NSAIDs Are Not So Safe Either

It’s hard to believe that opioid overdose now kills more people than car accidents in the US, but we’ve been told this so often that it must be true. Pressure is building on prescribers to use something else to treat most patients with chronic pain, and in many cases that something else will probably be […]

More Testosterone

As promised in this space 2 years ago, a well-designed, randomized, placebo-controlled clinical trial on the effects of testosterone treatment in older men has been published (NEJM 2016; 374:611) . The Medical Letter will try to keep pace by publishing an article in our next issue (1490; March 14) on the safety of testosterone replacement […]

Why Not Screen for Melanoma?

We will soon publish our tenth article in the last 4 years on yet another drug for the treatment of unresectable or metastatic melanoma. All of these drugs are obscenely expensive. None of them cures the disease. Melanoma detected early is nearly 100% curable. Unresectable or metastatic melanoma is usually fatal. Early detection of melanoma […]

Beefed-Up Flu Vaccine for Seniors

The current issue of The Medical Letter (1486; January 18, 2016) includes an article on Fluad, an adjuvanted seasonal flu vaccine for older adults that will become available in the US later this year for use in the 2016-2017 influenza season. Fluad has been available in Europe since 1997 for persons >65 years old, so […]

Homeopathic Drugs

The next issue of The Medical Letter (1485; January 4, 2016) includes an article on ColciGel, a homeopathic drug currently being marketed to the public for the treatment of gout. We generally do not review homeopathic drugs, but since the FDA requires a prescription for homeopathic drugs sold for treatment of “conditions not amenable to […]

Old Drugs

The next issue of The Medical Letter (1483; December 7, 2015) includes an update of one of my all-time favorites, an article on drugs past their expiration date. We had received several inquiries over the years about whether outdated drugs were safe enough to use in an emergency, including one from a surgeon in Bosnia […]

Conflicting Results with an IV Antiplatelet Drug

Cangrelor (Kengreal), the first IV P2Y12 platelet inhibitor to be approved by the FDA, will be reviewed in the next issue of The Medical Letter (1480; October 26, 2015). Its competition for use in percutaneous coronary intervention (PCI), its only approved indication, comes from three oral P2Y12 platelet inhibitors – clopidogrel (Plavix, and generics), prasugrel […]


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