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
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.
3
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).
4
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.
5
Penmenvy — A Second Pentavalent Meningococcal Vaccine
The Medical Letter on Drugs and Therapeutics • April 14, 2025; (Issue 1726)
The FDA has licensed the pentavalent vaccine
Penmenvy (GSK) for prevention of invasive
meningococcal disease caused by Neisseria
meningitidis serogroups A, B, C, W, or Y (MenABCWY)
in persons 10-25 years old. Penmenvy is the second
pentavalent meningococcal vaccine to become
available in the US; Penbraya was licensed in 2023.
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
In Brief: Label Changes for Testosterone Products
The Medical Letter on Drugs and Therapeutics • April 14, 2025; (Issue 1726)
The FDA has required changes in the labels of all
testosterone products to reflect new data on their
cardiovascular effects. The updated labels will no
longer include a boxed warning about an increased risk
of adverse cardiovascular outcomes, but will contain a
new warning about an increase in blood pressure.
8
In Brief: Once-Monthly Lecanemab (Leqembi) for Alzheimer's Disease
The Medical Letter on Drugs and Therapeutics • April 14, 2025; (Issue 1726)
The amyloid beta-directed monoclonal antibody
lecanemab-irmb (Leqembi – Eisai/Biogen) has now
been approved by the FDA for once-monthly use for
treatment of Alzheimer's disease (AD) in patients with
mild cognitive impairment (MCI) or mild dementia. It
was previously approved only for administration once
every 2 weeks. Now, lecanemab can be given every
4 weeks after an 18-month initiation phase of
biweekly administration.
9
In Brief: New Labeling for Once-Monthly Subcutaneous Buprenorphine (Sublocade)
The Medical Letter on Drugs and Therapeutics • April 14, 2025; (Issue 1726)
The FDA has approved changes to the labeling of
Sublocade (Indivior), an extended-release formulation
of the partial opioid agonist buprenorphine, to permit
faster initiation and use of alternative injection
sites. Sublocade is indicated for once-monthly
subcutaneous treatment of moderate to severe opioid
use disorder.
10
In Brief: Fexofenadine (Allegra) and Fruit Juice
The Medical Letter on Drugs and Therapeutics • May 30, 2011; (Issue 1365)
Fexofenadine (Allegra, and others) is the most recent second-generation H1-antihistamine to become available over the counter (OTC). Cetirizine (Zyrtec, and others) and loratadine (Claritin, and others) are already available OTC. Cetirizine can be sedating in usual doses. Loratadine can be sedating in higher-than-usual doses. Fexofenadine remains nonsedating even in higher doses.