1
In Brief: Alternatives to Adderall
The Medical Letter on Drugs and Therapeutics • November 28, 2022; (Issue 1664)
The short-acting formulation of mixed amphetamine
salts (Adderall, and generics) FDA-approved for
treatment of attention-deficit hyperactivity disorder
(ADHD) and narcolepsy, is currently in short supply in
the US. Until an adequate supply is restored, patients
may be looking for alternatives.
2
Capvaxive – A 21-Valent Pneumococcal Conjugate Vaccine
The Medical Letter on Drugs and Therapeutics • October 14, 2024; (Issue 1713)
The FDA has licensed Capvaxive (PCV21; Merck),
a 21-valent pneumococcal conjugate vaccine, for
prevention of invasive pneumococcal disease (IPD)
and pneumococcal pneumonia in adults. Four other
pneumococcal vaccines are currently available in the
US: Prevnar 20 (PCV20), Vaxneuvance (PCV15), and
Prevnar 13 (PCV13) are conjugate vaccines licensed
for use in persons ≥6 weeks old, and Pneumovax 23
(PPSV23) is a pneumococcal polysaccharide vaccine
licensed for use in persons ≥2 years old (see Table 1).
3
Antiviral Drugs for Seasonal Influenza for 2024-2025
The Medical Letter on Drugs and Therapeutics • December 9, 2024; (Issue 1717)
Influenza is generally a self-limited illness, but
pneumonia, respiratory failure, and death can occur,
especially in persons at increased risk for influenza
complications (see Table 1). Updated information on
influenza activity and antiviral resistance is available
from the CDC at cdc.gov/flu.
4
In Brief: Azmiro — A Single-Dose Injectable Formulation of Testosterone Cypionate
The Medical Letter on Drugs and Therapeutics • March 17, 2025; (Issue 1724)
The FDA has approved Azmiro (Azurity), the first
injectable formulation of testosterone cypionate to
become available in single-dose vials and prefilled
syringes for treatment of males with conditions
associated with a deficiency or absence of endogenous
testosterone. Injectable testosterone cypionate has
been available in multidose vials (Depo-Testosterone,
and generics) for many years. Testosterone enanthate
(Xyosted) is available in prefilled autoinjectors for use
in adult men. No testosterone products are approved
for treatment of low testosterone levels due solely
to aging. All testosterone products are classified as
schedule III controlled substances.
5
In Brief: OTC Ivermectin for Head Lice
The Medical Letter on Drugs and Therapeutics • June 26, 2023; (Issue 1679)
Topical ivermectin lotion 0.5% (Sklice, and generics),
which has been available by prescription since 2012,
is now FDA-approved for sale over the counter (OTC)
for treatment of head lice in patients ≥6 months old.
Ivermectin is also available by prescription as a 1%
cream (Soolantra) approved for topical treatment of
inflammatory lesions of rosacea and in oral tablets
(Stromectol, and generics) for treatment of various
parasitic infections.
6
Antibacterial Drugs for Community-Acquired Pneumonia
The Medical Letter on Drugs and Therapeutics • January 25, 2021; (Issue 1616)
Treatment of community-acquired pneumonia (CAP)
is usually empiric, with selected antibiotic regimens
directed against some of the most common causative
pathogens. Recommended empiric regimens are
listed in Table 2; recommended antibiotic dosages for
treatment of CAP are listed in Tables 3 and 4. Joint
guidelines for treatment of CAP by the American
Thoracic Society and the Infectious Diseases Society of
America (ATS/IDSA) were updated in 2019.
7
Correction
The Medical Letter on Drugs and Therapeutics • March 31, 2025; (Issue 1725)
In our recent article on the combination of vanzacaftor, tezacaftor,
and deutivacaftor (Alyftrek) for cystic fibrosis (Med Lett Drugs Ther
2025; 67:41), Table 3 misstated the formulations and dosage of the
combination of elexacaftor, tezacaftor, and ivacaftor (Trikafta).
8
Treatment of Allergic Rhinitis and Allergic Conjunctivitis
The Medical Letter on Drugs and Therapeutics • March 31, 2025; (Issue 1725)
Initial treatment of allergic rhinitis (AR) depends
on the severity of symptoms and whether they are
intermittent or persistent (see Table 1).
9
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 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.
10
Comparison Table: Some Oral Drugs for Allergic Rhinitis (online only)
The Medical Letter on Drugs and Therapeutics • March 31, 2025; (Issue 1725)
View the Comparison Table: Some Oral Drugs for Allergic Rhinitis