1
Addendum: Bupropion Safety in Pregnancy
The Medical Letter on Drugs and Therapeutics • April 1, 2024; (Issue 1699)
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.
2
Drugs for Bipolar Disorder
The Medical Letter on Drugs and Therapeutics • April 1, 2024; (Issue 1699)
Bipolar disorder is characterized by episodes of
mania, hypomania, and depression. Recurrences of
manic or (more frequently) depressive symptoms
are common. About 15-20% of patients with bipolar
disorder die by suicide.
3
Omalizumab (Xolair) for Food Allergy
The Medical Letter on Drugs and Therapeutics • April 1, 2024; (Issue 1699)
Omalizumab (Xolair – Genentech), a recombinant
anti-IgE monoclonal antibody FDA-approved for
treatment of allergic asthma, chronic rhinosinusitis
with nasal polyps, and chronic urticaria, has now
also been approved for use in conjunction with food
allergen avoidance to reduce IgE-mediated food
allergic reactions caused by accidental exposure in
patients ≥1 year old. Omalizumab is the first drug to
be approved in the US to reduce allergic reactions to
more than one food. Palforzia, an oral peanut allergen
powder, was approved in 2020 to mitigate allergic
reactions caused by accidental peanut exposure in
patients with a confirmed peanut allergy.
4
Airsupra: An Inhaled Albuterol/Budesonide Combination for Asthma
The Medical Letter on Drugs and Therapeutics • March 18, 2024; (Issue 1698)
The FDA has approved Airsupra (AstraZeneca), a
metered-dose inhaler containing the short-acting
beta2-agonist (SABA) albuterol and the inhaled
corticosteroid (ICS) budesonide, for use as needed for
treatment or prevention of bronchoconstriction and to
reduce the risk of exacerbations in patients ≥18 years
old with asthma. Airsupra is the first combination of
a SABA and an ICS to become available in the US. It is
not approved for use as maintenance therapy.
5
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.
6
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.
7
Roflumilast Foam (Zoryve) for Seborrheic Dermatitis
The Medical Letter on Drugs and Therapeutics • April 15, 2024; (Issue 1700)
The FDA has approved a 0.3% foam formulation of
the phosphodiesterase-4 (PDE4) inhibitor roflumilast
(Zoryve – Arcutis) for topical treatment of seborrheic
dermatitis in patients ≥9 years old. Roflumilast is
the first PDE4 inhibitor to be approved in the US for
this indication. It is also available in a 0.3% cream
formulation (Zoryve) for treatment of plaque psoriasis
and in an oral formulation (Daliresp, and generics) for
treatment of chronic obstructive pulmonary disease.
A 0.15% cream formulation for treatment of atopic
dermatitis in patients ≥6 years old will be reviewed by
the FDA in July.
8
Cabtreo: A Three-Drug Gel for Acne
The Medical Letter on Drugs and Therapeutics • April 15, 2024; (Issue 1700)
The FDA has approved Cabtreo (Bausch Health), a gel
containing the retinoid adapalene, the oxidizing agent
benzoyl peroxide, and the antibiotic clindamycin, for
treatment of acne vulgaris in patients ≥12 years old.
Cabtreo is the first three-drug topical formulation to
become available in the US for treatment of acne.
9
Resmetirom (Rezdiffra) for Metabolic Dysfunction-Associated Steatohepatitis
The Medical Letter on Drugs and Therapeutics • April 29, 2024; (Issue 1701)
Resmetirom (Rezdiffra – Madrigal), a thyroid hormone
receptor-beta agonist, has received accelerated
approval from the FDA for treatment of noncirrhotic
nonalcoholic steatohepatitis (NASH) with moderate
to advanced fibrosis in adults. NASH has recently
been renamed metabolic dysfunction-associated
steatohepatitis (MASH). Resmetirom is the first drug
to be approved in the US for this indication.
10
Antibiotic Prophylaxis for Dental Procedures
The Medical Letter on Drugs and Therapeutics • April 29, 2024; (Issue 1701)
Since 2007, antimicrobial prophylaxis for dental
procedures has been recommended to prevent
viridans group streptococcal infective endocarditis
only for patients at highest risk of an adverse
outcome. Limiting use to such patients does not
appear to have led to an increased incidence of
infective endocarditis or increased mortality due to
infective endocarditis.