this article.
Phexxi – A Nonhormonal Contraceptive Gel
The Medical Letter • Volume 62, August 24, 2020
Revisions: The third bullet in the Phexxi Summary box and the Conclusion have been edited, as well as Phexxi in Table 1.
View the updated online version of this article.
Antiviral Drugs for Influenza for 2020-2021
The Medical Letter • Volume 62, November 2, 2020
Revision: The chemoprophylaxis effectiveness paragraph and Table 2 were revised to reflect the new indication and availability of a new formulation of baloxavir.
View the updated online version of this article.
In Brief: New Benzodiazepine Warnings
In Brief: New Warnings on NSAID Use in Pregnancy
The Medical Letter • Volume 62, November 2, 2020
Revision – Canadian-English version only: The first sentence in both the benzodiazepine and NSAID articles have been changed to also reflect Health Canada’s new warnings.
An EUA for Bamlanivimab – A Monoclonal Antibody for COVID-19
The Medical Letter • Volume 62, November 30, 2020
Revision: A new paragraph on Variants has been added.
View the updated online version of this article.
An EUA for Casirivimab and Imdevimab for COVID-19
The Medical Letter • Volume 62, December 28, 2020
Revisions:
3/22/21: A new paragraph on Variants has been added.
6/17/21: On May 21, 2021, the FDA revised the criteria by which an outpatient with COVID-19 can be deemed high-risk. On June 3, 2021, the FDA reissued its Emergency Use Authorization for casirivimab and imdevimab with new dosage and administration instructions.
1/6/2022: The Variants paragraph has been updated.
View the updated online version of this article.
Plenvu – A Low-Volume PEG-Based Colonoscopy Preparation
The Medical Letter • Volume 61, January 28, 2019
Correction: The comparator drug in the DAYB trial was not Prepopik, but rather Citrafleet. Also, Plenvu can be taken as two doses in a single day or split over two days (not as a single- or split-dose regimen).
View the updated online version of this article.
Drug Interaction between Opioids and Oral P2Y12 Platelet Inhibitors
The Medical Letter • Volume 62, February 25, 2019
Addendum: Opioids delay gastric emptying and the absorption of many oral drugs, including the P2Y12 inhibitors clopidogrel (Plavix, and generics), prasugrel (Effient, and generics), and ticagrelor (Brilinta), which are commonly used for initial treatment of acute coronary syndrome (ACS). An article in our February 25, 2019 issue reviewed studies showing that coadministration of opioids delayed and decreased absorption of oral P2Y12 inhibitors and increased platelet reactivity. Recently published clinical outcomes data may add to these concerns. …
View the complete addendum.
Drugs for Chronic Heart Failure
The Medical Letter • Volume 61, April 8, 2019
Correction: In our Drugs for Chronic Heart Failure article, our description of the PARADIGM-HF trial comparing the combination of the ARB valsartan and the neprilysin inhibitor sacubitril (Entresto) with the ACE inhibitor enalapril for treatment of heart failure with reduced ejection fraction (HFrEF) characterized the dosage of enalapril as “suboptimal”. Some readers have objected to that characterization. …
View the complete correction.
View the updated online version of this article.
Brexanolone (Zulresso) for Postpartum Depression
The Medical Letter • Volume 61, May 6, 2019
Revision: The article was revised following scheduling of brexanolone as a schedule IV controlled substance by the DEA.
View the updated online version of this article.
Estradiol/Progesterone (Bijuva) for Menopausal Vasomotor Symptoms
The Medical Letter • Volume 61, July 1, 2019
Addendum: Single-ingredient oral formulations of estradiol and progesterone have been added to Table 1, as well as medroxyprogesterone (Provera, and generic).
View the updated online version of this article.
Annovera – A New Contraceptive Vaginal Ring
The Medical Letter • Volume 61, December 16, 2019
Revision: The introduction, cost, and conclusion paragraphs were revised to reflect the availability of generic NuvaRing products (Eluryng, and others).
View the updated online version of this article.
Drugs for GERD and Peptic Ulcer Disease
The Medical Letter • Volume 60, January 15, 2018
Revision: Information warning about an increased risk of cardiac events and death with clarithromycin has been added. The last sentence in the peptic ulcer disease section was revised to improve clarity. In the H2-receptor antagonists (H2RAs) section, the third sentence was revised to include information about the onset of action of H2RAs.
View the updated online version of this article.
Semaglutide (Ozempic) – Another Injectable GLP-1 Receptor Agonist for Type 2 Diabetes
The Medical Letter • Volume 60, January 29, 2018
Revision: Footnote 15 was added to Table 2 and the Dosage and Administration section was revised to reflect the availability of separate pens for 0.5-mg and 1.0-mg doses of Ozempic. The SUSTAIN-7 trial was added to Table 3 and the Clinical Studies section.
View the updated online version of this article.
Nonopioid Drugs for Pain
The Medical Letter • Volume 60, February 12, 2018
Revisions: The section on salicylates has been revised to include more details about the antiplatelet effects of diflunisal. In the Other Effects section, first paragraph, the last sentence was revised.
View the updated online version of this article.
Benralizumab (Fasenra) for Severe Eosinophilic Asthma
The Medical Letter • Volume 60, February 26, 2018
Revision: Information in the Dosage section regarding hypersensitivity reactions was revised.
View the updated online version of this article.
Opioids for Pain
The Medical Letter • Volume 60, April 9, 2018
Revision: Footnote 19 has been added to Table 2.
View the updated online version of this article.
Adult Immunization
The Medical Letter • Volume 60, May 5, 2018
Revision: The section on Recommendation for Use of hepatitis A vaccine has been updated to include “persons experiencing homelessness.”
View the updated online version of this article.
Drugs for Inflammatory Bowel Disease
The Medical Letter • Volume 60, July 2, 2018
Revision: Information about the risk of pulmonary thromboembolism and death with tofacitinib was added to the JAK inhibitor section.
View the updated online version of this article.
Management of Opioid Withdrawal Symptoms
The Medical Letter • Volume 60, August 27, 2018
Clarification: Some readers have questioned our characterization of opioid withdrawal as not life-threatening. While death during opioid withdrawal is unusual, it is possible — for example, due to severe untreated dehydration, withdrawal-induced suicidality, or rare myocardial events. We probably should have said that opioid withdrawal is generally not life-threatening. We have make that addition to the article.
View the updated online version of this article.
Choice of Contraceptives
The Medical Letter • Volume 60, October 8, 2018
Revision: The paragraph about Liletta in the intrauterine devices (IUDs) section was revised to reflect FDA approval (10/15/18) increasing the duration of use from 4 years to 5 years.
View the updated online version of this article.
Influenza Vaccine for 2018-2019
The Medical Letter • Volume 60, October 22, 2018
Revision: Tables 2 and 4 were revised to reflect the FDA’s recent approval of Afluria Quadrivalent for person ≥6 months old.
View the updated online version of this article.
Baloxavir Marboxil (Xofluza) for Treatment of Influenza
The Medical Letter • Volume 60, December 3, 2018
Revision: The Standard Treatment paragraph was revised to clarify that use of oseltamivir or peramivir for treatment of hospitalized or seriously ill patients is not an FDA-approved use.
View the updated online version of this article.
Another Insulin Glargine (Basaglar) for Diabetes
The Medical Letter • Volume 59, January 2, 2017
Revision: In the Dosage and Administration paragraph, we removed the word “syringe” in describing Basaglar‘s KwikPen device. Basaglar is not available as a prefilled syringe; it is only available as a KwikPen.
View the updated online version of this article.
Drugs for Type 2 Diabetes
The Medical Letter • Volume 59, January 16, 2017
Revisions: In the dulaglutide section, we mistakenly stated that Xultophy is a combination of albiglutide/insulin degludec; the correct combination of Xultophy is liraglutide/insulin degludec. We have also moved that sentence to the liraglutide paragraph. In Table 2, the price for Victoza was changed to $498.40 (from $249.20).
View the updated online version of this article.
Obeticholic Acid (Ocaliva) for Primary Biliary Cholangitis
The Medical Letter • Volume 59, March 27, 2017
Revision: See Dosage and Administration third paragraph.
View the updated online version of this article.
Drugs for COPD
The Medical Letter • Volume 59, April 10, 2017
Revision: Lonhala Magnair was added to Table 1, QVAR Redihaler and Trelegy Ellipta were added to Table 3.
View the updated online version of this article.
Prescription Drug Prices in the US
The Medical Letter • Volume 59, May 22, 2017
Revision: In Table 2, footnote 11 has been added, and is related to the Canadian cost of Advair HFA.
View the updated online version of this article.
Abuse-Deterrent Opioids
The Medical Letter • Volume 59, June 5, 2017
Correction: The information on Targiniq ER in Table 1 is incorrect. The drug, which is not available in the US, is a combination of oxycodone ER and naloxone, not naltrexone, and naloxone is dispersed throughout the tablet, not sequestered. Targiniq ER has been deleted from the table.
View the updated online version of this article.
Drugs for Helicobacter pylori Infection
The Medical Letter • Volume 59, July 17, 2017
Correction: In table 3 on page 116, the price provided for Prevpac was for a 14-day supply, rather than for a 10-day supply as stated in footnote 1. The footnote has been corrected and the price of the generic formulation of Prevpac has been added.
Revision: Information warning about an increased risk of cardiac events and death with clarithromycin has been added.
View the updated online version of this article.
Drugs for Cognitive Loss and Dementia
The Medical Letter • Volume 59, September 25, 2017
Revision: The last sentence at the end of the article was incorrect; it has been deleted.
View the updated online version of this article.
Influenza Vaccine for 2017-2018
The Medical Letter • Volume 59, October 9, 2017
Revision: In Table 2, the recommended age for Fluarix Quadrivalent was changed to ≥6 months.
View the updated online version of this article.
Drugs for Common Bacterial Infections in Adults
The Medical Letter • Volume 59, October 23, 2017
Revision: In skin and soft tissue infections, nonpurulent infection section, “trimethoprim/sulfamethoxazole” was removed from the 5th sentence. It may be effective for treatment of such infections, but other antibiotics with established efficacy and fewer adverse effects are preferred.
Revision: Information warning about an increased risk of cardiac events and death with clarithromycin has been added.
View the updated online version of this article.
Shingrix – An Adjuvanted, Recombinant Herpes Zoster Vaccine
The Medical Letter • Volume 59, December 4, 2017
Revision: See New Recommendations paragraph.
View the updated online version of this article.
Naloxone (Narcan) Nasal Spray for Opioid Overdose
The Medical Letter • Volume 58, January 4, 2016
Clarification: A reader expressed concern that a statement in our article Naloxone (Narcan) Nasal Spray for Opioid Overdose (Med Lett Drugs Ther 2016; 58:1) might be misleading. We stated that heroin has a half-life of 2-6 minutes, which is correct, but heroin is a prodrug that is rapidly metabolized to 6-acetylmorphine and morphine. The risk of respiratory depression is related to those active metabolites, and it may persist well beyond the clearance of heroin from the blood.
Mepolizumab (Nucala) for Severe Eosinophilic Asthma
The Medical Letter • Volume 58, January 18, 2016
Revision: Information in the Dosage section regarding hypersensitivity reactions was revised.
View the updated online version of this article.
Drugs for Acne
The Medical Letter • Volume 58, February 1, 2016
Correction: In Table 1, the formulations for Differin, topical adapalene, should have been listed as 0.1% gel, cream, lotion; 0.3% gel (not 3% gel).
View the updated online version of this article.
Addendum: Our article earlier this year on Drugs for Acne (Med Lett Drugs Ther 2016; 58:13) stated that the oral retinoid isotretinoin (Accutane, and others) is the most effective drug available for patients with severe nodulocystic acne, but warned that depression, suicidality, myalgia, hypertriglyceridemia, and other adverse effects can occur. One of our readers objected to our listing depression and suicidality, which are the subject of a prominent warning in the package insert, in the same sentence as indisputable side effects…
View the complete addendum.
Patiromer (Veltassa) for Hyperkalemia
The Medical Letter • Volume 58, February 15, 2016
Revision: In the Drug Interactions paragraph, a sentence was added about a November 2016 revision in the prescribing information.
View the updated online version of this article.
Treatment of Lyme Disease
The Medical Letter • Volume 58, May 9, 2016
Addendum: A reader commenting on our Treatment of Lyme Disease article (Med Lett Drugs Ther 2016; 58:57) objected to a footnote in the table advising against use of doxycycline in children <8 years old. This warning has been included in the labeling of all tetracyclines since 1970 when it was recognized, after decades of use, that these drugs caused permanent staining and enamel hypoplasia of developing teeth. The CDC recently stated…
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Drugs for Depression
The Medical Letter • Volume 58, July 4, 2016
Revision: The adverse effects sections of SSRIs, SNRIs, and tricyclic antidepressants have been revised to include information on QT interval prolongation.
View the updated online version of this article.
Cannabis and Cannabinoids
The Medical Letter • Volume 58, August 1, 2016
Addendum: A dose/cost table has been added.
View the updated online version of this article.
Daclizumab (Zinbryta) for Multiple Sclerosis
The Medical Letter • Volume 58, September 12, 2016
Revision: Withdrawn from the market March 2018 due to safety concerns.
View the updated online version of this article.
Influenza Vaccine for 2016-2017
The Medical Letter • Volume 58, October 10, 2016
Revisions: A sentence regarding Flublok Quadrivalent has been added to the “Quadrivalent vs Trivalent” section; in Table 2, the recommended age in for FluLaval Quadrivalent was changed to ≥6 months (from ≥3 years).
View the updated online version of this article.
Lipid-Lowering Drugs
The Medical Letter • Volume 58, October 24, 2016
Addendum: In our recent article on Lipid-Lowering Drugs,we said that statins can reduce the risk of first cardiovascular events and death (primary prevention) in patients at high risk for atherosclerotic cardiovascular disease (CVD) and significantly reduce the incidence of cardiovascular events in patients at lower risk for CVD. Now the United States Preventive Services Task Force (USPSTF)…
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Diet, Drugs, and Surgery for Weight Loss
The Medical Letter • Volume 57, February 16, 2015
Addendum: The mean weight loss listed in table 1 included, at the lower end of the range, the mean weight loss reported with a lower than FDA-approved dose of lorcaserin (Belviq). The placebo-corrected weight loss reported with FDA-approved doses of lorcaserin is 2.9-3.6 kg.
View the updated online version of this article.
Suvorexant (Belsomra) for Insomnia
The Medical Letter • Volume 57, March 2, 2015
Revision: In Table 2, the Pregnancy Category for flurazepam is “X” (not “C”).
View the updated online version of this article.
Nivolumab (Opdivo) for Metastatic Melanoma and Metastatic NSCLC
The Medical Letter • Volume 57, June 8, 2015
Addendum: After our article on nivolumab (Opdivo – BMS) for treatment of metastatic melanoma and metastatic squamous non-small cell lung cancer (NSCLC) was published in the most recent issue of The Medical Letter (June 8, 2015), some new data became available supporting the efficacy of the drug in previously untreated melanoma and previously treated nonsquamous NSCLC. …
View the complete addendum.
Flibanserin (Addyi) for Hypoactive Sexual Desire Disorder
The Medical Letter • Volume 57, September 28, 2015
Addendum: When our article on flibanserin (Addyi) was published, the drug had not yet been marketed. Flibanserin became available on October 17, 2015 at a cost of $800 for a 30-day supply.
Update (April 12, 2019): The label of flibanserin (Addyi) has been revised based on postmarketing studies evaluating the risk of consuming alcohol while taking flibanserin. According to the new label, flibanserin is contraindicated for use within 2 hours following discontinuation of alcohol. Alcohol should not be consumed until at least the morning after taking flibanserin.
View the updated online version of this article.
Eloctate for Hemophilia A
The Medical Letter • Volume 57, October 12, 2015
Correction: In the table on page 144, the indications and half-life listed for Nuwiq were erroneously taken from the European package insert. The table has been revised online to reflect the US prescribing information. The cost for Nuwiq has also been updated.
View the updated online version of this article.
Drugs for Hypothyroidism
The Medical Letter • Volume 57, October 26, 2015
Addendum: In our October 26, 2015 article on drugs for hypothyroidism, we said that levothyroxine should be taken on an empty stomach with a full glass of water 30-60 minutes (60 is preferable) before breakfast. We should have added that taking the drug consistently at bedtime, at least 3 hours after the last meal, is an alternative that some patients may find more convenient.
A Sumatriptan Patch (Zecuity) for Migraine
The Medical Letter • Volume 57, November 9, 2015
Correction: In the introduction on page 151, the triptans were referred to as serotonin (5-HT) receptor antagonists; they are 5-HT1B/1D-receptor agonists.
View the updated online version of this article.
Cobicistat (Tybost) and Combinations for HIV
The Medical Letter • Volume 57, November 23, 2015
Correction: In the Adverse Effects section, 3rd sentence, the word “reabsorption” has been replaced with “secretion”.
View the updated online version of this article.
Insulin Degludec (Tresiba) – A New Long-Acting Insulin for Diabetes
The Medical Letter • Volume 57, December 7, 2015
Revision: In Table 3, footnote 1 was changed to: “Approximate WAC for 30 days’ treatment with 40 units/day in prefilled pens.”
View the updated online version of this article.
Dapagliflozin (Farxiga) for Type 2 Diabetes
The Medical Letter • Volume 56, February 17, 2014
Correction: In the Drug Interactions paragraph, the second sentence about dapagliflozin exposure has been rewritten.
View the updated online version of this article.
Influenza Vaccine for 2014-2015
The Medical Letter • Volume 56, October 13, 2014
Revision: See Tables 1 and 2 for new age indication for FluBlock (now ≥18 years).
View the updated online version of this article.
PCV13 for Adults 65 Years and Older
The Medical Letter • Volume 57, October 13, 2014
Addendum: In 2014, the US Advisory Committee on Immunization Practices (ACIP) recommended that all adults 65 years old and older being vaccinated against pneumococcus for the fi rst time receive the pneumococcal conjugate vaccine (PCV13) followed 6 to 12 months later by the pneumococcal polysaccharide vaccine …
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Secondary Prevention of Stroke
The Medical Letter • Volume 56, December 8, 2014
Revision: In the Clopidogrel Plus Aspirin section, the last sentence has been revised. In the Conclusion, “90 days” has been changed to “21 days”.
View the updated online version of this article.
Drugs for Epilepsy
Treatment Guidelines • Volume 11, February 2013
Correction: The dosage of topiramate in Table 2 on page 11 has been changed from 200-400 mg/day in 2 doses to 100-400 mg/day in 2 doses. The dosage recommendation in the labeling for monotherapy is 400 mg per day, but Medical Letter consultants have pointed out that in clinical practice, the usual dose of topiramate for monotherapy is 100-200 mg per day. Higher doses may be needed for adjunctive use.
View the updated online version of this article.
Drugs for Pain
Treatment Guidelines • Volume 11, April 2013
Correction: In Table 1 (Some Nonopioid Analgesics), the price for IV ibuprofen (Caldolor) has been revised.
View the updated online version of this article.
Nutritional Supplements for Age-Related Macular Degeneration Revisited
The Medical Letter • Volume 55, June 24, 2013
Revision: The last sentence in the Conclusion has been changed
View the updated online version of this article.
Drugs for Bacterial Infections
Treatment Guidelines • Volume 11, July 2013
Correction: The price of tigecycline (Tygacil) in Table 2 has been corrected.
View the updated online version of this article.
Ospemifene (Osphena) for Dyspareunia
The Medical Letter • Volume 55, July 8, 2013
Addendum: Some readers have objected to our recommendation that postmenopausal women with an intact uterus who take the oral estrogen agonist/antagonist ospemifene (Osphena) to reduce the severity of dyspareunia should also take a progestin. Ospemifene has agonistic effects on the endometrium, and the Osphena package insert says: “Generally, when a product with estrogen agonistic effects on the endometrium is prescribed for a postmenopausal woman with a uterus, a progestin …
View the complete addendum.
More Less
Deferiprone (Ferriprox) for Iron Overload
The Medical Letter • Volume 54, February 20, 2012
Correction: The second sentence in deferiprone’s conclusion has been changed to fix a grammatical error.
View the updated online version of this article.
Tafluprost (Zioptan) – A New Topical Prostaglandin for Glaucoma
The Medical Letter • Volume 54, April 16, 2012
Correction: In Table 1 on page 31, the formulation column should have included a 0.01% solution of bimatoprost. The size, daily dosage and cost of 0.01% bimatoprost are the same as those of the 0.03% solution.
View the updated online version of this article.
Drugs for Menopausal Symptoms
The Medical Letter • Volume 54, May 28, 2012
Addendum: A reader commented that our article on treatment of menopausal symptoms should have mentioned the potential advantages of transdermal estrogen. Transdermal estrogens are probably as effective as oral estrogens in treating vasomotor menopausal symptoms, but transdermal administration may have less effect on serum triglycerides, C-reactive protein, thyroxine-binding globulin, cortisol-binding globulin and sex hormone-binding globulin. Observational data suggest that the risk of venous thromboembolism may be lower with transdermal administration compared to standard-dose oral estrogens, but comparative randomized controlled trials are lacking.
Axitinib (Inlyta) for Advanced Renal Cell Carcinoma
The Medical Letter • Volume 54, June 11, 2012
Correction: In Table 1 on page 47, footnote 2 has been removed from the cost of axitinib.
View the updated online version of this article.
Bisphosphonates – Duration of Use Revisited
The Medical Letter • Volume 54, June 25, 2012
Correction: In the first sentence of the conclusion, the words “with osteoporosis” were removed immediately after “women”.
View the updated online version of this article.
Renal Sympathetic Denervation for Hypertension
The Medical Letter • Volume 54, July 9, 2012
Addendum: Our July 9, 2012 article on renal sympathetic denervation for multiple-drug resistant hypertension concluded that the catheter-based procedure (Symplicity Catheter System – Medtronic) can lower blood pressure in most patients with hypertension resistant to ≥3 antihypertensive drugs. That conclusion was based on the results of 2 studies. SYMPLICITY HTN-1 compared outcomes to baseline blood pressures. SYMPLICITY HTN-2 randomized patients to renal denervation or usual care. …
View the complete addendum.
Drugs for Urinary Tract Infections
The Medical Letter • Volume 54, July 23, 2012
Addendum: A reader suggested that our July 23 article on Drugs for Urinary Tract Infection should have included information on the cost of the drugs we recommended for treatment of acute uncomplicated cystitis.
Trimethoprim/sulfamethoxazole DS — Generic formulations are available at large discount pharmacies for $4 for 20 tablets. Trimethoprim/sulfamethoxazole DS is generally found on tier 1 (lowest co-pay) of insurance company formularies.
Nitrofurantoin monohydrate/macrocrystals — The wholesale acquisition cost of the generic formulation is about $2.50 per tablet (PricePointRx™. Reprinted with permission by FDB. All rights reserved. ©2012. http://www.firstdatabank.com/support/drug-pricing-policy.aspx. Accessed July 31, 2012. Actual retail prices may be higher). The drug is on tier 1 of some insurance company formularies, but on tier 2 or 3 of others.
Fosfomycin — Available only as Monurol, a single dose of fosfomycin is effective in most cases of acute uncomplicated cystitis, but the manufacturer charges a wholesale acquisition cost of more than $40 for that dose (PricePointRx™. Reprinted with permission by FDB. All rights reserved. ©2012. http://www.firstdatabank.com/support/drug-pricing-policy.aspx. Accessed July 31, 2012. Actual retail prices may be higher). Most insurance companies place Monurol on tier 3 of their formularies, or do not include it on their formularies at all.
Not recommended: Ciprofloxacin – Fluoroquinolones should not be used empirically to treat acute uncomplicated cystitis. The fact that ciprofloxacin is available at large discount pharmacies for $4 for 20 500-mg tablets and is on tier 1 on most insurance company formularies may be part of the reason for its continued overuse.
What Comes After Metformin for Type 2 Diabetes?
The Medical Letter • Volume 54, July 23, 2012
Addendum: Several readers have raised questions about the statement in our recent article that long-acting insulins, like metformin and sulfonylureas, have been shown to decrease long-term cardiovascular risk. Our statement was based on the extension of the UKPDS (RR Holman et al, N Engl J Med 2008; 359:1577), which is the longest prospective trial of drug therapy in patients with type 2 diabetes. Shorter studies in older patients with long-standing diabetes did not find a reduction in cardiovascular risk with these and other drugs (The Action to Control Cardiovascular Risk in Diabetes Study Group. N Engl J Med 2008; 358:2545; The ADVANCE Collaborative Group. N Engl J Med 2008; 358:2560; W Duckworth et al. N Engl J Med 2009; 360:129).
Two New Drugs for Weight Loss
The Medical Letter • Volume 54, September 3, 2012
Correction: On page 71 in the “Drug Interactions” paragraph, the last sentence should read: “Phentermine is contraindicated while taking, and for 14 days after stopping, a monoamine oxidase (MAO) inhibitor because of the risk of hypertensive crisis.”
View the updated online version of this article.
Endocarditis Prophylaxis for Dental Procedures
The Medical Letter • Volume 54, September 17, 2012
Correction: In the Dental Procedures paragraph, 6th line, the word “rubber” has been omitted before the word “bands” because placement of rubber bands does not require prophylaxis; placement of orthodontic metal bands does.
View the updated online version of this article.
A 4-Drug Combination (Stribild) for HIV
The Medical Letter • Volume 54, November 26, 2012
Correction: In the “Drug Interactions” paragraph, the word “oral” has been inserted before “midazolam” in the 3rd sentence.
View the updated online version of this article.
Cephalosporins for Patients with Penicilllin Allergy
The Medical Letter • Volume 54, December 24, 2012
Addendum: A reader who took the online continuing medical education (CME) exam for issue 1406 pointed out that the first question assumed that a rash following oral administration of ampicillin would be due to allergy. Perhaps we should have mentioned in our article on penicillin allergy that late-appearing maculopapular rashes associated with oral ampicillin or amoxicillin are generally considered non-allergic and need not preclude subsequent administration of ampicillin or amoxicillin.
In Brief: Delayed-Release Risedronate (Atelvia)
The Medical Letter • Volume 53, March 21, 2011
Correction: The In-Brief article on delayed-release risedronate in issue 1360 included a statement that alendronate is currently the only bisphosphonate available generically. That would have been accurate if we had added “that is FDA-approved for treatment of osteoporosis.” Etidronate (Didronel, and others), which was the first bisphosphonate used to treat osteoporosis (Medical Letter 1990; 32:111) but was never approved for such use by the FDA, is also available generically. It is approved for treatment of Paget’s disease and for prevention and treatment of heterotropic ossification following hip replacement and in spinal-cord injured patients.
View the updated online version of this article.
Intravenous Acetaminophen (Ofirmev)
The Medical Letter • Volume 53, April 4, 2011
Clarification: The cost of ketorolac listed in Table 1 on page 27 is for a single 30-mg prefilled syringe. A 30-mg vial costs about $1.63 according to AWP listings in Red Book 2010.
View the updated online version of this article.
A New Testosterone Gel (Fortesta) for Hypogonadism
The Medical Letter • Volume 53, April 18, 2011
Correction: In Table 1, the price of a 5-mL (200 mg/mL) vial of testosterone enanthate should have been $79.30 for the generic and $91.30 for the brand (Delatestryl), not $15.86 for the generic and $18.26 for the brand.
View the updated online version of this article.
Drugs for Treatment of ADHD
Treatment Guidelines • Volume 9, May 2011
Correction: The Daily Adult Dosages for Focalin and generic methylphenidate in Table 1 have been updated.
View the updated online version of this article.
Dextromethorphan/Quinidine (Nuedexta) for Pseudobulbar Affect
The Medical Letter • Volume 53, June 13, 2011
Correction: In our June 13, 2011 article, we said that the FDA has approved Nuedexta for treatment of pseudobulbar affect in patients with amyotrophic lateral sclerosis (ALS) or multiple sclerosis (MS). That is not quite correct. The package insert says that the drug is indicated for the treatment of pseudobulbar affect and then goes on to say, in the next two sentences, that studies to support the effectiveness of Nuedexta were performed in patients with underlying ALS or MS, and that the drug has not been shown to be safe or effective in other types of emotional lability. Also, the second sentence in the Drug Interactions paragraph should have said: “Other drugs that prolong the QT interval, inhibit CYP3A4, or are metabolized by CYP2D6 and prolong the QT interval, should be used with caution, if at all.”
View the updated online version of this article.
Telaprevir (Incivek) and Boceprevir (Victrelis) for Chronic Hepatitis C
The Medical Letter • Volume 53, July 25, 2011
Correction: In the clinical studies section for telaprevir, “among patients who had a previous relapse” was added to the REALIZE trial sentence.
View the updated online version of this article.
Vemurafenib (Zelboraf) for Metastatic Melanoma
The Medical Letter • Volume 53, October 3, 2011
Correction: In the Dosage and Cost section on page 78, the minimum dose of vemurafenib was changed from 420 mg twice daily to 480 mg twice daily.
View the updated online version of this article.
A Fixed-Dose Combination of Ibuprofen and Famotidine (Duexis)
The Medical Letter • Volume 53, October 31, 2011
Correction: In the clinical studies section, the overall incidence of endoscopic gastroduodenal ulcers should have been 11% with Duexis and 21.9% with ibuprofen alone and, in low dose aspirin users, 12.8% with Duexis and 32.8% with ibuprofen alone.
View the updated online version of this article.
Who Should Take Vitamin Supplements?
The Medical Letter • Volume 53, December 12/26, 2011
Revision: The first paragraph on vitamin E has been revised.
View the updated online version of this article.
Ustekinumab (Stelara) for Psoriasis
The Medical Letter • Volume 52, January 25, 2010
Addendum: Footnote 2 in table 2 should have included a second sentence: $5595.60 is the cost of one 45-mg syringe.
View the updated online version of this article.
Ferumoxytol (Feraheme) – A New Parenteral Iron Formulation
The Medical Letter • Volume 52, March 22, 2010
Correction: The last sentence of the Dosage, Administration and Cost paragraph should have listed the cost of 1 gram of sodium ferric gluconate (Ferrlecit) as about $600.
View the updated online version of this article.
Safety of Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease (COPD)
The Medical Letter • Volume 52, May 31, 2010
Correction: The last sentence in the Efficacy paragraph should say, “…budesonide/formoterol…” (not budesonide/salmeterol).
View the updated online version of this article.
A Sumatriptan Needle-Free Injection for Migraine
The Medical Letter • Volume 52, June 28, 2010
Correction: In Table 2, the injection volumes of Imitrex and Sumaval are listed as 5 mL. They should be 0.5 mL.
View the updated online version of this article.
Pitavastatin (Livalo) – The Seventh Statin
The Medical Letter • Volume 52, July 26, 2010
Correction: In the table, the usual decrease in LDL-cholesterol with pitavastatin has been changed to 35-40% (2 mg) and 40-45% (4 mg). Also, in the Dosage and Administration paragraph, the GFR has been changed to 30-<60 ml/min/1.73 m2.
View the updated online version of this article.
Drugs for Parasitic Infections
Handbook (2nd Edition) • July 2010
Correction: In the table titled, “Manufacturers of Drugs Used to Treat Parasitic Infections”, the first footnote on page 81 should say, ” …(see footnote 3 on page 4).”
Drugs for Sexually Transmitted Infection
Treatment Guidelines • Volume 8, July 2010
Correction: The last two sentences in the Epididymitis section have been reworded.
View the updated online version of this article.
Mometasone/Formoterol (Dulera) for Asthma
The Medical Letter • Volume 52, October 18, 2010
Correction: In the Clinical Studies section, the second clinical trial compared the 2 different strengths of the combinations with mometasone alone, 400 mcg twice daily, and not with placebo.
View the updated online version of this article.
Vancomycin Dosing and Monitoring
The Medical Letter • Volume 51, April 6, 2009
Correction: Dosing paragraph: The next to last sentence should be “…organism is =2 mg/L, the new….” (not >2 mg/L).
View the updated online version of this article.
Milnacipran (Savella) for Fibromyalgia
The Medical Letter • Volume 51, June 15, 2009
Correction: In the 2nd sentence, “similar to gabapentin” was added. It now reads, “…a gamma-aminobutyric acid (GABA) analog similar to gabapentin…”
View the updated online version of this article.
In Brief: Biennial IV Zoledronic Acid (Reclast) for Prevention of Osteoporosis
The Medical Letter • Volume 51, June 29, 2009
Correction: The first word of the title was changed from Biannual to Biennial.
View the updated online version of this article.
Antimicrobial Prophylaxis for Surgery
Treatment Guidelines • Volume 7, June 2009
Addendum: Table 1: Footnote 14 was added to the Gastrointestinal/Colorectal section and a second sentence was added to footnote 5.
View the updated online version of this article.
Golimumab (Simponi) for Inflammatory Arthritis
The Medical Letter • Volume 51, July 13, 2009
Correction: In the first sentence “humanized” was changed to “human” to describe golimumab. In Table 1, the source for certolizumab (Cimzia) was changed to “humanized” and the price should have been $1,341.68 (not $3,136.40).
View the updated online version of this article.
Benzyl Alcohol Lotion for Head Lice
The Medical Letter • Volume 51, July 27, 2009
Correction: In Table 1, the price for lindane 1% shampoo should have been $136.86 (not $3.00).
View the updated online version of this article.
When a Statin Fails
The Medical Letter • Volume 51, July 27, 2009
Correction: The first paragraph should have included the words “for patients at high risk” after 100 mg/dL (2.6 mmol/L)
View the updated online version of this article.
Tapentadol (Nucynta) – A New Analgesic
The Medical Letter • Volume 51, August 10, 2009
Correction: In the pharmacokinetics table, the half-life for tapentadol was changed from “24” to “4”.
View the updated online version of this article.
Colchicine and Other Drugs for Gout
The Medical Letter • Volume 51, November 30, 2009
Correction: In the Uricosuric agents paragraph, the last two words in the last sentence (“and theophylline.”) were deleted.
View the updated online version of this article.
Advice for Travelers
Treatment Guidelines • Volume 7, November 2009
Correction: In the oral rehydration salts paragraph, the first sentence has been changed from “…can help maintain electrolyte balance…” to “can prevent and treat dehydration…”
View the updated online version of this article.
Veregen: A Botanical for Treatment of Genital Warts
The Medical Letter • Volume 50, February 25, 2008
Correction: Theophylline was deleted from the pharmacology section on page 15; it is not among the components that make up 2.5% of the drug weight. Table 1: 2.3% discontinuation rate due to adverse effects for Veregen (not 5%)
View the updated online version of this article.
Diet, Drugs and Surgery for Weight Loss
Treatment Guidelines • Volume 6, April 2008
Correction: In the Adjustable Gastric Banding section on page 37, the first sentence has been changed from “Use of a laparoscopically adjustable gastric band placed around…” to “Use of an adjustable gastric band placed laparoscopically around…” In the second sentence, the words through a subcutaneous reservoir have been added.
View the updated online version of this article.
Natalizumab (Tysabri) for Crohn’s Disease
The Medical Letter • Volume 50, May 5, 2008
Correction: The May 5, 2008 article on the approval of natalizumab (Tysabri) for treatment of Crohn’s disease in the “Adverse Effects” section on page 35 included the statement: “… postmarketing hepatotoxicity, sometimes fatal or requiring liver transplantation, has occurred.” Actually, no fatal hepatotoxicity or liver transplantation has been reported to date. The FDA warning about post-marketing hepatotoxicity with Tysabri that was the basis for our statement said: “The combination of transaminase elevations and elevated bilirubin without evidence of obstruction is recognized as an important predictor of severe liver injury that may lead to [emphasis added] death or the need for a liver transplant in some patients.” Also, in the last sentence of the Conclusion, we should have said: “Because of the risk of serious hepatic toxicity and the rare but even more serious risk of developing progressive multifocal leukoencephalopathy, it should be used only in patients who have not responded to other drugs, including a TNF inhibitor.” The italicized words should be substituted for “it is FDA-approved for use.”
View the updated online version of this article.
Pharmacogenetic-Based Dosing of Warfarin
The Medical Letter • Volume 50, May 19, 2008
Addendum – Warfarin-Acetaminophen Interaction: A reader expressed disappointment that our recent listing of “Some Warfarin Drug Interactions” 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.
View the updated online version of this article.
In Brief: Measles Outbreak
The Medical Letter • Volume 50, June 2, 2008
Illinois has been added to the first sentence. It is among the states where measles was reported.
View the updated online version of this article.
The EarCheck Middle Ear Monitor
The Medical Letter • Volume 50, July 14, 2008
Correction: The article in the July 14th issue contained an error in the last sentence of the last paragraph beginning on page 55. The instrument’s reading is determined not by the degree of protrusion of the tympanic membrane, but rather by its mobility.
View the updated online version of this article.
Drugs for Tobaco Dependence
Treatment Guidelines • Volume 6, September 2008
Table 1: Some footnotes were renumbered.
View the updated online version of this article.
Bendamustine (Treanda) for CLL and NHL
The Medical Letter • Volume 50, November 17, 2008
Correction: In the Clinical Studies section, the complete response rate with chlorambucil for CLL was 2% (not 24%).
View the updated online version of this article.
CT Colonography
The Medical Letter • Volume 50, December 1, 2008
Correction: In table 1, “Invasive” should be “less” and “more” rather than “no” and “yes” for CT colonography and colonoscopy, respectively. In the conclusion, “noninvasive” should be “less invasive.”
View the updated online version of this article.
Drugs for Asthma
Treatment Guidelines • Volume 6, December 2008
Correction: In the table on page 86, the last sentence of footnote 7 was incomplete. It now correctly reads: “Zileuton is taken within 1 hour after morning and evening meals.”
View the updated online version of this article.
2024
Treatment of Atrial Fibrillation
The Medical Letter • Volume 66, January 8, 2024
Addendum: The Interruption of Anticoagulation section of our article on Treatment of Atrial Fibrillation cited the recommendations of the American College of Chest Physicians on perioperative management of antithrombotic therapy (JD Douketis et al. Chest 2022; 162:e207). A reader suggested that our general statement …
View the complete addendum. 2023
In Brief: Over-the-Counter Narcan Nasal Spray
The Medical Letter • Volume 65, May 1, 2023
Addendum: Since the publication of our articles entitled Drugs for Opioid Use Disorder and In Brief: Over-the-Counter Narcan Nasal Spray earlier this year, Narcan (Emergent), a nasal spray that delivers 4 mg of the opioid antagonist naloxone, has become available for sale over the counter (OTC). According to the manufacturer …
View the complete addendum. Choice of Contraceptives
The Medical Letter • Volume 65, May 15, 2023
Revisions:
In the Diaphragm with Spermicide section in Table 1, failure rate for typical use is 17% (not 7% as originally stated).
In the “Progestin-Only Oral Contraceptives” section, Opill contains 0.075 mg of norgestrel (not 0.75 mg as originally stated).
View the updated online version of this article.Drugs for Anxiety Disorders
The Medical Letter • Volume 65, August 7, 2023
Addendum: A nephrologist and longtime reader of The Medical Letter wrote us to say that our recent article entitled Drugs for Anxiety Disorders should have said more about the need for dosage adjustment of gabapentin (Neurontin, and others) and pregabalin (Lyrica, and others) in patients …
View the complete addendum. Drugs for Opioid Use Disorder
The Medical Letter • Volume 65, September 4, 2023
Addendum: Since the publication of our articles entitled Drugs for Opioid Use Disorder and In Brief: Over-the-Counter Narcan Nasal Spray earlier this year, Narcan (Emergent), a nasal spray that delivers 4 mg of the opioid antagonist naloxone, has become available for sale over the counter (OTC). According to the manufacturer …
View the complete addendum. COVID-19 Update: New Pfizer and Moderna Vaccine Formulations for 2023-2024
The Medical Letter • Volume 65, October 16, 2023
Correction: In our article in issue 1687 on the updated 2023-2024 COVID-19 vaccines from Pfizer and Moderna (Med Lett Drugs Ther 2023; 65:161), the doses and formulations of the Pfizer vaccine were incorrect. A revised table has been posted in the online version of the article.
View the updated online version of this article.Antiviral Drugs for Influenza for 2023-2024
The Medical Letter • Volume 65, November 13, 2023
Addendum: In the printed version of our article entitled Antiviral Drugs for Influenza for 2023-2024 in issue 1689 (Med Lett Drugs Ther 2023; 65:177), the clinical studies section should have included a meta-analysis of 15 randomized trials in 6295 outpatient adolescents and adults with influenza that found that use of oseltamivir did not reduce the risk of hospitalization in the overall population or in those ≥65 years old compared to placebo or standard of care. It has been added in the online version of the article.
View the updated online version of this article.Drugs for Depression
The Medical Letter • Volume 65, December 11, 2023
Addendum 2/5/2024: In our article on Drugs for Depression, we should have included tardive dyskinesia (TD) in our list of adverse effects of second-generation antipsychotic (SGA) drugs. TD, which is more commonly associated with first-generation antipsychotics, can also occur in patients taking an SGA…
View the complete addendum. Addendum 4/1/2024: Our December 11, 2023 article on Drugs for Depression included a single sentence on the safety of bupropion use during pregnancy: “The safety of bupropion during pregnancy has not been established; data from a bupropion pregnancy registry suggested a possible increase in cardiac malformations.” A reader asked us to provide more information. …
View the complete addendum. 2022
Drugs for GERD and Peptic Ulcer Disease
The Medical Letter • Volume 64, April 4, 2022
Addendum: A reader commented that our recent article on Drugs for GERD and Peptic Ulcer Disease did not include enough information on dexlansoprazole (Dexilant, and generics), a proton pump inhibitor (PPI) claimed to provide “all-day and all-night relief from heartburn”. Dexlansoprazole recently became available generically, but it is much more expensive than other generic PPIs. …
View the complete addendum. Prevention and Treatment of Monkeypox
The Medical Letter • Volume 64, September 5, 2022
Revision: In the Prevention section, “smallpox” was removed in the first paragraph, last sentence of The Vaccines section when describing the vaccinia virus; it was also removed in Table 2, 3rd column of Vaccine virus.
View the updated online version of this article.Nalmefene Returns for Reversal of Opioid Overdose
The Medical Letter • Volume 64, September 5, 2022
Revision: In Table 2, footnote 3, the last sentence about a challenge dosage has been changed from 0.1 mg/kg to 0.1 mg/70 kg (“70” was missing).
View the updated online version of this article.Drugs for Type 2 Diabetes
The Medical Letter • Volume 64, November 14, 2022
Revision: The GLP-1 agonist lixisenatide (Adlyxin) is no longer available in the US. Soliqua, the fixed-dose combination of lixisenatide and insulin glargine, is still available.
View the updated online version of this article.Opioids for Pain
The Medical Letter • Volume 64, December 12, 2022
Revision: In the Pregnancy paragraph, the last sentence has been revised from “Pregnant women who are physically dependent on opioids should receive buprenorphine or methadone.” to “Pregnant women with opioid use disorder should receive buprenorphine or methadone for maintenance treatment.”
View the updated online version of this article.2021
FDA Authorizes Pfizer-BioNTech COVID-19 Vaccine
The Medical Letter • Volume 63, January 11, 2021
Revisions: On March 3, 2021, the CDC changed the “contraindication” to use of a mRNA COVID-19 vaccine in patients with polysorbate allergy to a “precaution”: https://bit.ly/38i7CIH. The last paragraph of the Adverse Effects section has been updated to reflect this. 6/15/21: The Storage and Administration section has been updated.
View the updated online version of this article.FDA Authorizes Moderna COVID-19 Vaccine
The Medical Letter • Volume 63, January 25, 2021
Revisions: On March 3, 2021, the CDC changed the “contraindication” to use of a mRNA COVID-19 vaccine in patients with polysorbate allergy to a “precaution”: https://bit.ly/38i7CIH. The last paragraph of the Adverse Effects section has been updated to reflect this. 4/5/21: The Storage and Administration section has been updated.
View the updated online version of this article.Drugs for Parkinson’s Disease
The Medical Letter • Volume 63, February 22, 2021
Revision: Canadian-English Edition: In Table 1, the price of Duodopa has been changed to reflect the monthly cost (the price previously listed was the daily cost).
View the updated online version of this article.An EUA for Bamlanivimab and Etesevimab for COVID-19
The Medical Letter • Volume 63, April 5, 2021
Revisions:
1/6/2022: The Variants paragraph has been updated.
9/23/2021: As of September 2, 2021, distribution of bamlanivimab and etesevimab has resumed in all US jurisdictions (https://bit.ly/3AynAdr).
7/1/2021: On June 25, 2021, federal distribution of bamlanivimab and etesevimab was suspended because an increasing percentage of COVID-19 cases in the US are being caused by SARS-CoV-2 variants that are resistant to the drugs (https://bit.ly/3dsDH2I).
View the updated online version of this article.Semaglutide (Ozempic) for Weight Loss
The Medical Letter • Volume 63, April 5, 2021
Revision: The Clinical Studies section and Table 2 have been updated to reflect data from a new study (STEP 4) that was released after press.
View the updated online version of this article.Drugs for Chronic Heart Failure
The Medical Letter • Volume 63, June 14, 2021
Revision: The 2nd paragraph of the ivabradine section has been reworded.
View the updated online version of this article.An EUA for Sotrovimab for Treatment of COVID-19
The Medical Letter • Volume 63, June 28, 2021
Revisions:
7/1/2021: The Availability paragraph has been revised.
1/6/2022: The Variants paragraph has been updated.
View the updated online version of this article.Aducanumab (Aduhelm) for Alzheimer’s Disease
The Medical Letter • Volume 63, July 12, 2021
Addendum: In June 2021, the FDA approved the IV amyloid beta-directed monoclonal antibody aducanumab (Aduhelm) for treatment of Alzheimer’s disease. The approval did not restrict use of the drug to patients with mild cognitive impairment or mild dementia, which was the population enrolled in the clinical trials. Now, Biogen, with the permission of the FDA…
View the complete addendum. Casirivimab and Imdevimab (REGEN-COV) for Post-Exposure Prophylaxis of COVID-19
The Medical Letter • Volume 63, August 23, 2021
Revision: The Variants paragraph has been revised.
View the updated online version of this article.Bamlanivimab and Etesevimab for Post-Exposure Prophylaxis of COVID-19
The Medical Letter • Volume 63, October 18, 2021
Revision: The Variants paragraph has been revised.
View the updated online version of this article.2020
Drospirenone (Slynd) – A New Progestin-Only Oral Contraceptive
The Medical Letter • Volume 62, February 10, 2020
Revision: In the Drug Interactions section, the last sentence was added to warn about an increased risk of hyperkalemia when drospirenone and spironolactone are used concurrently.
Addendum: In our article on Slynd (Med Lett Drugs Ther 2020; 62:18), the drospirenone-only oral contraceptive, we mentioned that drospirenone has antiandrogenic activity that could improve acne and antimineralocorticoid activity that could cause hyperkalemia. We should have added that concurrent use of drospirenone with other drugs that increase potassium levels, such as the anti-androgen aldosterone receptor antagonist spironolactone (Aldactone, and generics), which is often used off-label for treatment of acne, can increase the risk of hyperkalemia.
View the updated online version of this article. Brolucizumab (Beovu) for Age-Related Macular Degeneration
The Medical Letter • Volume 62, February 10, 2020
Addendum: We reviewed brolucizumab (Beovu – Novartis) for treatment of neovascular (wet) age-related macular degeneration in our February 10 issue. On February 23, the American Society of Retina Specialists reported that 14 patients who received the drug have developed retinal vasculitis…
View the complete addendum. Drugs for Osteoarthritis
The Medical Letter • Volume 62, April 20, 2020
Revision: In the turmeric paragraph, information on a recent trial has been added.
View the updated online version of this article.Durysta – A Bimatoprost Implant for Glaucoma
The Medical Letter • Volume 62, July 27, 2020
Revision: In the 2nd sentence of the Clinical Studies section, bimatoprost implants were administered at day 1, week 16, and week 32 (not week 24 as originally stated).
View the updated online version of this article.Drugs for Menopausal Symptoms
The Medical Letter • Volume 62, August 10, 2020
Correction: In Table 1, Estring‘s formulation and dosage was changed to 7.5 mcg/day (not 75 mcg/day).
View the updated online version of this article.Phexxi – A Nonhormonal Contraceptive Gel
The Medical Letter • Volume 62, August 24, 2020
Revisions: The third bullet in the Phexxi Summary box and the Conclusion have been edited, as well as Phexxi in Table 1.
View the updated online version of this article.Antiviral Drugs for Influenza for 2020-2021
The Medical Letter • Volume 62, November 2, 2020
Revision: The chemoprophylaxis effectiveness paragraph and Table 2 were revised to reflect the new indication and availability of a new formulation of baloxavir.
View the updated online version of this article.In Brief: New Benzodiazepine Warnings
In Brief: New Warnings on NSAID Use in Pregnancy
The Medical Letter • Volume 62, November 2, 2020
Revision – Canadian-English version only: The first sentence in both the benzodiazepine and NSAID articles have been changed to also reflect Health Canada’s new warnings.
An EUA for Bamlanivimab – A Monoclonal Antibody for COVID-19
The Medical Letter • Volume 62, November 30, 2020
Revision: A new paragraph on Variants has been added.
View the updated online version of this article. An EUA for Casirivimab and Imdevimab for COVID-19
The Medical Letter • Volume 62, December 28, 2020
Revisions:
3/22/21: A new paragraph on Variants has been added.
6/17/21: On May 21, 2021, the FDA revised the criteria by which an outpatient with COVID-19 can be deemed high-risk. On June 3, 2021, the FDA reissued its Emergency Use Authorization for casirivimab and imdevimab with new dosage and administration instructions.
1/6/2022: The Variants paragraph has been updated.
View the updated online version of this article. 2019
Plenvu – A Low-Volume PEG-Based Colonoscopy Preparation
The Medical Letter • Volume 61, January 28, 2019
Correction: The comparator drug in the DAYB trial was not Prepopik, but rather Citrafleet. Also, Plenvu can be taken as two doses in a single day or split over two days (not as a single- or split-dose regimen).
View the updated online version of this article. Drug Interaction between Opioids and Oral P2Y12 Platelet Inhibitors
The Medical Letter • Volume 62, February 25, 2019
Addendum: Opioids delay gastric emptying and the absorption of many oral drugs, including the P2Y12 inhibitors clopidogrel (Plavix, and generics), prasugrel (Effient, and generics), and ticagrelor (Brilinta), which are commonly used for initial treatment of acute coronary syndrome (ACS). An article in our February 25, 2019 issue reviewed studies showing that coadministration of opioids delayed and decreased absorption of oral P2Y12 inhibitors and increased platelet reactivity. Recently published clinical outcomes data may add to these concerns. …
View the complete addendum. Drugs for Chronic Heart Failure
The Medical Letter • Volume 61, April 8, 2019
Correction: In our Drugs for Chronic Heart Failure article, our description of the PARADIGM-HF trial comparing the combination of the ARB valsartan and the neprilysin inhibitor sacubitril (Entresto) with the ACE inhibitor enalapril for treatment of heart failure with reduced ejection fraction (HFrEF) characterized the dosage of enalapril as “suboptimal”. Some readers have objected to that characterization. …
View the complete correction. View the updated online version of this article. Brexanolone (Zulresso) for Postpartum Depression
The Medical Letter • Volume 61, May 6, 2019
Revision: The article was revised following scheduling of brexanolone as a schedule IV controlled substance by the DEA.
View the updated online version of this article. Estradiol/Progesterone (Bijuva) for Menopausal Vasomotor Symptoms
The Medical Letter • Volume 61, July 1, 2019
Addendum: Single-ingredient oral formulations of estradiol and progesterone have been added to Table 1, as well as medroxyprogesterone (Provera, and generic).
View the updated online version of this article. Annovera – A New Contraceptive Vaginal Ring
The Medical Letter • Volume 61, December 16, 2019
Revision: The introduction, cost, and conclusion paragraphs were revised to reflect the availability of generic NuvaRing products (Eluryng, and others).
View the updated online version of this article. 2018
Drugs for GERD and Peptic Ulcer Disease
The Medical Letter • Volume 60, January 15, 2018
Revision: Information warning about an increased risk of cardiac events and death with clarithromycin has been added. The last sentence in the peptic ulcer disease section was revised to improve clarity. In the H2-receptor antagonists (H2RAs) section, the third sentence was revised to include information about the onset of action of H2RAs.
View the updated online version of this article. Semaglutide (Ozempic) – Another Injectable GLP-1 Receptor Agonist for Type 2 Diabetes
The Medical Letter • Volume 60, January 29, 2018
Revision: Footnote 15 was added to Table 2 and the Dosage and Administration section was revised to reflect the availability of separate pens for 0.5-mg and 1.0-mg doses of Ozempic. The SUSTAIN-7 trial was added to Table 3 and the Clinical Studies section.
View the updated online version of this article. Nonopioid Drugs for Pain
The Medical Letter • Volume 60, February 12, 2018
Revisions: The section on salicylates has been revised to include more details about the antiplatelet effects of diflunisal. In the Other Effects section, first paragraph, the last sentence was revised.
View the updated online version of this article. Benralizumab (Fasenra) for Severe Eosinophilic Asthma
The Medical Letter • Volume 60, February 26, 2018
Revision: Information in the Dosage section regarding hypersensitivity reactions was revised.
View the updated online version of this article. Opioids for Pain
The Medical Letter • Volume 60, April 9, 2018
Revision: Footnote 19 has been added to Table 2.
View the updated online version of this article. Adult Immunization
The Medical Letter • Volume 60, May 5, 2018
Revision: The section on Recommendation for Use of hepatitis A vaccine has been updated to include “persons experiencing homelessness.”
View the updated online version of this article. Drugs for Inflammatory Bowel Disease
The Medical Letter • Volume 60, July 2, 2018
Revision: Information about the risk of pulmonary thromboembolism and death with tofacitinib was added to the JAK inhibitor section.
View the updated online version of this article. Management of Opioid Withdrawal Symptoms
The Medical Letter • Volume 60, August 27, 2018
Clarification: Some readers have questioned our characterization of opioid withdrawal as not life-threatening. While death during opioid withdrawal is unusual, it is possible — for example, due to severe untreated dehydration, withdrawal-induced suicidality, or rare myocardial events. We probably should have said that opioid withdrawal is generally not life-threatening. We have make that addition to the article.
View the updated online version of this article. Choice of Contraceptives
The Medical Letter • Volume 60, October 8, 2018
Revision: The paragraph about Liletta in the intrauterine devices (IUDs) section was revised to reflect FDA approval (10/15/18) increasing the duration of use from 4 years to 5 years.
View the updated online version of this article. Influenza Vaccine for 2018-2019
The Medical Letter • Volume 60, October 22, 2018
Revision: Tables 2 and 4 were revised to reflect the FDA’s recent approval of Afluria Quadrivalent for person ≥6 months old.
View the updated online version of this article. Baloxavir Marboxil (Xofluza) for Treatment of Influenza
The Medical Letter • Volume 60, December 3, 2018
Revision: The Standard Treatment paragraph was revised to clarify that use of oseltamivir or peramivir for treatment of hospitalized or seriously ill patients is not an FDA-approved use.
View the updated online version of this article. 2017
Another Insulin Glargine (Basaglar) for Diabetes
The Medical Letter • Volume 59, January 2, 2017
Revision: In the Dosage and Administration paragraph, we removed the word “syringe” in describing Basaglar‘s KwikPen device. Basaglar is not available as a prefilled syringe; it is only available as a KwikPen.
View the updated online version of this article. Drugs for Type 2 Diabetes
The Medical Letter • Volume 59, January 16, 2017
Revisions: In the dulaglutide section, we mistakenly stated that Xultophy is a combination of albiglutide/insulin degludec; the correct combination of Xultophy is liraglutide/insulin degludec. We have also moved that sentence to the liraglutide paragraph. In Table 2, the price for Victoza was changed to $498.40 (from $249.20).
View the updated online version of this article. Obeticholic Acid (Ocaliva) for Primary Biliary Cholangitis
The Medical Letter • Volume 59, March 27, 2017
Revision: See Dosage and Administration third paragraph.
View the updated online version of this article. Drugs for COPD
The Medical Letter • Volume 59, April 10, 2017
Revision: Lonhala Magnair was added to Table 1, QVAR Redihaler and Trelegy Ellipta were added to Table 3.
View the updated online version of this article. Prescription Drug Prices in the US
The Medical Letter • Volume 59, May 22, 2017
Revision: In Table 2, footnote 11 has been added, and is related to the Canadian cost of Advair HFA.
View the updated online version of this article. Abuse-Deterrent Opioids
The Medical Letter • Volume 59, June 5, 2017
Correction: The information on Targiniq ER in Table 1 is incorrect. The drug, which is not available in the US, is a combination of oxycodone ER and naloxone, not naltrexone, and naloxone is dispersed throughout the tablet, not sequestered. Targiniq ER has been deleted from the table.
View the updated online version of this article. Drugs for Helicobacter pylori Infection
The Medical Letter • Volume 59, July 17, 2017
Correction: In table 3 on page 116, the price provided for Prevpac was for a 14-day supply, rather than for a 10-day supply as stated in footnote 1. The footnote has been corrected and the price of the generic formulation of Prevpac has been added.
Revision: Information warning about an increased risk of cardiac events and death with clarithromycin has been added.
View the updated online version of this article. Drugs for Cognitive Loss and Dementia
The Medical Letter • Volume 59, September 25, 2017
Revision: The last sentence at the end of the article was incorrect; it has been deleted.
View the updated online version of this article. Influenza Vaccine for 2017-2018
The Medical Letter • Volume 59, October 9, 2017
Revision: In Table 2, the recommended age for Fluarix Quadrivalent was changed to ≥6 months.
View the updated online version of this article. Drugs for Common Bacterial Infections in Adults
The Medical Letter • Volume 59, October 23, 2017
Revision: In skin and soft tissue infections, nonpurulent infection section, “trimethoprim/sulfamethoxazole” was removed from the 5th sentence. It may be effective for treatment of such infections, but other antibiotics with established efficacy and fewer adverse effects are preferred.
Revision: Information warning about an increased risk of cardiac events and death with clarithromycin has been added.
View the updated online version of this article. Shingrix – An Adjuvanted, Recombinant Herpes Zoster Vaccine
The Medical Letter • Volume 59, December 4, 2017
Revision: See New Recommendations paragraph.
View the updated online version of this article. 2016
Naloxone (Narcan) Nasal Spray for Opioid Overdose
The Medical Letter • Volume 58, January 4, 2016
Clarification: A reader expressed concern that a statement in our article Naloxone (Narcan) Nasal Spray for Opioid Overdose (Med Lett Drugs Ther 2016; 58:1) might be misleading. We stated that heroin has a half-life of 2-6 minutes, which is correct, but heroin is a prodrug that is rapidly metabolized to 6-acetylmorphine and morphine. The risk of respiratory depression is related to those active metabolites, and it may persist well beyond the clearance of heroin from the blood.
Mepolizumab (Nucala) for Severe Eosinophilic Asthma
The Medical Letter • Volume 58, January 18, 2016
Revision: Information in the Dosage section regarding hypersensitivity reactions was revised.
View the updated online version of this article. Drugs for Acne
The Medical Letter • Volume 58, February 1, 2016
Correction: In Table 1, the formulations for Differin, topical adapalene, should have been listed as 0.1% gel, cream, lotion; 0.3% gel (not 3% gel).
View the updated online version of this article. Addendum: Our article earlier this year on Drugs for Acne (Med Lett Drugs Ther 2016; 58:13) stated that the oral retinoid isotretinoin (Accutane, and others) is the most effective drug available for patients with severe nodulocystic acne, but warned that depression, suicidality, myalgia, hypertriglyceridemia, and other adverse effects can occur. One of our readers objected to our listing depression and suicidality, which are the subject of a prominent warning in the package insert, in the same sentence as indisputable side effects…
View the complete addendum. Patiromer (Veltassa) for Hyperkalemia
The Medical Letter • Volume 58, February 15, 2016
Revision: In the Drug Interactions paragraph, a sentence was added about a November 2016 revision in the prescribing information.
View the updated online version of this article. Treatment of Lyme Disease
The Medical Letter • Volume 58, May 9, 2016
Addendum: A reader commenting on our Treatment of Lyme Disease article (Med Lett Drugs Ther 2016; 58:57) objected to a footnote in the table advising against use of doxycycline in children <8 years old. This warning has been included in the labeling of all tetracyclines since 1970 when it was recognized, after decades of use, that these drugs caused permanent staining and enamel hypoplasia of developing teeth. The CDC recently stated…
View the complete addendum. Drugs for Depression
The Medical Letter • Volume 58, July 4, 2016
Revision: The adverse effects sections of SSRIs, SNRIs, and tricyclic antidepressants have been revised to include information on QT interval prolongation.
View the updated online version of this article.Cannabis and Cannabinoids
The Medical Letter • Volume 58, August 1, 2016
Addendum: A dose/cost table has been added.
View the updated online version of this article. Daclizumab (Zinbryta) for Multiple Sclerosis
The Medical Letter • Volume 58, September 12, 2016
Revision: Withdrawn from the market March 2018 due to safety concerns.
View the updated online version of this article. Influenza Vaccine for 2016-2017
The Medical Letter • Volume 58, October 10, 2016
Revisions: A sentence regarding Flublok Quadrivalent has been added to the “Quadrivalent vs Trivalent” section; in Table 2, the recommended age in for FluLaval Quadrivalent was changed to ≥6 months (from ≥3 years).
View the updated online version of this article. Lipid-Lowering Drugs
The Medical Letter • Volume 58, October 24, 2016
Addendum: In our recent article on Lipid-Lowering Drugs,we said that statins can reduce the risk of first cardiovascular events and death (primary prevention) in patients at high risk for atherosclerotic cardiovascular disease (CVD) and significantly reduce the incidence of cardiovascular events in patients at lower risk for CVD. Now the United States Preventive Services Task Force (USPSTF)…
View the complete addendum. 2015
Diet, Drugs, and Surgery for Weight Loss
The Medical Letter • Volume 57, February 16, 2015
Addendum: The mean weight loss listed in table 1 included, at the lower end of the range, the mean weight loss reported with a lower than FDA-approved dose of lorcaserin (Belviq). The placebo-corrected weight loss reported with FDA-approved doses of lorcaserin is 2.9-3.6 kg.
View the updated online version of this article. Suvorexant (Belsomra) for Insomnia
The Medical Letter • Volume 57, March 2, 2015
Revision: In Table 2, the Pregnancy Category for flurazepam is “X” (not “C”).
View the updated online version of this article. Nivolumab (Opdivo) for Metastatic Melanoma and Metastatic NSCLC
The Medical Letter • Volume 57, June 8, 2015
Addendum: After our article on nivolumab (Opdivo – BMS) for treatment of metastatic melanoma and metastatic squamous non-small cell lung cancer (NSCLC) was published in the most recent issue of The Medical Letter (June 8, 2015), some new data became available supporting the efficacy of the drug in previously untreated melanoma and previously treated nonsquamous NSCLC. …
View the complete addendum. Flibanserin (Addyi) for Hypoactive Sexual Desire Disorder
The Medical Letter • Volume 57, September 28, 2015
Addendum: When our article on flibanserin (Addyi) was published, the drug had not yet been marketed. Flibanserin became available on October 17, 2015 at a cost of $800 for a 30-day supply.
Update (April 12, 2019): The label of flibanserin (Addyi) has been revised based on postmarketing studies evaluating the risk of consuming alcohol while taking flibanserin. According to the new label, flibanserin is contraindicated for use within 2 hours following discontinuation of alcohol. Alcohol should not be consumed until at least the morning after taking flibanserin.
View the updated online version of this article. Eloctate for Hemophilia A
The Medical Letter • Volume 57, October 12, 2015
Correction: In the table on page 144, the indications and half-life listed for Nuwiq were erroneously taken from the European package insert. The table has been revised online to reflect the US prescribing information. The cost for Nuwiq has also been updated.
View the updated online version of this article. Drugs for Hypothyroidism
The Medical Letter • Volume 57, October 26, 2015
Addendum: In our October 26, 2015 article on drugs for hypothyroidism, we said that levothyroxine should be taken on an empty stomach with a full glass of water 30-60 minutes (60 is preferable) before breakfast. We should have added that taking the drug consistently at bedtime, at least 3 hours after the last meal, is an alternative that some patients may find more convenient.
A Sumatriptan Patch (Zecuity) for Migraine
The Medical Letter • Volume 57, November 9, 2015
Correction: In the introduction on page 151, the triptans were referred to as serotonin (5-HT) receptor antagonists; they are 5-HT1B/1D-receptor agonists.
View the updated online version of this article. Cobicistat (Tybost) and Combinations for HIV
The Medical Letter • Volume 57, November 23, 2015
Correction: In the Adverse Effects section, 3rd sentence, the word “reabsorption” has been replaced with “secretion”.
View the updated online version of this article. Insulin Degludec (Tresiba) – A New Long-Acting Insulin for Diabetes
The Medical Letter • Volume 57, December 7, 2015
Revision: In Table 3, footnote 1 was changed to: “Approximate WAC for 30 days’ treatment with 40 units/day in prefilled pens.”
View the updated online version of this article. 2014
Dapagliflozin (Farxiga) for Type 2 Diabetes
The Medical Letter • Volume 56, February 17, 2014
Correction: In the Drug Interactions paragraph, the second sentence about dapagliflozin exposure has been rewritten.
View the updated online version of this article. Influenza Vaccine for 2014-2015
The Medical Letter • Volume 56, October 13, 2014
Revision: See Tables 1 and 2 for new age indication for FluBlock (now ≥18 years).
View the updated online version of this article. PCV13 for Adults 65 Years and Older
The Medical Letter • Volume 57, October 13, 2014
Addendum: In 2014, the US Advisory Committee on Immunization Practices (ACIP) recommended that all adults 65 years old and older being vaccinated against pneumococcus for the fi rst time receive the pneumococcal conjugate vaccine (PCV13) followed 6 to 12 months later by the pneumococcal polysaccharide vaccine …
View the complete addendum. Secondary Prevention of Stroke
The Medical Letter • Volume 56, December 8, 2014
Revision: In the Clopidogrel Plus Aspirin section, the last sentence has been revised. In the Conclusion, “90 days” has been changed to “21 days”.
View the updated online version of this article. 2013
Drugs for Epilepsy
Treatment Guidelines • Volume 11, February 2013
Correction: The dosage of topiramate in Table 2 on page 11 has been changed from 200-400 mg/day in 2 doses to 100-400 mg/day in 2 doses. The dosage recommendation in the labeling for monotherapy is 400 mg per day, but Medical Letter consultants have pointed out that in clinical practice, the usual dose of topiramate for monotherapy is 100-200 mg per day. Higher doses may be needed for adjunctive use.
View the updated online version of this article. Drugs for Pain
Treatment Guidelines • Volume 11, April 2013
Correction: In Table 1 (Some Nonopioid Analgesics), the price for IV ibuprofen (Caldolor) has been revised.
View the updated online version of this article. Nutritional Supplements for Age-Related Macular Degeneration Revisited
The Medical Letter • Volume 55, June 24, 2013
Revision: The last sentence in the Conclusion has been changed
View the updated online version of this article. Drugs for Bacterial Infections
Treatment Guidelines • Volume 11, July 2013
Correction: The price of tigecycline (Tygacil) in Table 2 has been corrected.
View the updated online version of this article. Ospemifene (Osphena) for Dyspareunia
The Medical Letter • Volume 55, July 8, 2013
Addendum: Some readers have objected to our recommendation that postmenopausal women with an intact uterus who take the oral estrogen agonist/antagonist ospemifene (Osphena) to reduce the severity of dyspareunia should also take a progestin. Ospemifene has agonistic effects on the endometrium, and the Osphena package insert says: “Generally, when a product with estrogen agonistic effects on the endometrium is prescribed for a postmenopausal woman with a uterus, a progestin …
View the complete addendum. More Less
2012
Deferiprone (Ferriprox) for Iron Overload
The Medical Letter • Volume 54, February 20, 2012
Correction: The second sentence in deferiprone’s conclusion has been changed to fix a grammatical error.
View the updated online version of this article. Tafluprost (Zioptan) – A New Topical Prostaglandin for Glaucoma
The Medical Letter • Volume 54, April 16, 2012
Correction: In Table 1 on page 31, the formulation column should have included a 0.01% solution of bimatoprost. The size, daily dosage and cost of 0.01% bimatoprost are the same as those of the 0.03% solution.
View the updated online version of this article. Drugs for Menopausal Symptoms
The Medical Letter • Volume 54, May 28, 2012
Addendum: A reader commented that our article on treatment of menopausal symptoms should have mentioned the potential advantages of transdermal estrogen. Transdermal estrogens are probably as effective as oral estrogens in treating vasomotor menopausal symptoms, but transdermal administration may have less effect on serum triglycerides, C-reactive protein, thyroxine-binding globulin, cortisol-binding globulin and sex hormone-binding globulin. Observational data suggest that the risk of venous thromboembolism may be lower with transdermal administration compared to standard-dose oral estrogens, but comparative randomized controlled trials are lacking.
Axitinib (Inlyta) for Advanced Renal Cell Carcinoma
The Medical Letter • Volume 54, June 11, 2012
Correction: In Table 1 on page 47, footnote 2 has been removed from the cost of axitinib.
View the updated online version of this article. Bisphosphonates – Duration of Use Revisited
The Medical Letter • Volume 54, June 25, 2012
Correction: In the first sentence of the conclusion, the words “with osteoporosis” were removed immediately after “women”.
View the updated online version of this article. Renal Sympathetic Denervation for Hypertension
The Medical Letter • Volume 54, July 9, 2012
Addendum: Our July 9, 2012 article on renal sympathetic denervation for multiple-drug resistant hypertension concluded that the catheter-based procedure (Symplicity Catheter System – Medtronic) can lower blood pressure in most patients with hypertension resistant to ≥3 antihypertensive drugs. That conclusion was based on the results of 2 studies. SYMPLICITY HTN-1 compared outcomes to baseline blood pressures. SYMPLICITY HTN-2 randomized patients to renal denervation or usual care. …
View the complete addendum. Drugs for Urinary Tract Infections
The Medical Letter • Volume 54, July 23, 2012
Addendum: A reader suggested that our July 23 article on Drugs for Urinary Tract Infection should have included information on the cost of the drugs we recommended for treatment of acute uncomplicated cystitis.
Trimethoprim/sulfamethoxazole DS — Generic formulations are available at large discount pharmacies for $4 for 20 tablets. Trimethoprim/sulfamethoxazole DS is generally found on tier 1 (lowest co-pay) of insurance company formularies.
Nitrofurantoin monohydrate/macrocrystals — The wholesale acquisition cost of the generic formulation is about $2.50 per tablet (PricePointRx™. Reprinted with permission by FDB. All rights reserved. ©2012. http://www.firstdatabank.com/support/drug-pricing-policy.aspx. Accessed July 31, 2012. Actual retail prices may be higher). The drug is on tier 1 of some insurance company formularies, but on tier 2 or 3 of others.
Fosfomycin — Available only as Monurol, a single dose of fosfomycin is effective in most cases of acute uncomplicated cystitis, but the manufacturer charges a wholesale acquisition cost of more than $40 for that dose (PricePointRx™. Reprinted with permission by FDB. All rights reserved. ©2012. http://www.firstdatabank.com/support/drug-pricing-policy.aspx. Accessed July 31, 2012. Actual retail prices may be higher). Most insurance companies place Monurol on tier 3 of their formularies, or do not include it on their formularies at all.
Not recommended: Ciprofloxacin – Fluoroquinolones should not be used empirically to treat acute uncomplicated cystitis. The fact that ciprofloxacin is available at large discount pharmacies for $4 for 20 500-mg tablets and is on tier 1 on most insurance company formularies may be part of the reason for its continued overuse.
What Comes After Metformin for Type 2 Diabetes?
The Medical Letter • Volume 54, July 23, 2012
Addendum: Several readers have raised questions about the statement in our recent article that long-acting insulins, like metformin and sulfonylureas, have been shown to decrease long-term cardiovascular risk. Our statement was based on the extension of the UKPDS (RR Holman et al, N Engl J Med 2008; 359:1577), which is the longest prospective trial of drug therapy in patients with type 2 diabetes. Shorter studies in older patients with long-standing diabetes did not find a reduction in cardiovascular risk with these and other drugs (The Action to Control Cardiovascular Risk in Diabetes Study Group. N Engl J Med 2008; 358:2545; The ADVANCE Collaborative Group. N Engl J Med 2008; 358:2560; W Duckworth et al. N Engl J Med 2009; 360:129).
Two New Drugs for Weight Loss
The Medical Letter • Volume 54, September 3, 2012
Correction: On page 71 in the “Drug Interactions” paragraph, the last sentence should read: “Phentermine is contraindicated while taking, and for 14 days after stopping, a monoamine oxidase (MAO) inhibitor because of the risk of hypertensive crisis.”
View the updated online version of this article. Endocarditis Prophylaxis for Dental Procedures
The Medical Letter • Volume 54, September 17, 2012
Correction: In the Dental Procedures paragraph, 6th line, the word “rubber” has been omitted before the word “bands” because placement of rubber bands does not require prophylaxis; placement of orthodontic metal bands does.
View the updated online version of this article. A 4-Drug Combination (Stribild) for HIV
The Medical Letter • Volume 54, November 26, 2012
Correction: In the “Drug Interactions” paragraph, the word “oral” has been inserted before “midazolam” in the 3rd sentence.
View the updated online version of this article. Cephalosporins for Patients with Penicilllin Allergy
The Medical Letter • Volume 54, December 24, 2012
Addendum: A reader who took the online continuing medical education (CME) exam for issue 1406 pointed out that the first question assumed that a rash following oral administration of ampicillin would be due to allergy. Perhaps we should have mentioned in our article on penicillin allergy that late-appearing maculopapular rashes associated with oral ampicillin or amoxicillin are generally considered non-allergic and need not preclude subsequent administration of ampicillin or amoxicillin.
2011
In Brief: Delayed-Release Risedronate (Atelvia)
The Medical Letter • Volume 53, March 21, 2011
Correction: The In-Brief article on delayed-release risedronate in issue 1360 included a statement that alendronate is currently the only bisphosphonate available generically. That would have been accurate if we had added “that is FDA-approved for treatment of osteoporosis.” Etidronate (Didronel, and others), which was the first bisphosphonate used to treat osteoporosis (Medical Letter 1990; 32:111) but was never approved for such use by the FDA, is also available generically. It is approved for treatment of Paget’s disease and for prevention and treatment of heterotropic ossification following hip replacement and in spinal-cord injured patients.
View the updated online version of this article. Intravenous Acetaminophen (Ofirmev)
The Medical Letter • Volume 53, April 4, 2011
Clarification: The cost of ketorolac listed in Table 1 on page 27 is for a single 30-mg prefilled syringe. A 30-mg vial costs about $1.63 according to AWP listings in Red Book 2010.
View the updated online version of this article. A New Testosterone Gel (Fortesta) for Hypogonadism
The Medical Letter • Volume 53, April 18, 2011
Correction: In Table 1, the price of a 5-mL (200 mg/mL) vial of testosterone enanthate should have been $79.30 for the generic and $91.30 for the brand (Delatestryl), not $15.86 for the generic and $18.26 for the brand.
View the updated online version of this article. Drugs for Treatment of ADHD
Treatment Guidelines • Volume 9, May 2011
Correction: The Daily Adult Dosages for Focalin and generic methylphenidate in Table 1 have been updated.
View the updated online version of this article. Dextromethorphan/Quinidine (Nuedexta) for Pseudobulbar Affect
The Medical Letter • Volume 53, June 13, 2011
Correction: In our June 13, 2011 article, we said that the FDA has approved Nuedexta for treatment of pseudobulbar affect in patients with amyotrophic lateral sclerosis (ALS) or multiple sclerosis (MS). That is not quite correct. The package insert says that the drug is indicated for the treatment of pseudobulbar affect and then goes on to say, in the next two sentences, that studies to support the effectiveness of Nuedexta were performed in patients with underlying ALS or MS, and that the drug has not been shown to be safe or effective in other types of emotional lability. Also, the second sentence in the Drug Interactions paragraph should have said: “Other drugs that prolong the QT interval, inhibit CYP3A4, or are metabolized by CYP2D6 and prolong the QT interval, should be used with caution, if at all.”
View the updated online version of this article. Telaprevir (Incivek) and Boceprevir (Victrelis) for Chronic Hepatitis C
The Medical Letter • Volume 53, July 25, 2011
Correction: In the clinical studies section for telaprevir, “among patients who had a previous relapse” was added to the REALIZE trial sentence.
View the updated online version of this article. Vemurafenib (Zelboraf) for Metastatic Melanoma
The Medical Letter • Volume 53, October 3, 2011
Correction: In the Dosage and Cost section on page 78, the minimum dose of vemurafenib was changed from 420 mg twice daily to 480 mg twice daily.
View the updated online version of this article. A Fixed-Dose Combination of Ibuprofen and Famotidine (Duexis)
The Medical Letter • Volume 53, October 31, 2011
Correction: In the clinical studies section, the overall incidence of endoscopic gastroduodenal ulcers should have been 11% with Duexis and 21.9% with ibuprofen alone and, in low dose aspirin users, 12.8% with Duexis and 32.8% with ibuprofen alone.
View the updated online version of this article. Who Should Take Vitamin Supplements?
The Medical Letter • Volume 53, December 12/26, 2011
Revision: The first paragraph on vitamin E has been revised.
View the updated online version of this article. 2010
Ustekinumab (Stelara) for Psoriasis
The Medical Letter • Volume 52, January 25, 2010
Addendum: Footnote 2 in table 2 should have included a second sentence: $5595.60 is the cost of one 45-mg syringe.
View the updated online version of this article. Ferumoxytol (Feraheme) – A New Parenteral Iron Formulation
The Medical Letter • Volume 52, March 22, 2010
Correction: The last sentence of the Dosage, Administration and Cost paragraph should have listed the cost of 1 gram of sodium ferric gluconate (Ferrlecit) as about $600.
View the updated online version of this article. Safety of Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease (COPD)
The Medical Letter • Volume 52, May 31, 2010
Correction: The last sentence in the Efficacy paragraph should say, “…budesonide/formoterol…” (not budesonide/salmeterol).
View the updated online version of this article. A Sumatriptan Needle-Free Injection for Migraine
The Medical Letter • Volume 52, June 28, 2010
Correction: In Table 2, the injection volumes of Imitrex and Sumaval are listed as 5 mL. They should be 0.5 mL.
View the updated online version of this article. Pitavastatin (Livalo) – The Seventh Statin
The Medical Letter • Volume 52, July 26, 2010
Correction: In the table, the usual decrease in LDL-cholesterol with pitavastatin has been changed to 35-40% (2 mg) and 40-45% (4 mg). Also, in the Dosage and Administration paragraph, the GFR has been changed to 30-<60 ml/min/1.73 m2.
View the updated online version of this article. Drugs for Parasitic Infections
Handbook (2nd Edition) • July 2010
Correction: In the table titled, “Manufacturers of Drugs Used to Treat Parasitic Infections”, the first footnote on page 81 should say, ” …(see footnote 3 on page 4).”
Drugs for Sexually Transmitted Infection
Treatment Guidelines • Volume 8, July 2010
Correction: The last two sentences in the Epididymitis section have been reworded.
View the updated online version of this article. Mometasone/Formoterol (Dulera) for Asthma
The Medical Letter • Volume 52, October 18, 2010
Correction: In the Clinical Studies section, the second clinical trial compared the 2 different strengths of the combinations with mometasone alone, 400 mcg twice daily, and not with placebo.
View the updated online version of this article. 2009
Vancomycin Dosing and Monitoring
The Medical Letter • Volume 51, April 6, 2009
Correction: Dosing paragraph: The next to last sentence should be “…organism is =2 mg/L, the new….” (not >2 mg/L).
View the updated online version of this article. Milnacipran (Savella) for Fibromyalgia
The Medical Letter • Volume 51, June 15, 2009
Correction: In the 2nd sentence, “similar to gabapentin” was added. It now reads, “…a gamma-aminobutyric acid (GABA) analog similar to gabapentin…”
View the updated online version of this article. In Brief: Biennial IV Zoledronic Acid (Reclast) for Prevention of Osteoporosis
The Medical Letter • Volume 51, June 29, 2009
Correction: The first word of the title was changed from Biannual to Biennial.
View the updated online version of this article. Antimicrobial Prophylaxis for Surgery
Treatment Guidelines • Volume 7, June 2009
Addendum: Table 1: Footnote 14 was added to the Gastrointestinal/Colorectal section and a second sentence was added to footnote 5.
View the updated online version of this article. Golimumab (Simponi) for Inflammatory Arthritis
The Medical Letter • Volume 51, July 13, 2009
Correction: In the first sentence “humanized” was changed to “human” to describe golimumab. In Table 1, the source for certolizumab (Cimzia) was changed to “humanized” and the price should have been $1,341.68 (not $3,136.40).
View the updated online version of this article. Benzyl Alcohol Lotion for Head Lice
The Medical Letter • Volume 51, July 27, 2009
Correction: In Table 1, the price for lindane 1% shampoo should have been $136.86 (not $3.00).
View the updated online version of this article. When a Statin Fails
The Medical Letter • Volume 51, July 27, 2009
Correction: The first paragraph should have included the words “for patients at high risk” after 100 mg/dL (2.6 mmol/L)
View the updated online version of this article. Tapentadol (Nucynta) – A New Analgesic
The Medical Letter • Volume 51, August 10, 2009
Correction: In the pharmacokinetics table, the half-life for tapentadol was changed from “24” to “4”.
View the updated online version of this article. Colchicine and Other Drugs for Gout
The Medical Letter • Volume 51, November 30, 2009
Correction: In the Uricosuric agents paragraph, the last two words in the last sentence (“and theophylline.”) were deleted.
View the updated online version of this article. Advice for Travelers
Treatment Guidelines • Volume 7, November 2009
Correction: In the oral rehydration salts paragraph, the first sentence has been changed from “…can help maintain electrolyte balance…” to “can prevent and treat dehydration…”
View the updated online version of this article. 2008
Veregen: A Botanical for Treatment of Genital Warts
The Medical Letter • Volume 50, February 25, 2008
Correction: Theophylline was deleted from the pharmacology section on page 15; it is not among the components that make up 2.5% of the drug weight. Table 1: 2.3% discontinuation rate due to adverse effects for Veregen (not 5%)
View the updated online version of this article. Diet, Drugs and Surgery for Weight Loss
Treatment Guidelines • Volume 6, April 2008
Correction: In the Adjustable Gastric Banding section on page 37, the first sentence has been changed from “Use of a laparoscopically adjustable gastric band placed around…” to “Use of an adjustable gastric band placed laparoscopically around…” In the second sentence, the words through a subcutaneous reservoir have been added.
View the updated online version of this article. Natalizumab (Tysabri) for Crohn’s Disease
The Medical Letter • Volume 50, May 5, 2008
Correction: The May 5, 2008 article on the approval of natalizumab (Tysabri) for treatment of Crohn’s disease in the “Adverse Effects” section on page 35 included the statement: “… postmarketing hepatotoxicity, sometimes fatal or requiring liver transplantation, has occurred.” Actually, no fatal hepatotoxicity or liver transplantation has been reported to date. The FDA warning about post-marketing hepatotoxicity with Tysabri that was the basis for our statement said: “The combination of transaminase elevations and elevated bilirubin without evidence of obstruction is recognized as an important predictor of severe liver injury that may lead to [emphasis added] death or the need for a liver transplant in some patients.” Also, in the last sentence of the Conclusion, we should have said: “Because of the risk of serious hepatic toxicity and the rare but even more serious risk of developing progressive multifocal leukoencephalopathy, it should be used only in patients who have not responded to other drugs, including a TNF inhibitor.” The italicized words should be substituted for “it is FDA-approved for use.”
View the updated online version of this article. Pharmacogenetic-Based Dosing of Warfarin
The Medical Letter • Volume 50, May 19, 2008
Addendum – Warfarin-Acetaminophen Interaction: A reader expressed disappointment that our recent listing of “Some Warfarin Drug Interactions” 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.
View the updated online version of this article. In Brief: Measles Outbreak
The Medical Letter • Volume 50, June 2, 2008
Illinois has been added to the first sentence. It is among the states where measles was reported.
View the updated online version of this article. The EarCheck Middle Ear Monitor
The Medical Letter • Volume 50, July 14, 2008
Correction: The article in the July 14th issue contained an error in the last sentence of the last paragraph beginning on page 55. The instrument’s reading is determined not by the degree of protrusion of the tympanic membrane, but rather by its mobility.
View the updated online version of this article. Drugs for Tobaco Dependence
Treatment Guidelines • Volume 6, September 2008
Table 1: Some footnotes were renumbered.
View the updated online version of this article. Bendamustine (Treanda) for CLL and NHL
The Medical Letter • Volume 50, November 17, 2008
Correction: In the Clinical Studies section, the complete response rate with chlorambucil for CLL was 2% (not 24%).
View the updated online version of this article. CT Colonography
The Medical Letter • Volume 50, December 1, 2008
Correction: In table 1, “Invasive” should be “less” and “more” rather than “no” and “yes” for CT colonography and colonoscopy, respectively. In the conclusion, “noninvasive” should be “less invasive.”
View the updated online version of this article.Drugs for Asthma
Treatment Guidelines • Volume 6, December 2008
Correction: In the table on page 86, the last sentence of footnote 7 was incomplete. It now correctly reads: “Zileuton is taken within 1 hour after morning and evening meals.”
View the updated online version of this article.