This department includes information about new drugs from the perspective of the five attributes to be considered when weighing the advantages of one drug over another: Safety, Tolerability, Effectiveness, Price, and Simplicity.

Oct 15, 2015 Issue
Levomilnacipran (Fetzima) for Major Depressive Disorder
Levomilnacipran should not be used in patients with mild to moderate depression until studies have proven its effectiveness. It is somewhat effective in patients with moderate to severe depression. The short-term adverse effect profile of levomilnacipran is similar to that of other SNRIs.

Aug 15, 2015 Issue
Vorapaxar (Zontivity) for the Prevention of Thrombotic Cardiovascular Events
Vorapaxar should be limited to select patients with a history of MI or peripheral arterial disease who desire additional treatment for the prevention of MI.

Jun 15, 2015 Issue
Dapagliflozin (Farxiga) for Type 2 Diabetes Mellitus
Dapagliflozin will lower A1C levels by an average of 0.7 percentage points when used alone or by an average of 0.5 percentage points when added to metformin therapy. Its effect on diabetes-associated morbidity and mortality has not been studied, and although it is well tolerated, there is an association with bladder cancer and diabetic ketoacidosis.

Apr 15, 2015 Issue
Naltrexone/Bupropion (Contrave) for Weight Loss
Naltrexone/bupropion produces clinically significant weight loss when combined with a diet and exercise program. It decreases body weight in patients with diabetes, but its effect on diabetic outcomes is not known. A significant proportion of patients will experience adverse effects.

Mar 1, 2015 Issue
Vortioxetine (Brintellix) for the Treatment of Depression
Current evidence does not support the routine use of vortioxetine in the treatment of depression. Family physicians most often encounter patients with mild to moderate depression, and vortioxetine has not been studied in this population. There is no clear benefit of using vortioxetine over other more affordable options in its class.

Dec 15, 2014 Issue
Lorcaserin (Belviq) for Weight Loss
Lorcaserin, combined with diet and exercise, can be used to produce additional weight loss, although the effect on morbidity and mortality is not known. It should be discontinued in patients who do not lose at least 5% of their body weight in the first 12 weeks because they are unlikely to have any additional weight loss.

Oct 15, 2014 Issue
Phentermine/Topiramate (Qsymia) for Chronic Weight Management
Phentermine/topiramate has been shown to be a good option for sustained weight loss in patients who are unable to lose weight with diet and exercise alone. It should not be given to patients with a history of significant heart disease, and women of childbearing age should use contraception and have regular pregnancy tests when taking phentermine/topiramate.

Aug 15, 2014 Issue
Indacaterol (Arcapta) for COPD
Indacaterol provides a similar benefit to other long-acting bronchodilators for the treatment of moderate to severe COPD, with once-daily dosing. As with other LABAs, it should be used only as add-on therapy in patients already taking inhaled corticosteroids.

Jun 15, 2014 Issue
Ivermectin Lotion (Sklice) for Head Lice
Topical ivermectin is safe, effective, and easy to administer because it involves only a single application-rinse cycle and does not require nit combing. However, it is significantly more expensive than nonprescription treatments and its benefits may not be worth the cost for most patients.

Apr 15, 2014 Issue
Apixaban (Eliquis) for Stroke Prevention in Atrial Fibrillation
Apixaban is at least as effective as aspirin or warfarin for preventing strokes in high-risk patients with nonvalvular atrial fibrillation, especially those who cannot or will not take warfarin. It is slightly less likely to cause major bleeding and may have better compliance because it does not require frequent laboratory monitoring. However, apixaban is significantly more expensive than warfarin or aspirin, and its anticoagulation effect cannot be reversed in the event of an emergency.

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