Matching articles for "propranolol"
Drugs for Hypertension
The Medical Letter on Drugs and Therapeutics • May 27, 2024; (Issue 1703)
American College of Cardiology/American Heart
Association (ACC/AHA) guidelines for treatment of
hypertension were last published in 2018. Treatment
of hypertensive urgencies and emergencies is not
discussed...
American College of Cardiology/American Heart
Association (ACC/AHA) guidelines for treatment of
hypertension were last published in 2018. Treatment
of hypertensive urgencies and emergencies is not
discussed here.
Treatment of Atrial Fibrillation
The Medical Letter on Drugs and Therapeutics • January 8, 2024; (Issue 1693)
Atrial fibrillation (AF) is the most common arrhythmia
in the world. Risk factor modification, anticoagulation,
rhythm control, and rate control are the four pillars
of its management. American College of...
Atrial fibrillation (AF) is the most common arrhythmia
in the world. Risk factor modification, anticoagulation,
rhythm control, and rate control are the four pillars
of its management. American College of Cardiology/American Heart Association (ACC/AHA) guidelines
on management of AF were updated recently.
Drugs for Anxiety Disorders
The Medical Letter on Drugs and Therapeutics • August 7, 2023; (Issue 1682)
Anxiety disorders (generalized anxiety disorder,
panic disorder, social anxiety disorder, and various
phobias) are the most common form of psychiatric
illness. They can be treated effectively with...
Anxiety disorders (generalized anxiety disorder,
panic disorder, social anxiety disorder, and various
phobias) are the most common form of psychiatric
illness. They can be treated effectively with cognitive
behavioral therapy (CBT) and/or pharmacotherapy.
Brexpiprazole (Rexulti) for Agitation in Alzheimer's Dementia
The Medical Letter on Drugs and Therapeutics • June 26, 2023; (Issue 1679)
The FDA has approved the oral second-generation
antipsychotic drug brexpiprazole (Rexulti – Otsuka/Lundbeck) for once-daily treatment of agitation associated
with dementia due to Alzheimer's disease...
The FDA has approved the oral second-generation
antipsychotic drug brexpiprazole (Rexulti – Otsuka/Lundbeck) for once-daily treatment of agitation associated
with dementia due to Alzheimer's disease (AD).
Brexpiprazole is the first drug to be approved in the US
for this indication. It is also approved for treatment of
schizophrenia and as an adjunct to antidepressants for
treatment of major depressive disorder.
Comparison Table: Triptans for Migraine (online only)
The Medical Letter on Drugs and Therapeutics • June 12, 2023; (Issue 1678)
...
View the Comparison Table: Triptans for Migraine
Comparison Table: Some Drugs for Migraine Prevention in Adults (online only)
The Medical Letter on Drugs and Therapeutics • June 12, 2023; (Issue 1678)
...
View the Comparison Table: Some Drugs for Migraine Prevention in Adults
Drugs for Migraine
The Medical Letter on Drugs and Therapeutics • June 12, 2023; (Issue 1678)
An oral nonopioid analgesic is often sufficient for
acute treatment of mild to moderate migraine pain
without severe nausea or vomiting. A triptan is the
drug of choice for treatment of moderate to...
An oral nonopioid analgesic is often sufficient for
acute treatment of mild to moderate migraine pain
without severe nausea or vomiting. A triptan is the
drug of choice for treatment of moderate to severe
migraine in most patients without vascular disease.
Treatment of pain when it is still mild to moderate in
intensity improves headache response and reduces
the risk of recurrence.
Atogepant (Qulipta) for Migraine Prevention
The Medical Letter on Drugs and Therapeutics • November 1, 2021; (Issue 1636)
Atogepant (Qulipta – Abbvie), an oral small-molecule
calcitonin gene-related peptide (CGRP) receptor
antagonist ("gepant"), has been approved by the
FDA for prevention of episodic migraine in adults....
Atogepant (Qulipta – Abbvie), an oral small-molecule
calcitonin gene-related peptide (CGRP) receptor
antagonist ("gepant"), has been approved by the
FDA for prevention of episodic migraine in adults. It
is the second oral CGRP receptor antagonist to be
approved in the US for this indication; the first was
rimegepant (Nurtec ODT), which is also approved
for acute treatment of migraine. Parenteral CGRP
monoclonal antibodies are approved for prevention
of migraine (see Table 3).
Drugs for Migraine
The Medical Letter on Drugs and Therapeutics • October 5, 2020; (Issue 1608)
An oral nonopioid analgesic is often sufficient for acute
treatment of mild to moderate migraine headache
without severe nausea or vomiting. A triptan is the
drug of choice for treatment of moderate to...
An oral nonopioid analgesic is often sufficient for acute
treatment of mild to moderate migraine headache
without severe nausea or vomiting. A triptan is the
drug of choice for treatment of moderate to severe
migraine headache pain in most patients without
vascular disease. Early treatment of pain when it is
still mild to moderate in intensity improves headache
response and reduces the risk of recurrence.
Eptinezumab (Vyepti) for Migraine Prevention
The Medical Letter on Drugs and Therapeutics • June 1, 2020; (Issue 1599)
The FDA has approved eptinezumab-jjmr (Vyepti –
Lundbeck), a calcitonin gene-related peptide (CGRP)
antagonist administered IV once every 3 months, for
migraine prevention in adults. It is the fourth...
The FDA has approved eptinezumab-jjmr (Vyepti –
Lundbeck), a calcitonin gene-related peptide (CGRP)
antagonist administered IV once every 3 months, for
migraine prevention in adults. It is the fourth monoclonal
antibody to be approved for this indication; erenumab
(Aimovig), fremanezumab (Ajovy), and galcanezumab
(Emgality), which are all given subcutaneously once
monthly (fremanezumab can also be given once every 3
months), were approved earlier.
Drugs for Hypertension
The Medical Letter on Drugs and Therapeutics • May 18, 2020; (Issue 1598)
Drugs available for treatment of chronic hypertension
and their dosages, adverse effects, and costs are
listed in the tables. Treatment
of hypertensive urgencies and emergencies is not
discussed...
Drugs available for treatment of chronic hypertension
and their dosages, adverse effects, and costs are
listed in the tables. Treatment
of hypertensive urgencies and emergencies is not
discussed here.
Drugs for Atrial Fibrillation
The Medical Letter on Drugs and Therapeutics • September 9, 2019; (Issue 1580)
Treatment of atrial fibrillation includes anticoagulation,
rate control, and rhythm control. US guidelines were
recently...
Treatment of atrial fibrillation includes anticoagulation,
rate control, and rhythm control. US guidelines were
recently updated.
Drugs for Anxiety Disorders
The Medical Letter on Drugs and Therapeutics • August 12, 2019; (Issue 1578)
Anxiety disorders (generalized anxiety disorder, panic
disorder, social anxiety disorder, and various phobias)
are the most common form of psychiatric illness. They
can be treated effectively with cognitive...
Anxiety disorders (generalized anxiety disorder, panic
disorder, social anxiety disorder, and various phobias)
are the most common form of psychiatric illness. They
can be treated effectively with cognitive behavioral
therapy (CBT) and/or pharmacotherapy. Obsessive-compulsive
disorder and posttraumatic stress
disorder are now considered separate entities in the
Diagnostic and Statistical Manual of Mental Disorders
(DSM-5); they can also be treated with CBT and many
of the same drugs.
Fremanezumab (Ajovy) and Galcanezumab (Emgality) for Migraine Prevention
The Medical Letter on Drugs and Therapeutics • November 5, 2018; (Issue 1559)
The FDA has approved two subcutaneously
injected calcitonin gene-related peptide (CGRP)
antagonists, fremanezumab-vfrm (Ajovy – Teva) and
galcanezumab-gnlm (Emgality – Lilly), for migraine
prevention in...
The FDA has approved two subcutaneously
injected calcitonin gene-related peptide (CGRP)
antagonists, fremanezumab-vfrm (Ajovy – Teva) and
galcanezumab-gnlm (Emgality – Lilly), for migraine
prevention in adults. Fremanezumab and galcanezumab
are the second and third subcutaneously
injected monoclonal antibodies that target the CGRP
pathway to be approved by the FDA for this indication;
erenumab-aooe (Aimovig), which targets the CGRP
receptor, was the first.
Erenumab (Aimovig) for Migraine Prevention
The Medical Letter on Drugs and Therapeutics • June 18, 2018; (Issue 1549)
The FDA has approved erenumab-aooe (Aimovig –
Amgen/Novartis), a once-monthly, subcutaneously-injected,
monoclonal antibody against the calcitonin
gene-related peptide receptor, for preventive...
The FDA has approved erenumab-aooe (Aimovig –
Amgen/Novartis), a once-monthly, subcutaneously-injected,
monoclonal antibody against the calcitonin
gene-related peptide receptor, for preventive treatment
of migraine in adults. It is the first drug in its class to
be approved by the FDA.
Drugs for Asthma
The Medical Letter on Drugs and Therapeutics • August 28, 2017; (Issue 1528)
The goal of asthma treatment is to control symptoms
and prevent exacerbations. Management of acute
exacerbations of asthma is not discussed...
The goal of asthma treatment is to control symptoms
and prevent exacerbations. Management of acute
exacerbations of asthma is not discussed here.
Exablate Neuro for Essential Tremor
The Medical Letter on Drugs and Therapeutics • March 27, 2017; (Issue 1517)
The FDA has approved use of Exablate Neuro (Insightec)
for unilateral thalamotomy to treat medication-refractory
essential tremor in patients ≥22 years old.
Exablate Neuro uses magnetic...
The FDA has approved use of Exablate Neuro (Insightec)
for unilateral thalamotomy to treat medication-refractory
essential tremor in patients ≥22 years old.
Exablate Neuro uses magnetic resonance-guided
focused ultrasound (MRgFUS) to create lesions in the
ventral intermediate nucleus of the thalamus. MRgFUS
is also approved in the US for treatment of uterine
fibroids and for pain palliation of bone metastases.
Drugs for Hypertension
The Medical Letter on Drugs and Therapeutics • March 13, 2017; (Issue 1516)
in the US and their dosages, adverse effects, and
costs are listed in the tables.
Treatment of hypertensive urgencies and emergencies
is not discussed...
in the US and their dosages, adverse effects, and
costs are listed in the tables.
Treatment of hypertensive urgencies and emergencies
is not discussed here.
Drugs for Migraine
The Medical Letter on Drugs and Therapeutics • February 13, 2017; (Issue 1514)
An oral nonopioid analgesic may be sufficient for
treatment of mild to moderate migraine without severe
nausea or vomiting. A triptan is the drug of choice for
treatment of moderate to severe migraine. Use...
An oral nonopioid analgesic may be sufficient for
treatment of mild to moderate migraine without severe
nausea or vomiting. A triptan is the drug of choice for
treatment of moderate to severe migraine. Use of
a triptan early in an attack when pain is still mild to
moderate in intensity improves headache response
and reduces recurrence rates.
Comparison Table: Some Drugs for Migraine Prevention in Adults (online only)
The Medical Letter on Drugs and Therapeutics • February 13, 2017; (Issue 1514)
...
View the Comparison Table: Some Drugs for Migraine Prevention in Adults
Oral Propranolol (Hemangeol) for Infantile Hemangioma
The Medical Letter on Drugs and Therapeutics • July 21, 2014; (Issue 1447)
The FDA has approved an oral solution of the
nonselective beta-adrenergic blocker propranolol
(Hemangeol – Pierre Fabre) for treatment of proliferating
infantile...
The FDA has approved an oral solution of the
nonselective beta-adrenergic blocker propranolol
(Hemangeol – Pierre Fabre) for treatment of proliferating
infantile hemangiomas.
Treatment of Atrial Fibrillation
The Medical Letter on Drugs and Therapeutics • July 7, 2014; (Issue 1446)
The treatment of atrial fibrillation includes anticoagulation,
rate control, and rhythm control. New US
guidelines for the management of atrial fibrillation
have recently been...
The treatment of atrial fibrillation includes anticoagulation,
rate control, and rhythm control. New US
guidelines for the management of atrial fibrillation
have recently been published.
Drugs for Hypertension
The Medical Letter on Drugs and Therapeutics • May 1, 2014; (Issue 141)
Most recent guidelines recommend a BP goal of 140/90 mm Hg. For patients ≥60 years old without diabetes
or chronic kidney disease, one guideline recommends
150/90 mm Hg both as the drug treatment...
Most recent guidelines recommend a BP goal of 140/90 mm Hg. For patients ≥60 years old without diabetes
or chronic kidney disease, one guideline recommends
150/90 mm Hg both as the drug treatment initiation
threshold and treatment target; this higher target is
controversial, except in patients ≥80 years old.
Drugs for Migraine
The Medical Letter on Drugs and Therapeutics • December 1, 2013; (Issue 136)
Treatment of migraine in the emergency department,
which may involve use of intravenous drugs, is not
discussed...
Treatment of migraine in the emergency department,
which may involve use of intravenous drugs, is not
discussed here.
Beta-Adrenergic Blockers and Breast Cancer
The Medical Letter on Drugs and Therapeutics • January 23, 2012; (Issue 1382)
Three retrospective studies have recently reported an
association between beta-blocker use and a reduction
in breast cancer metastasis and recurrence. No
prospective, randomized trials have been...
Three retrospective studies have recently reported an
association between beta-blocker use and a reduction
in breast cancer metastasis and recurrence. No
prospective, randomized trials have been published.
Drugs for Hypertension
The Medical Letter on Drugs and Therapeutics • January 1, 2012; (Issue 113)
Drugs available in the US for treatment of chronic
hypertension, with their dosages and adverse effects,
are listed in the tables that begin on page 2.
Combination products are listed on page 8. Drugs...
Drugs available in the US for treatment of chronic
hypertension, with their dosages and adverse effects,
are listed in the tables that begin on page 2.
Combination products are listed on page 8. Drugs for
treatment of hypertensive emergencies are not discussed
here. They were reviewed previously.
In Brief: Oral Propranolol for Infantile Hemangiomas
The Medical Letter on Drugs and Therapeutics • October 31, 2011; (Issue 1376)
The surprising observation that oral administration of the beta-blocker propranolol (Inderal, and others) can stop the growth and rapidly cause the involution of disfiguring or life-threatening infantile...
The surprising observation that oral administration of the beta-blocker propranolol (Inderal, and others) can stop the growth and rapidly cause the involution of disfiguring or life-threatening infantile hemangiomas1 has quickly led to a series of confirmatory observations and now a controlled trial. The mechanism of this effect is not known, but is thought to be related to down-regulation of the RAF mitogen-activated protein kinase signaling pathway resulting in inhibition of vascular endothelial growth factor (VEGF) and apoptosis in capillary endothelial cells. The response of infantile hemangiomas to propranolol, which may be detectable within a day, has been similar regardless of the age of the child or the location or depth of the lesion.2 A randomized controlled trial in 40 children 9 weeks to 5 years old with primarily facial hemangiomas compared propranolol 2 mg/kg/day to a placebo, each given in 3 divided doses, for 6 months. Propranolol was significantly more effective in reducing the volume, redness and elevation of the lesions. No significant hypoglycemia, hypotension or bradycardia occurred.3
1. C Léauté-Labrèze et al. Propranolol for severe hemangiomas of infancy. N Engl J Med 2008; 358:2649.
2. L Bagazgoitia et al. Propranolol for infantile hemangiomas. Pediatr Dermatol 2011; 28:108.
3. M Hogeling et al. A randomized controlled trial of propranolol for infantile hemangiomas. Pediatrics 2011; 128: e259.
Download U.S. English
1. C Léauté-Labrèze et al. Propranolol for severe hemangiomas of infancy. N Engl J Med 2008; 358:2649.
2. L Bagazgoitia et al. Propranolol for infantile hemangiomas. Pediatr Dermatol 2011; 28:108.
3. M Hogeling et al. A randomized controlled trial of propranolol for infantile hemangiomas. Pediatrics 2011; 128: e259.
Download U.S. English
Drugs for Migraine
The Medical Letter on Drugs and Therapeutics • February 1, 2011; (Issue 102)
Drugs for treatment of migraine are listed in Table 2
on page 9. Drugs for prevention of migraine are listed
in Table 3 on page 10. Treatment of migraine in the
emergency room, which may involve use of...
Drugs for treatment of migraine are listed in Table 2
on page 9. Drugs for prevention of migraine are listed
in Table 3 on page 10. Treatment of migraine in the
emergency room, which may involve use of intravenous
drugs, is not included here.
Treatment of Atrial Fibrillation
The Medical Letter on Drugs and Therapeutics • September 1, 2010; (Issue 97)
The treatment of atrial fibrillation includes ventricular rate control, anticoagulation, conversion to normal sinus rhythm and maintenance of sinus rhythm. The choice of therapies that can achieve these goals...
The treatment of atrial fibrillation includes ventricular rate control, anticoagulation, conversion to normal sinus rhythm and maintenance of sinus rhythm. The choice of therapies that can achieve these goals is discussed in the text that follows. Some drugs are recommended here for indications that have not been approved by the FDA.
Dronedarone (Multaq) for Atrial Fibrillation
The Medical Letter on Drugs and Therapeutics • October 5, 2009; (Issue 1322)
Dronedarone (Multaq - Sanofi-Aventis) has been approved by the FDA for oral treatment of atrial fibrillation and flutter. Amiodarone (Cordarone, and others) is the most effective drug for this indication, but...
Dronedarone (Multaq - Sanofi-Aventis) has been approved by the FDA for oral treatment of atrial fibrillation and flutter. Amiodarone (Cordarone, and others) is the most effective drug for this indication, but has considerable toxicity.
Drugs for Thyroid Disorders
The Medical Letter on Drugs and Therapeutics • August 1, 2009; (Issue 84)
Primary hypothyroidism is usually the result of Hashimoto's thyroiditis, thyroidectomy for hyperthyroidism, goiter or cancer, or radioactive iodine therapy for...
Primary hypothyroidism is usually the result of Hashimoto's thyroiditis, thyroidectomy for hyperthyroidism, goiter or cancer, or radioactive iodine therapy for hyperthyroidism.
Drugs for Hypertension
The Medical Letter on Drugs and Therapeutics • January 1, 2009; (Issue 77)
Drugs available in the US for treatment of chronic hypertension, with their dosages, adverse effects and costs, are listed in the tables that begin on page 2. Combination products are listed on page 9. Drugs...
Drugs available in the US for treatment of chronic hypertension, with their dosages, adverse effects and costs, are listed in the tables that begin on page 2. Combination products are listed on page 9. Drugs for treatment of hypertensive emergencies are not discussed here. They were reviewed in Treatment Guidelines (volume 1, page 19, December 2002) and in The Medical Letter (volume 50, page 73, September 22, 2008).
Drugs for Asthma
The Medical Letter on Drugs and Therapeutics • December 1, 2008; (Issue 76)
No truly new drugs have been approved for treatment of asthma since omalizumab (Xolair) in 2003, but some randomized controlled trials of older drugs have been published, and new guidelines have become...
No truly new drugs have been approved for treatment of asthma since omalizumab (Xolair) in 2003, but some randomized controlled trials of older drugs have been published, and new guidelines have become available.
Nebivolol (Bystolic) for Hypertension
The Medical Letter on Drugs and Therapeutics • March 10, 2008; (Issue 1281)
Nebivolol (Bystolic - Forest) is a new beta-blocker that has been approved by the FDA for treatment of hypertension. It has been marketed in Europe since 1999 for treatment of hypertension and heart...
Nebivolol (Bystolic - Forest) is a new beta-blocker that has been approved by the FDA for treatment of hypertension. It has been marketed in Europe since 1999 for treatment of hypertension and heart failure.
Drugs for Migraine
The Medical Letter on Drugs and Therapeutics • March 1, 2008; (Issue 67)
Some drugs for treatment of migraine attacks are listed in table 2 on page 18. Drugs for prevention of migraine are listed in table 3 on page 20. Treatment of migraine in the emergency room, which may involve...
Some drugs for treatment of migraine attacks are listed in table 2 on page 18. Drugs for prevention of migraine are listed in table 3 on page 20. Treatment of migraine in the emergency room, which may involve use of intravenous drugs, is not included here.
Drugs for Cardiac Arrhythmias
The Medical Letter on Drugs and Therapeutics • June 1, 2007; (Issue 58)
The drugs of choice for treatment of common cardiac arrhythmias are listed in Tables 1 and 2. Some drugs are recommended for indications that have not been approved by the FDA....
The drugs of choice for treatment of common cardiac arrhythmias are listed in Tables 1 and 2. Some drugs are recommended for indications that have not been approved by the FDA.
AmpliChip CYP450 Test
The Medical Letter on Drugs and Therapeutics • August 15, 2005; (Issue 1215)
The FDA recently cleared the AmpliChip CYP450 Test (Roche), which analyzes blood-derived DNA to detect genetic variations in the activity of cytochrome P450 (CYP) enzymes CYP2D6 and CYP2C19 and determines the...
The FDA recently cleared the AmpliChip CYP450 Test (Roche), which analyzes blood-derived DNA to detect genetic variations in the activity of cytochrome P450 (CYP) enzymes CYP2D6 and CYP2C19 and determines the metabolizer status of the patient. The test is intended to help guide clinicians in prescribing individualized drug therapy. About 25% of all drugs, including many antidepressants and antipsychotics, are substrates of either CYP2D6 or CYP2C19. The test is being promoted initially to psychiatrists.
Drugs for Hypertension
The Medical Letter on Drugs and Therapeutics • June 1, 2005; (Issue 34)
Drugs available in the US for treatment of chronic hypertension, with their dosages, adverse effects and costs, are listed in the tables that begin on page 40. Combination products are listed on page 47. Drugs...
Drugs available in the US for treatment of chronic hypertension, with their dosages, adverse effects and costs, are listed in the tables that begin on page 40. Combination products are listed on page 47. Drugs for treatment of hypertensive emergencies are not discussed here.
Drugs for Asthma
The Medical Letter on Drugs and Therapeutics • May 1, 2005; (Issue 33)
Patients with mild, infrequent asthma symptoms may require only intermittent, asneeded use of an inhaled short-acting beta2-adrenergic agonist. Use of a short-acting beta2-agonist more than twice weekly, other...
Patients with mild, infrequent asthma symptoms may require only intermittent, asneeded use of an inhaled short-acting beta2-adrenergic agonist. Use of a short-acting beta2-agonist more than twice weekly, other than for exercise-induced bronchospasm, indicates a need for anti-inflammatory treatment. Inhaled corticosteroids are the most effective anti-inflammatory medication; leukotriene modifiers are less effective alternatives. If regular use of an inhaled corticosteroid in a low dose does not prevent symptoms, a long-acting beta2-agonist should be added; addition of a second drug is more effective than raising the dose of the inhaled steroid. A leukotriene modifier can also be used as the second drug. Omalizumab may be considered as adjunctive therapy for patients more than 12 years old who have allergic asthma not controlled by other drugs. A short course of oral corticosteroids may be useful for acute exacerbations. Treatment of acute severe asthma as a medical emergency is not included here; it has been reviewed elsewhere (ER McFadden Jr, Am J Respir Crit Care Med 2003; 168:740).
Topiramate (Topamax) for Prevention of Migraine
The Medical Letter on Drugs and Therapeutics • January 31, 2005; (Issue 1201)
Patients with frequent, severe or disabling migraine headaches may benefit from taking a drug to prevent the attacks. Beta-blockers traditionally have been the prophylactic treatment of choice, but in recent...
Patients with frequent, severe or disabling migraine headaches may benefit from taking a drug to prevent the attacks. Beta-blockers traditionally have been the prophylactic treatment of choice, but in recent years some antiepileptic drugs such as valproate (Depakote, and others) and topiramate (Topamax) have also been used for this indication. Valproate was approved by the FDA for such use in 1996. Now topiramate has also been approved.
Drugs for Cardiac Arrhythmias
The Medical Letter on Drugs and Therapeutics • November 1, 2004; (Issue 27)
The drugs of choice for treatment of common cardiac arrhythmias are listed in the table that begins on the next page; some drugs are recommended for indications for which they have not been approved by the US...
The drugs of choice for treatment of common cardiac arrhythmias are listed in the table that begins on the next page; some drugs are recommended for indications for which they have not been approved by the US FDA. The dosages and adverse effects of each drug are listed in the table that begins on page 80. Antiarrhythmic drugs may themselves cause arrhythmias, which can be fatal. Some of these drugs may increase rather than decrease mortality, especially in patients with structural heart disease.
Drugs for Migraine
The Medical Letter on Drugs and Therapeutics • September 1, 2004; (Issue 25)
Drugs for treatment of migraine attacks are listed in the table on page 64. All of the oral drugs are most effective if taken early in an attack when the pain is mild (H Christoph-Diener et al, Neurology 2004;...
Drugs for treatment of migraine attacks are listed in the table on page 64. All of the oral drugs are most effective if taken early in an attack when the pain is mild (H Christoph-Diener et al, Neurology 2004; 63:520). Drugs for prevention of migraine are listed in the table on page 65. Treatment of migraine in the emergency room, which may involve use of intravenous drugs, is not included here.
New Indications for Modafinil (Provigil)
The Medical Letter on Drugs and Therapeutics • April 26, 2004; (Issue 1181)
Modafinil (Provigil - Cephalon; Alertec - Draxis in Canada), first approved by the FDA in 1999 for treatment of excessive daytime sleepiness associated with narcolepsy (Medical Letter 1999; 41:30), has now also...
Modafinil (Provigil - Cephalon; Alertec - Draxis in Canada), first approved by the FDA in 1999 for treatment of excessive daytime sleepiness associated with narcolepsy (Medical Letter 1999; 41:30), has now also been approved for treatment of patients with excessive sleepiness due to obstructive sleep apnea/hypopnea syndrome (OSAHS) or shift work sleep disorder (SWSD) (DSM-IV, text revision, Washington, DC: American Psychiatric Association, 2000, page 622).
Drugs for Psychiatric Disorders
The Medical Letter on Drugs and Therapeutics • July 1, 2003; (Issue 11)
The number of drugs marketed for psychiatric indications has increased sharply in recent years. The recommendations in this article are based on the results of controlled trials and on the experience and...
The number of drugs marketed for psychiatric indications has increased sharply in recent years. The recommendations in this article are based on the results of controlled trials and on the experience and opinions of Medical Letter consultants. Interactions with other drugs can be found in The Medical Letter Handbook of Adverse Drug Interactions, 2003.
Drug Interactions
The Medical Letter on Drugs and Therapeutics • June 8, 2003; (Issue 1158)
Changes caused by one drug in the absorption, distribution, metabolism or excretion of another may lead to a pharmacokinetic adverse drug interaction (DN Juurlink et al, JAMA 2003; 289:1652). Additive drug...
Changes caused by one drug in the absorption, distribution, metabolism or excretion of another may lead to a pharmacokinetic adverse drug interaction (DN Juurlink et al, JAMA 2003; 289:1652). Additive drug interactions, such as vasodilation caused by both sildenafil (Viagra) and nitrates, can also have adverse effects.
Eletriptan (Relpax) for Migraine
The Medical Letter on Drugs and Therapeutics • April 28, 2003; (Issue 1155)
Eletriptan hydrobromide (Relpax Pfizer) is now available in the US for oral treatment of migraine headache in adults. It is the seventh serotonin 5-HT1B/1D-receptor agonist (triptan) to be approved by the FDA...
Eletriptan hydrobromide (Relpax Pfizer) is now available in the US for oral treatment of migraine headache in adults. It is the seventh serotonin 5-HT1B/1D-receptor agonist (triptan) to be approved by the FDA for this indication. This review describes the pharmacokinetics, adverse effects, drug interactions and recommended dosage of eletriptan. Clinical trials comparing the new drug to placebo and to sumatriptan are presented. A dosage and cost table for all the triptans available in the US is also included. The review concludes with an overall assessment of eletriptan's efficacy and safety.
Drugs for Hypertension
The Medical Letter on Drugs and Therapeutics • February 1, 2003; (Issue 6)
Drugs available in the US for treatment of chronic hypertension, with their dosages, adverse effects and costs, are listed in the table that begins on page 35. Combination products are listed on page 39. Drugs...
Drugs available in the US for treatment of chronic hypertension, with their dosages, adverse effects and costs, are listed in the table that begins on page 35. Combination products are listed on page 39. Drugs for treatment of hypertensive emergencies were discussed in Treatment Guidelines volume 1, issue 4, page 19, December 2002.
Drugs for Hypertension
The Medical Letter on Drugs and Therapeutics • March 5, 2001; (Issue 1099)
Drugs available in the USA for treatment of chronic hypertension, their dosages and adverse affects are listed in the table and discussed in the...
Drugs available in the USA for treatment of chronic hypertension, their dosages and adverse affects are listed in the table and discussed in the text.
Which Beta-Blocker?
The Medical Letter on Drugs and Therapeutics • February 5, 2001; (Issue 1097)
Some classes of drugs include so many agents that hospital formulary committees, managed care organizations and individual practitioners may find it difficult to choose among them. Fifteen beta-adrenergic...
Some classes of drugs include so many agents that hospital formulary committees, managed care organizations and individual practitioners may find it difficult to choose among them. Fifteen beta-adrenergic receptor antagonists (beta-blockers) are now marketed for systemic use in the USA. One or more have been approved by the FDA for use in hypertension and eight other indications.
Drug Interactions
The Medical Letter on Drugs and Therapeutics • July 2, 1999; (Issue 1056)
Reports of adverse interactions between drugs continue to accumulate. Recently, the FDA has expanded the recommendations on drug interactions found in the package inserts of new...
Reports of adverse interactions between drugs continue to accumulate. Recently, the FDA has expanded the recommendations on drug interactions found in the package inserts of new drugs.
Miglitol for Type 2 Diabetes Mellitus
The Medical Letter on Drugs and Therapeutics • May 21, 1999; (Issue 1053)
Miglitol, an oral alpha-glucosidase inhibitor similar to acarbase, is now available for treatment of type 2...
Miglitol, an oral alpha-glucosidase inhibitor similar to acarbase, is now available for treatment of type 2 diabetes.
Drugs for Depression and Anxiety
The Medical Letter on Drugs and Therapeutics • April 9, 1999; (Issue 1050)
The number of drugs marketed for treatment of depression has increased in recent years. Antidepressants are generally also effective for treatment of...
The number of drugs marketed for treatment of depression has increased in recent years. Antidepressants are generally also effective for treatment of anxiety.
Drugs for Hypertension
The Medical Letter on Drugs and Therapeutics • March 12, 1999; (Issue 1048)
Drugs available in the USA for treatment of chronic hypertension, their dosages and adverse affects are listed in the table and discussed in the...
Drugs available in the USA for treatment of chronic hypertension, their dosages and adverse affects are listed in the table and discussed in the text.
New "Triptans" and Other Drugs for Migraine
The Medical Letter on Drugs and Therapeutics • October 9, 1998; (Issue 1037)
Three new 5-HT1 receptors agonissts ('triptans') have been marketed recently for treatment of migraine. Some drugs for prevention of migraine are listed in the table on page 99. Treatment of migraine in the...
Three new 5-HT1 receptors agonissts ('triptans') have been marketed recently for treatment of migraine. Some drugs for prevention of migraine are listed in the table on page 99. Treatment of migraine in the emergency room, which may involve use of intravenous drugs, is not included here.
Drugs for Psychiatric Disorders
The Medical Letter on Drugs and Therapeutics • April 11, 1997; (Issue 998)
The number of new drugs marketed for psychiatric indications has increased sharply in recent years. The recommendations in this article are based on the results of controlled trials and on the experience and...
The number of new drugs marketed for psychiatric indications has increased sharply in recent years. The recommendations in this article are based on the results of controlled trials and on the experience and opinions of Medical Letter consultants. Interactions with other drugs can be found in The Medical Letter Handbook of Adverse Drug Interactions, 1997.
Zileuton for Asthma
The Medical Letter on Drugs and Therapeutics • February 28, 1997; (Issue 995)
Zileuton (zye loo' ton; Zyflo - Abbott), an inhibitor of leukotriene synthesis, has been approved by the US Food and Drug Administration (FDA) for prophylaxis and maintenance treatment of chronic asthma in...
Zileuton (zye loo' ton; Zyflo - Abbott), an inhibitor of leukotriene synthesis, has been approved by the US Food and Drug Administration (FDA) for prophylaxis and maintenance treatment of chronic asthma in adults and children more than 12 years old. A related drug—zafirlukast (Accolate), a leukotriene receptor antagonist—was recently reviewed in the Medical Letter (vol. 38, page 111, December 20, 1996). Neither of these drugs is recommended for treatment of acute asthma.
Drugs for Migraine
The Medical Letter on Drugs and Therapeutics • March 3, 1995; (Issue 943)
Drugs are used both to prevent and treat migraine symptoms. The effectiveness of such use can be difficult to evaluate, even with double-blind controlled trials, because migraine is episodic, response to...
Drugs are used both to prevent and treat migraine symptoms. The effectiveness of such use can be difficult to evaluate, even with double-blind controlled trials, because migraine is episodic, response to placebo is frequent, and patients vary in response to a given agent (KMA Welch, N Engl J Med, 329:1476, 1993; SD Silberstein and RB Lipton, Neurology, 44 suppl 7:S6, Oct 1994).
Fluvoxamine for Obsessive-Compulsive Disorder
The Medical Letter on Drugs and Therapeutics • February 17, 1995; (Issue 942)
Fluvoxamine (Luvox - Solvay), a selective serotonin reuptake inhibitor (SSRI), has been approved for treatment of obsessive-compulsive disorder (OCD) by the US Food and Drug Administration. Fluoxetine...
Fluvoxamine (Luvox - Solvay), a selective serotonin reuptake inhibitor (SSRI), has been approved for treatment of obsessive-compulsive disorder (OCD) by the US Food and Drug Administration. Fluoxetine (Prozac), another SSRI antidepressant, and clomipramine (Anafranil), a tricyclic antidepressant that also inhibits serotonin reuptake, are the only other drugs available for this indication in the USA. Antidepressants that do not inhibit serotonin reuptake have not been effective for treatment of this condition.
Drugs for Stable Angina Pectoris
The Medical Letter on Drugs and Therapeutics • December 9, 1994; (Issue 937)
Many nitrates, beta-blockers, and calcium-channel blockers have now been approved by the US Food and Drug Administration for treatment of stable angina pectoris. The table beginning on page 112 lists the...
Many nitrates, beta-blockers, and calcium-channel blockers have now been approved by the US Food and Drug Administration for treatment of stable angina pectoris. The table beginning on page 112 lists the individual drugs, their dosage, and their cost.
Sotalol for Cardiac Arrhythmias
The Medical Letter on Drugs and Therapeutics • April 2, 1993; (Issue 893)
Sotalol (hydrochloride (Betapace -Berlex; Sotacor -Bristol Laboratories of Canada), an antiarrhythmic drug that prolongs repolarization (Class III) and also has beta-adrenergic-blocking activity (Class II),...
Sotalol (hydrochloride (Betapace -Berlex; Sotacor -Bristol Laboratories of Canada), an antiarrhythmic drug that prolongs repolarization (Class III) and also has beta-adrenergic-blocking activity (Class II), was recently approved by the US Food and Drug Administration (FDA) for oral treatment of life-threatening ventricular arrhythmias.
Sumatriptan for Migraine
The Medical Letter on Drugs and Therapeutics • October 2, 1992; (Issue 880)
Sumatriptan (soo ma trip' tan; Imitrex - Glaxo), a serotonin (5-HT) agonist, is now available in Canada and may soon be available in the USA for oral or parenteral treatment of migraine headache. The...
Sumatriptan (soo ma trip' tan; Imitrex - Glaxo), a serotonin (5-HT) agonist, is now available in Canada and may soon be available in the USA for oral or parenteral treatment of migraine headache. The parenteral formulation is designed for patients to inject themselves subcutaneously. Sumatriptan is not recommended for prophylactic use.
Isradipine For Hypertension
The Medical Letter on Drugs and Therapeutics • May 31, 1991; (Issue 845)
Isradipine (DynaCirc - Sandoz), a dihydropyridine calcium-channel blocker chemically related to nicardipine (Cardene) and nifedipine (Procardia, and others), was recently approved by the US Food and Drug...
Isradipine (DynaCirc - Sandoz), a dihydropyridine calcium-channel blocker chemically related to nicardipine (Cardene) and nifedipine (Procardia, and others), was recently approved by the US Food and Drug Administration for oral treatment of hypertension.
Bepridil for Angina Pectoris
The Medical Letter on Drugs and Therapeutics • May 31, 1991; (Issue 845)
Bepridil hydrochloride (Vascor - McNeil Pharmaceutical/Wallace Laboratories), a calcium-channel blocking agent chemically unrelated to verapamil (Calan, and others), nifedipine (Procardia, and others), or...
Bepridil hydrochloride (Vascor - McNeil Pharmaceutical/Wallace Laboratories), a calcium-channel blocking agent chemically unrelated to verapamil (Calan, and others), nifedipine (Procardia, and others), or other drugs in this class, was recently approved by the US Food and Drug Administration for oral treatment of chronic stable angina pectoris. Because of its potential adverse effects, the labeling recommends reserving the drug for patients who fail to respond optimally to or are intolerant of other antianginal agents.
Doxazosin For Treatment of Hypertension
The Medical Letter on Drugs and Therapeutics • February 22, 1991; (Issue 838)
Doxazosin (mesylate - Roerig), an alpha1-adrenergic receptor blocker similar to prazosin (Minipress, and others) and terazosin (Hytrin), was recently approved by the US Food and Drug Administration for...
Doxazosin (mesylate - Roerig), an alpha1-adrenergic receptor blocker similar to prazosin (Minipress, and others) and terazosin (Hytrin), was recently approved by the US Food and Drug Administration for treatment of hypertension.
Moricizine for Cardiac Arrhythmias
The Medical Letter on Drugs and Therapeutics • November 2, 1990; (Issue 830)
Moricizine (mor i'; siz een) hydrochloride (Ethmozine - Du Pont), a class I antiarrhythmic drug developed in the USSR, was recently approved by the US Food and Drug Administration (FDA) for oral treatment of...
Moricizine (mor i'; siz een) hydrochloride (Ethmozine - Du Pont), a class I antiarrhythmic drug developed in the USSR, was recently approved by the US Food and Drug Administration (FDA) for oral treatment of life-threatening ventricular arrhythmias.
Drugs That Cause Pulmonary Toxicity
The Medical Letter on Drugs and Therapeutics • September 21, 1990; (Issue 827)
Some commonly used systemic drugs that may cause pulmonary toxicity are listed in the table below. These adverse effects may sometimes be difficult to distinguish from the underlying disease (JAD Cooper, Jr...
Some commonly used systemic drugs that may cause pulmonary toxicity are listed in the table below. These adverse effects may sometimes be difficult to distinguish from the underlying disease (JAD Cooper, Jr et al, Am Rev Respir Dis, 133:321, 488, 1986). Pulmonary effects that are part of a generalized reaction or are indirect effects of drugs - on respiratory muscles, for example, or on the immune system - are not included here.
Betaxolol for Hypertension
The Medical Letter on Drugs and Therapeutics • June 29, 1990; (Issue 821)
Betaxolol (Kerlone - Searle), an oral beta-adrenergic blocker, was recently approved by the US Food and Drug Administration for once-daily treatment of hypertension. The new drug is beta 1 (cardio)-selective...
Betaxolol (Kerlone - Searle), an oral beta-adrenergic blocker, was recently approved by the US Food and Drug Administration for once-daily treatment of hypertension. The new drug is beta 1 (cardio)-selective with no intrinsic sympathomimetic (partial agonist) activity. It is also available in a topical formulation for treatment of glaucoma (Betoptic - Medical Letter, 28:45, 1986). Beta-blockers currently available in the USA for treatment of hypertension are listed in the table below.
Propafenone for Cardiac Arrhythmia
The Medical Letter on Drugs and Therapeutics • April 20, 1990; (Issue 816)
Propafenone (Rythmol - Knoll), a class IC antiarrhythmic drug used in Europe for treatment of various arrhythmias for more than 10 years, was recently marketed in the USA for oral treatment of...
Propafenone (Rythmol - Knoll), a class IC antiarrhythmic drug used in Europe for treatment of various arrhythmias for more than 10 years, was recently marketed in the USA for oral treatment of life-threatening ventricular arrhythmias such as sustained ventricular tachycardia. This restrictive labeling reflects concerns arising from the interim report of the Cardiac Arrhythmia Suppression Trial, in which post-myocardial infarction patients with asymptomatic or mildly symptomatic ventricular arrhythmias treated with the class IC antiarrhythmic drugs encainide (Enkaid) or flecainide (Tambocor) had a higher mortality rate than patients taking placebo (CAST, N Engl J Med, 321:406, 1989).
Mefloquine for Malaria
The Medical Letter on Drugs and Therapeutics • February 9, 1990; (Issue 811)
Mefloquine hydrochloride (Lariam - Roche), a new antimalarial drug chemically related to quinine, has been approved by the US Food and Drug Administration (FDA) for prevention and treatment of Plasmodium...
Mefloquine hydrochloride (Lariam - Roche), a new antimalarial drug chemically related to quinine, has been approved by the US Food and Drug Administration (FDA) for prevention and treatment of Plasmodium falciparum and P. vivax malaria.
Carteolol and Penbutolol For Hypertension
The Medical Letter on Drugs and Therapeutics • July 28, 1989; (Issue 797)
Carteolol (Cartrol - Abbott) and penbutolol (Levatol - Reed & Carnrick), two oral beta-adrenergic blocking drugs, were recently approved by the US Food and Drug Administration for once-daily treatment of...
Carteolol (Cartrol - Abbott) and penbutolol (Levatol - Reed & Carnrick), two oral beta-adrenergic blocking drugs, were recently approved by the US Food and Drug Administration for once-daily treatment of systemic hypertension. Both drugs are non-selective beta-blockers with mild partial agonist activity. Beta-blockers currently available in the USA for treatment of hypertension are listed in the table on the next page.
Nicardipine - A New Calcium-Entry Blocker
The Medical Letter on Drugs and Therapeutics • May 5, 1989; (Issue 791)
Nicardipine (Cardene - Syntex), a dihydropyridine calcium-entry blocker structurally related to nifedipine (Procardia; Adalat), was recently approved by the US Food and Drug Administration for oral treatment...
Nicardipine (Cardene - Syntex), a dihydropyridine calcium-entry blocker structurally related to nifedipine (Procardia; Adalat), was recently approved by the US Food and Drug Administration for oral treatment of angina and hypertension. Advertisements for the drug claim that nicardipine is more vasoselective; than other calcium-channel blockers and does not depress myocardial contractility.
Drugs for Hypertensive Emergencies
The Medical Letter on Drugs and Therapeutics • April 7, 1989; (Issue 789)
Hypertensive emergencies include hypertensive encephalopathy, intracranial hemorrhage with hypertension, aortic dissection, acute pulmonary edema with hypertension, acute cardiac ischemia with hypertension,...
Hypertensive emergencies include hypertensive encephalopathy, intracranial hemorrhage with hypertension, aortic dissection, acute pulmonary edema with hypertension, acute cardiac ischemia with hypertension, malignant hypertension and severe hypertension after vascular surgery; hypertensive crisis due to pheochromocytoma or occurring during pregnancy is not discussed in this review. Although immediate reduction of blood pressure is necessary in hypertensive emergencies, an excessive decrease may cause stroke, myocardial infarction or visual changes. Most experienced clinicians aim initially for a 25% decrease in mean arterial pressure, with a minimum diastolic pressure of 100 mm Hg; lower pressures may be indicated for patients with aortic dissection.
Drugs for Parkinsonism
The Medical Letter on Drugs and Therapeutics • December 16, 1988; (Issue 781)
Patients with Parkinson's disease have a deficiency of the neurotransmitter dopamine, a catecholamine. Dpamine itself cannot be used to treat the disease because it does not cross the blood-brain barrier, but...
Patients with Parkinson's disease have a deficiency of the neurotransmitter dopamine, a catecholamine. Dpamine itself cannot be used to treat the disease because it does not cross the blood-brain barrier, but its metabolic precursor, levodopa, does cross into the brain and is converted to dopamine by a decarboxylase present both in the brain and in the intestinal tract (JM Cedarbaum, Clin Pharmacokinet, 13:141, 1987).