June 17th 2021
The COX-2 inhibitor Anjeso, a faster-acting injectable formulation of meloxicam, reduces opioid use after surgery.
November 18th 2014
June 13th 2013
June 12th 2013
New class may help smokers quit, curb post-cessation weight gain
May 4th 2004In phase 3 trials, the first agent in a novel class known as the selective cannabinoid type 1 receptor blockers doubled the odds of quitting smoking while reducing post-cessation weight gain compared with placebo. The agent, rimonabant, also improved several features of the metabolic syndrome in patients with abdominal obesity, reported researchers at the 53rd Annual Scientific Session of the American College of Cardiology (ACC).
Enoxaparin clinically equivalent to UFH in the treatment of high-risk ACS
May 4th 2004>Enoxaparin is an effective and safe alternative to unfractionated heparin (UFH) in the early and invasive management of high-risk patients with non-ST-elevation acute coronary syndromes (ACS), said Robert Califf, MD, at the 53rd Annual Scientific Session of the American College of Cardiology (ACC).
Medicare coverage boosts interest in drug value, prices
May 1st 2004Mark McClellan, MD, PhD, now administrator of the Centers for Medicare and Medicaid Services (CMS), is seeking more evidence-based information about how medical treatments affect patients in the real world. Dr McClellan says his first priority is to use the new Medicare pharmacy program, starting with the drug discount card, to lower drug costs. One prime strategy for doing so is to evaluate which therapies are most efficacious as well as cost-effective for specific patient subgroups in order to curb unnecessary spending on prescription drugs.
Ezetimibe added to statin results in greater achievement of LDL goals
May 1st 2004Ezetimibe added to a stable dose of statin therapy reduces low-densitylipoprotein (LDL) cholesterol by an additional 23% and results in significantlymore patients achieving their LDL cholesterol goals, said Thomas Pearson,MD, MPH, at the 53rd Annual Scientific Session of the American College ofCardiology (ACC) in New Orleans.
Erectile dysfunction: A review and update
May 1st 2004Erectile dysfunction (ED) is now recognized as a common problem in men. Several medical problems, including diabetes mellitus, coronary artery disease, hypertension, and hyperlipidemia are known to increase the likelihood of developing ED. Diagnosis depends on an adequate history and physical examination. Several therapies are now available for the treatment of ED. With the advent of the phosphodiesterase type 5 (PDE5) inhibitors, therapy for ED has become more acceptable for many men. Oral therapy is usually the first-line treatment due to the ease of use and the effectiveness of this therapy. For men who do not respond to or have a contraindication to PDE5 therapy, intrapenile injection therapy, intraurethral therapy, and vacuum devices are effective alternatives.
Rasagiline: An oral irreversible MAO-B inhibitor for the treatment of Parkinson’s disease
May 1st 2004Rasagiline (Teva/Eisai), a second-generation irreversible MAO inhibitor highly selective for type B of the enzyme, is expected to gain FDA approval in late 2004/early 2005 for the treatment of Parkinson’s disease in monotherapy or as adjunct therapy to levodopa. Rasagiline is more potent than selegiline, the only FDA-approved drug within the same class, and may be devoid of the undesirable effects (blood pressure increases, euphoria, and sleep disturbances) often reported with selegiline. Rasagiline has been studied and proven effective versus placebo in patients with moderate and advanced Parkinson’s disease in both phase 2 and 3 clinical trials. The drug is administered orally once daily and does not require titration. Furthermore, rasagiline has demonstrated neuroprotective activity in various in vitro models and may show promise in the treatment of other neurologic diseases; however, these properties have yet to be studied in humans.
High-dose atorvastatin following ACS reduces risk of long-term adversecardiovascular outcomes
April 1st 2004Aggressive lipid-lowering with high-dose atorvastatin initiated immediatelyafter hospitalization for an acute coronary syndrome (ACS) significantlyreduces the risk of long-term adverse cardiovascular outcomes compared withlipid-lowering with standard-dose pravastatin. As such, target levels oflow-density lipoprotein cholesterol (LDL-C) may need to be lower than theones currently recommended in patients at risk of cardiovascular events,said Christopher Cannon, MD, at the 53rd annual scientific session of theAmerican College of Cardiology in New Orleans.
Tiotropium: A novel anticholinergic for the once-daily treatment of COPD (PDF)
April 1st 2004Chronic obstructive pulmonary disease (COPD) is a major public health problem, with inhaled anticholinergic agents being the treatment of choice. The disadvantage of currently approved therapies for the treatment of COPD is that agents such as ipratropium (Atrovent, Boehringer Ingelheim) must be administered numerous times daily. Tiotropium (Spiriva, Pfizer/Boehringer Ingelheim) is a new, recently FDA-approved, long-acting anticholinergic drug that requires only once-daily dosing. Tiotropium displays selective receptor kinetics by dissociating more slowly from M1 and M3 receptors than M2 receptors. In patients with COPD, tiotropium 18 mcg inhaled once daily results in significant improvement in lung function. Furthermore, improvements appear sustained for up to 3 weeks after discontinuing tiotropium. Tiotropium is well tolerated with minimal systemic absorption resulting in a favorable adverse effect profile. The most common adverse effect associated with tiotropium is dry mouth. Given the longer duration of action, once-daily dosing, minimal adverse effects, and documented improvements in lung function, tiotropium is poised to replace ipratropium as the inhaled anticholinergic of choice.
Fosamprenavir: A novel protease inhibitor and prodrug of amprenavir
March 1st 2004Fosamprenavir (Lexiva, GlaxoSmithKline/Vertex) is the latest protease inhibitor (PI) approved by FDA for the treatment HIV-1 infection. A prodrug of amprenavir (APV), fosamprenavir has improved solubility and bioavailability over the parent PI, allowing for once- or twice-daily dosing and a decreased pill size and burden. In clinical trials, fosamprenavir was studied alone or boosted with ritonavir (RTV) in both HIV treatment-naïve and -experienced patients. In both patient populations, fosamprenavir decreased HIV RNA, increased CD4 cell counts from baseline, and increased the proportion of patients reaching undetectable viral loads (<400 and <50 copies/mL). Patients who received treatment with fosamprenavir demonstrated protease gene mutations different than those commonly seen with other PIs (except APV). Fosamprenavir appears to have an adverse effect profile similar to that of other PIs.
Pharmacotherapeutic options to prevent radiocontrast-induced acute renal failure
March 1st 2004One of the primary etiologies of acute renal failure (ARF) is nephropathy secondary to the administration of radiocontrast dye. In the United States alone, the cost of ARF-related expenses is estimated at more than $8 billion per year. Since ARF contributes such a substantial burden to the cost of healthcare and may be associated with significant morbidity and mortality, initiatives to educate pharmacists, physicians, and other health-care providers about how to decrease the incidence of radiocontrast-induced ARF are warranted. It is important to identify patients at risk for developing this pathology and to play an active role in disease state prevention. This review covers the pathogenesis, signs and symptoms, and current treatment options for reducing the risk of radiocontrast-induced nephropathy. Current pharmacotherapy focuses on the use of aggressive hydration before and after the administration of a contrast agent. Clinical trials evaluating the application of periprocedural drugs are also reviewed.
Oral Contraceptives: The Extended Cycle Regimen
February 1st 2004Authors Derek Van Amerongen, MD, MS Chief Medical Officer Humana Health Plan of Ohio Cincinnati, Ohio DonnaChiefari, RPH Director, Clinical Services NMHC Rx Latham, NY The views and opinions expressed in this supplement are those of the faculty and do not necessarily reflect the views of Advanstar Communications, Inc., publishers of Formulary, or Barr Laboratories Copyright 2004 Advanstar Communications, Inc., All rights reserved.
Oral Contraceptives: The Extended Cycle Regimen (PDF)
February 1st 2004Extended use of combination monophasic oral contraceptives (OCs) used to treat women with menstrual disorders, such as endometriosis and dysmenorrhea, has been proven to be safe, effective, and acceptable to women. Even women without a medical indication for menstrual suppression may find that extending OC therapy may yield an improvement in their quality of life by diminishing menstrual symptoms associated with hormone withdrawal during the placebo interval. Most physicians and many women are aware of how to extend OC therapy, and commonly manipulate their cycles to avoid unwanted menstruation at inopportune times, such as during a honeymoon, vacation, or exams.
An update on oral contraceptive options (PDF)
February 1st 2004The oral contraceptive marketplace has undergone evolutionary changes over the years. Early oral contraceptive formulations contained higher doses of estrogen and progestin, which were associated with several safety concerns. Consequently, scientists returned to the laboratories to develop lower-dose formulations that would minimize risk without compromising efficacy. To date, numerous formulations have entered the marketplace that allow for tailored dosing to meet a woman?s clinical and individual needs. In order to provide additional treatment options and create more convenient oral contraceptive regimens, monophasic, multiphasic, extended-cycle, progestin-only, and chewable regimens have emerged. This article will review the main health risks and benefits of oral contraceptives, the concept of extended-cycle regimens, and the financial implications associated with oral contraceptive use.
Oral Contraceptives: The Extended Cycle Regimen
February 1st 2004Extended use of combination monophasic oral contraceptives (OCs) used to treat women with menstrual disorders, such as endometriosis and dysmenorrhea, has been proven to be safe, effective, and acceptable to women. Even women without a medical indication for menstrual suppression may find that extending OC therapy may yield an improvement in their quality of life by diminishing menstrual symptoms associated with hormone withdrawal during the placebo interval. Most physicians and many women are aware of how to extend OC therapy, and commonly manipulate their cycles to avoid unwanted menstruation at inopportune times, such as during a honeymoon, vacation, or exams.
Memantine: An oral NMDA antagonist for the treatment of moderate-to-severe Alzheimer?s disease
February 1st 2004Memantine (Namenda, Forest) is the newest medication to receive FDA approval for the treatment of Alzheimer?s disease and the first to be approved with a moderate-to-severe indication. All previously approved Alzheimer?s disease treatments belong to the cholinesterase inhibitor class and are approved with a mild-to-moderate indication. Memantine has been used for more than 10 years in Germany and features a novel mechanism of action: N-methyl-d-aspartate (NMDA) antagonism. It has been shown to be effective in double-blind, placebo-controlled trials as monotherapy and in combination therapy with the cholinesterase inhibitor donepezil in patients with moderate-to-severe Alzheimer?s disease.
Efalizumab: A new biologic therapy for the control of chronic plaque psoriasis
January 4th 2004Efalizumab (Raptiva, Genentech/Xoma) is a humanized monoclonal antibody of CD11a that exerts its effect through the blockade of the interaction between leukocyte function-associated antigen-1 (LFA-1) and intercellular adhesion molecule-1 (ICAM-1). FDA recently granted approval for efalizumab in the treatment of chronic moderate-to-severe plaque psoriasis in adults aged 18 years and older. Efalizumab does not achieve clinical response rates equal to cyclosporine or methotrexate, but it lacks the systemic organ toxicities of these agents and is associated with a more rapid onset of action (significant improvements in Psoriasis Area and Severity Index [PASI] response after 2 doses). In addition, efalizumab will likely compete with another approved biologic, alefacept, and off-label use of 2 other biologics currently on the market, etanercept and infliximab. At this time, until further studies comparing efalizumab to other drugs indicated for the treatment of psoriasis are completed and post-marketing surveillance is conducted, the agent?s place on the formulary remains unclear.
Docetaxel/platinum combinations are efficacious in treatment of NSCLC
January 1st 2004A regimen of docetaxel and cisplatin offers better survival and response rates than a combination of vinorelbine and cisplatin in the treatment of advanced non-small-cell lung cancer, according to a phase 3 study published in the online version of the Journal of Clinical Oncology. In addition, the findings demonstrated that docetaxel is as effective as vinorelbine/cisplatin when combined with another platinum, carboplatin.