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Corrections & Clarifications

This page contains all corrections published in recent Medical Letter publications (newsletter, handbooks, software).

Most recent items

Dapagliflozin (Farxiga) for Type 2 Diabetes
The Medical Letter • Volume 56, February 17, 2014
Correction: In the Drug Interactions paragraph, the second sentence about dapagliflozin exposure has been rewritten.
View the updated online version of this article.


Drugs for Treatment of ADHD
Treatment Guidelines • Volume 9, May 2011
Correction: The Daily Adult Dosages for Focalin and generic methylphenidate in Table 1 have been updated.
View the updated online version of this article.


2014

Dapagliflozin (Farxiga) for Type 2 Diabetes
The Medical Letter • Volume 56, February 17, 2014
Correction: In the Drug Interactions paragraph, the second sentence about dapagliflozin exposure has been rewritten.
View the updated online version of this article.


2013

Drugs for Epilepsy
Treatment Guidelines • Volume 11, February 2013
Correction: The dosage of topiramate in Table 2 on page 11 has been changed from 200-400 mg/day in 2 doses to 100-400 mg/day in 2 doses. The dosage recommendation in the labeling for monotherapy is 400 mg per day, but Medical Letter consultants have pointed out that in clinical practice, the usual dose of topiramate for monotherapy is 100-200 mg per day. Higher doses may be needed for adjunctive use.
View the updated online version of this article.


Drugs for Pain
Treatment Guidelines • Volume 11, April 2013
Correction: In Table 1 (Some Nonopioid Analgesics), the price for IV ibuprofen (Caldolor) has been revised.
View the updated online version of this article.


Drugs for Bacterial Infections
Treatment Guidelines • Volume 11, July 2013
Correction: The price of tigecycline (Tygacil) in Table 2 has been corrected.
View the updated online version of this article.


Ospemifene (Osphena) for Dyspareunia
The Medical Letter • Volume 55, July 8, 2013
Addendum: Some readers have objected to our recommendation that postmenopausal women with an intact uterus who take the oral estrogen agonist/antagonist ospemifene (Osphena) to reduce the severity of dyspareunia should also take a progestin. Ospemifene has agonistic effects on the endometrium, and the Osphena package insert says: "Generally, when a product with estrogen agonistic effects on the endometrium is prescribed for a postmenopausal woman with a uterus, a progestin ...
View the complete addendum.


2012

Deferiprone (Ferriprox) for Iron Overload
The Medical Letter • Volume 54, February 20, 2012
Correction: The second sentence in deferiprone’s conclusion has been changed to fix a grammatical error.
View the updated online version of this article.


Tafluprost (Zioptan) - A New Topical Prostaglandin for Glaucoma
The Medical Letter • Volume 54, April 16, 2012
Correction: In Table 1 on page 31, the formulation column should have included a 0.01% solution of bimatoprost. The size, daily dosage and cost of 0.01% bimatoprost are the same as those of the 0.03% solution.
View the updated online version of this article.


Drugs for Menopausal Symptoms
The Medical Letter • Volume 54, May 28, 2012
Addendum: A reader commented that our article on treatment of menopausal symptoms should have mentioned the potential advantages of transdermal estrogen. Transdermal estrogens are probably as effective as oral estrogens in treating vasomotor menopausal symptoms, but transdermal administration may have less effect on serum triglycerides, C-reactive protein, thyroxine-binding globulin, cortisol-binding globulin and sex hormone-binding globulin. Observational data suggest that the risk of venous thromboembolism may be lower with transdermal administration compared to standard-dose oral estrogens, but comparative randomized controlled trials are lacking.


Axitinib (Inlyta) for Advanced Renal Cell Carcinoma
The Medical Letter • Volume 54, June 11, 2012
Correction: In Table 1 on page 47, footnote 2 has been removed from the cost of axitinib.
View the updated online version of this article.


Bisphosphonates - Duration of Use Revisited
The Medical Letter • Volume 54, June 25, 2012
Correction: In the first sentence of the conclusion, the words "with osteoporosis" were removed immediately after "women".
View the updated online version of this article.


Renal Sympathetic Denervation for Hypertension
The Medical Letter • Volume 54, July 9, 2012
Addendum: Our July 9, 2012 article on renal sympathetic denervation for multiple-drug resistant hypertension concluded that the catheter-based procedure (Symplicity Catheter System – Medtronic) can lower blood pressure in most patients with hypertension resistant to ≥3 antihypertensive drugs. That conclusion was based on the results of 2 studies. SYMPLICITY HTN-1 compared outcomes to baseline blood pressures. SYMPLICITY HTN-2 randomized patients to renal denervation or usual care. ...
View the complete addendum.


Drugs for Urinary Tract Infections
The Medical Letter • Volume 54, July 23, 2012
Addendum: A reader suggested that our July 23 article on Drugs for Urinary Tract Infection should have included information on the cost of the drugs we recommended for treatment of acute uncomplicated cystitis.
Trimethoprim/sulfamethoxazole DS — Generic formulations are available at large discount pharmacies for $4 for 20 tablets. Trimethoprim/sulfamethoxazole DS is generally found on tier 1 (lowest co-pay) of insurance company formularies.
Nitrofurantoin monohydrate/macrocrystals — The wholesale acquisition cost of the generic formulation is about $2.50 per tablet (PricePointRx™. Reprinted with permission by FDB. All rights reserved. ©2012. http://www.firstdatabank.com/support/drug-pricing-policy.aspx. Accessed July 31, 2012. Actual retail prices may be higher). The drug is on tier 1 of some insurance company formularies, but on tier 2 or 3 of others.
Fosfomycin — Available only as Monurol, a single dose of fosfomycin is effective in most cases of acute uncomplicated cystitis, but the manufacturer charges a wholesale acquisition cost of more than $40 for that dose (PricePointRx™. Reprinted with permission by FDB. All rights reserved. ©2012. http://www.firstdatabank.com/support/drug-pricing-policy.aspx. Accessed July 31, 2012. Actual retail prices may be higher). Most insurance companies place Monurol on tier 3 of their formularies, or do not include it on their formularies at all.
Not recommended: Ciprofloxacin – Fluoroquinolones should not be used empirically to treat acute uncomplicated cystitis. The fact that ciprofloxacin is available at large discount pharmacies for $4 for 20 500-mg tablets and is on tier 1 on most insurance company formularies may be part of the reason for its continued overuse.


What Comes After Metformin for Type 2 Diabetes?
The Medical Letter • Volume 54, July 23, 2012
Addendum: Several readers have raised questions about the statement in our recent article that long-acting insulins, like metformin and sulfonylureas, have been shown to decrease long-term cardiovascular risk. Our statement was based on the extension of the UKPDS (RR Holman et al, N Engl J Med 2008; 359:1577), which is the longest prospective trial of drug therapy in patients with type 2 diabetes. Shorter studies in older patients with long-standing diabetes did not find a reduction in cardiovascular risk with these and other drugs (The Action to Control Cardiovascular Risk in Diabetes Study Group. N Engl J Med 2008; 358:2545; The ADVANCE Collaborative Group. N Engl J Med 2008; 358:2560; W Duckworth et al. N Engl J Med 2009; 360:129).


Two New Drugs for Weight Loss
The Medical Letter • Volume 54, September 3, 2012
Correction: On page 71 in the "Drug Interactions" paragraph, the last sentence should read: "Phentermine is contraindicated while taking, and for 14 days after stopping, a monoamine oxidase (MAO) inhibitor because of the risk of hypertensive crisis."
View the updated online version of this article.


Endocarditis Prophylaxis for Dental Procedures
The Medical Letter • Volume 54, September 17, 2012
Correction: In the Dental Procedures paragraph, 6th line, the word “rubber” has been omitted before the word “bands” because placement of rubber bands does not require prophylaxis; placement of orthodontic metal bands does.
View the updated online version of this article.


A 4-Drug Combination (Stribild) for HIV
The Medical Letter • Volume 54, November 26, 2012
Correction: In the “Drug Interactions” paragraph, the word “oral” has been inserted before “midazolam” in the 3rd sentence.
View the updated online version of this article.


Cephalosporins for Patients with Penicilllin Allergy
The Medical Letter • Volume 54, December 24, 2012
Addendum: A reader who took the online continuing medical education (CME) exam for issue 1406 pointed out that the first question assumed that a rash following oral administration of ampicillin would be due to allergy. Perhaps we should have mentioned in our article on penicillin allergy that late-appearing maculopapular rashes associated with oral ampicillin or amoxicillin are generally considered non-allergic and need not preclude subsequent administration of ampicillin or amoxicillin.


2011

In Brief: Delayed-Release Risedronate (Atelvia)
The Medical Letter • Volume 53, March 21, 2011
Correction: The In-Brief article on delayed-release risedronate in issue 1360 included a statement that alendronate is currently the only bisphosphonate available generically. That would have been accurate if we had added "that is FDA-approved for treatment of osteoporosis." Etidronate (Didronel, and others), which was the first bisphosphonate used to treat osteoporosis (Medical Letter 1990; 32:111) but was never approved for such use by the FDA, is also available generically. It is approved for treatment of Paget's disease and for prevention and treatment of heterotropic ossification following hip replacement and in spinal-cord injured patients.
View the updated online version of this article.


Intravenous Acetaminophen (Ofirmev)
The Medical Letter • Volume 53, April 4, 2011
Clarification: The cost of ketorolac listed in Table 1 on page 27 is for a single 30-mg prefilled syringe. A 30-mg vial costs about $1.63 according to AWP listings in Red Book 2010.
View the updated online version of this article.


A New Testosterone Gel (Fortesta) for Hypogonadism
The Medical Letter • Volume 53, April 18, 2011
Correction: In Table 1, the price of a 5-mL (200 mg/mL) vial of testosterone enanthate should have been $79.30 for the generic and $91.30 for the brand (Delatestryl), not $15.86 for the generic and $18.26 for the brand.
View the updated online version of this article.


Drugs for Treatment of ADHD
Treatment Guidelines • Volume 9, May 2011
Correction: The Daily Adult Dosages for Focalin and generic methylphenidate in Table 1 have been updated.
View the updated online version of this article.


Dextromethorphan/Quinidine (Nuedexta) for Pseudobulbar Affect
The Medical Letter • Volume 53, June 13, 2011
Correction: In our June 13, 2011 article, we said that the FDA has approved Nuedexta for treatment of pseudobulbar affect in patients with amyotrophic lateral sclerosis (ALS) or multiple sclerosis (MS). That is not quite correct. The package insert says that the drug is indicated for the treatment of pseudobulbar affect and then goes on to say, in the next two sentences, that studies to support the effectiveness of Nuedexta were performed in patients with underlying ALS or MS, and that the drug has not been shown to be safe or effective in other types of emotional lability. Also, the second sentence in the Drug Interactions paragraph should have said: "Other drugs that prolong the QT interval, inhibit CYP3A4, or are metabolized by CYP2D6 and prolong the QT interval, should be used with caution, if at all."
View the updated online version of this article.


Telaprevir (Incivek) and Boceprevir (Victrelis) for Chronic Hepatitis C
The Medical Letter • Volume 53, July 25, 2011
Correction: In the clinical studies section for telaprevir, "among patients who had a previous relapse" was added to the REALIZE trial sentence.
View the updated online version of this article.


Vemurafenib (Zelboraf) for Metastatic Melanoma
The Medical Letter • Volume 53, October 3, 2011
Correction: In the Dosage and Cost section on page 78, the minimum dose of vemurafenib was changed from 420 mg twice daily to 480 mg twice daily.
View the updated online version of this article.


A Fixed-Dose Combination of Ibuprofen and Famotidine (Duexis)
The Medical Letter • Volume 53, October 31, 2011
Correction: In the clinical studies section, the overall incidence of endoscopic gastroduodenal ulcers should have been 11% with Duexis and 21.9% with ibuprofen alone and, in low dose aspirin users, 12.8% with Duexis and 32.8% with ibuprofen alone.
View the updated online version of this article.


Who Should Take Vitamin Supplements?
The Medical Letter • Volume 53, December 12/26, 2011
Revision: The first paragraph on vitamin E has been revised.
View the updated online version of this article.


2010

Ustekinumab (Stelara) for Psoriasis
The Medical Letter • Volume 52, January 25, 2010
Addendum: Footnote 2 in table 2 should have included a second sentence: $5595.60 is the cost of one 45-mg syringe.
View the updated online version of this article.


Ferumoxytol (Feraheme) – A New Parenteral Iron Formulation
The Medical Letter • Volume 52, March 22, 2010
Correction: The last sentence of the Dosage, Administration and Cost paragraph should have listed the cost of 1 gram of sodium ferric gluconate (Ferrlecit) as about $600.
View the updated online version of this article.


Safety of Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease (COPD)
The Medical Letter • Volume 52, May 31, 2010
Correction: The last sentence in the Efficacy paragraph should say, "…budesonide/formoterol…" (not budesonide/salmeterol).
View the updated online version of this article.


A Sumatriptan Needle-Free Injection for Migraine
The Medical Letter • Volume 52, June 28, 2010
Correction: In Table 2, the injection volumes of Imitrex and Sumaval are listed as 5 mL. They should be 0.5 mL.
View the updated online version of this article.


Pitavastatin (Livalo) - The Seventh Statin
The Medical Letter • Volume 52, July 26, 2010
Correction: In the table, the usual decrease in LDL-cholesterol with pitavastatin has been changed to 35-40% (2 mg) and 40-45% (4 mg). Also, in the Dosage and Administration paragraph, the GFR has been changed to 30-<60 ml/min/1.73 m2.
View the updated online version of this article.


Drugs for Parasitic Infections
Handbook (2nd Edition) • July 2010
Correction: In the table titled, "Manufacturers of Drugs Used to Treat Parasitic Infections", the first footnote on page 81 should say, " …(see footnote 3 on page 4)."


Drugs for Sexually Transmitted Infection
Treatment Guidelines • Volume 8, July 2010
Correction: The last two sentences in the Epididymitis section have been reworded.
View the updated online version of this article.


Mometasone/Formoterol (Dulera) for Asthma
The Medical Letter • Volume 52, October 18, 2010
Correction: In the Clinical Studies section, the second clinical trial compared the 2 different strengths of the combinations with mometasone alone, 400 mcg twice daily, and not with placebo.
View the updated online version of this article.



2009

Vancomycin Dosing and Monitoring
The Medical Letter • Volume 51, April 6, 2009
Correction: Dosing paragraph: The next to last sentence should be "...organism is =2 mg/L, the new...." (not >2 mg/L).
View the updated online version of this article.


Milnacipran (Savella) for Fibromyalgia
The Medical Letter • Volume 51, June 15, 2009
Correction: In the 2nd sentence, "similar to gabapentin" was added. It now reads, “...a gamma-aminobutyric acid (GABA) analog similar to gabapentin...”
View the updated online version of this article.


In Brief: Biennial IV Zoledronic Acid (Reclast) for Prevention of Osteoporosis
The Medical Letter • Volume 51, June 29, 2009
Correction: The first word of the title was changed from Biannual to Biennial.
View the updated online version of this article.


Antimicrobial Prophylaxis for Surgery
Treatment Guidelines • Volume 7, June 2009
Addendum: Table 1: Footnote 14 was added to the Gastrointestinal/Colorectal section and a second sentence was added to footnote 5.
View the updated online version of this article.


Golimumab (Simponi) for Inflammatory Arthritis
The Medical Letter • Volume 51, July 13, 2009
Correction: In the first sentence "humanized" was changed to "human" to describe golimumab. In Table 1, the source for certolizumab (Cimzia) was changed to "humanized" and the price should have been $1,341.68 (not $3,136.40).
View the updated online version of this article.


Benzyl Alcohol Lotion for Head Lice
The Medical Letter • Volume 51, July 27, 2009
Correction: In Table 1, the price for lindane 1% shampoo should have been $136.86 (not $3.00).
View the updated online version of this article.


When a Statin Fails
The Medical Letter • Volume 51, July 27, 2009
Correction: The first paragraph should have included the words "for patients at high risk" after 100 mg/dL (2.6 mmol/L)
View the updated online version of this article.


Tapentadol (Nucynta) - A New Analgesic
The Medical Letter • Volume 51, August 10, 2009
Correction: In the pharmacokinetics table, the half-life for tapentadol was changed from "24" to "4".
View the updated online version of this article.


Colchicine and Other Drugs for Gout
The Medical Letter • Volume 51, November 30, 2009
Correction: In the Uricosuric agents paragraph, the last two words in the last sentence ("and theophylline.") were deleted.
View the updated online version of this article.


Advice for Travelers
Treatment Guidelines • Volume 7, November 2009
Correction: In the oral rehydration salts paragraph, the first sentence has been changed from "...can help maintain electrolyte balance..." to "can prevent and treat dehydration..."
View the updated online version of this article.



2008

Veregen: A Botanical for Treatment of Genital Warts
The Medical Letter • Volume 50, February 25, 2008
Correction: Theophylline was deleted from the pharmacology section on page 15; it is not among the components that make up 2.5% of the drug weight. Table 1: 2.3% discontinuation rate due to adverse effects for Veregen (not 5%)
View the updated online version of this article.


Diet, Drugs and Surgery for Weight Loss
Treatment Guidelines • Volume 6, April 2008
Correction: In the Adjustable Gastric Banding section on page 37, the first sentence has been changed from "Use of a laparoscopically adjustable gastric band placed around..." to "Use of an adjustable gastric band placed laparoscopically around..." In the second sentence, the words through a subcutaneous reservoir have been added.
View the updated online version of this article.

Natalizumab (Tysabri) for Crohn’s Disease
The Medical Letter • Volume 50, May 5, 2008
Correction: The May 5, 2008 article on the approval of natalizumab (Tysabri) for treatment of Crohn's disease in the "Adverse Effects" section on page 35 included the statement: "… postmarketing hepatotoxicity, sometimes fatal or requiring liver transplantation, has occurred." Actually, no fatal hepatotoxicity or liver transplantation has been reported to date. The FDA warning about post-marketing hepatotoxicity with Tysabri that was the basis for our statement said: "The combination of transaminase elevations and elevated bilirubin without evidence of obstruction is recognized as an important predictor of severe liver injury that may lead to [emphasis added] death or the need for a liver transplant in some patients." Also, in the last sentence of the Conclusion, we should have said: "Because of the risk of serious hepatic toxicity and the rare but even more serious risk of developing progressive multifocal leukoencephalopathy, it should be used only in patients who have not responded to other drugs, including a TNF inhibitor." The italicized words should be substituted for "it is FDA-approved for use."
View the updated online version of this article.


Pharmacogenetic-Based Dosing of Warfarin
The Medical Letter • Volume 50, May 19, 2008
Addendum - Warfarin-Acetaminophen Interaction: A reader expressed disappointment that our recent listing of “Some Warfarin Drug Interactions” did not include acetaminophen. Perhaps it should have. Acetaminophen can increase the anticoagulant effect of warfarin, particularly with continued use, but it does so inconsistently. The mechanism of this interaction has not been established, but may be related to an acetaminophen metabolite inhibiting vitamin K-epoxide reductase, the target for warfarin’s anticoagulant effect.
View the updated online version of this article.

In Brief: Measles Outbreak
The Medical Letter • Volume 50, June 2, 2008
Illinois has been added to the first sentence. It is among the states where measles was reported.
View the updated online version of this article.

The EarCheck Middle Ear Monitor
The Medical Letter • Volume 50, July 14, 2008
Correction: The article in the July 14th issue contained an error in the last sentence of the last paragraph beginning on page 55. The instrument’s reading is determined not by the degree of protrusion of the tympanic membrane, but rather by its mobility.
View the updated online version of this article.

Drugs for Tobaco Dependence
Treatment Guidelines • Volume 6, September 2008
Table 1: Some footnotes were renumbered.
View the updated online version of this article.

Bendamustine (Treanda) for CLL and NHL
The Medical Letter • Volume 50, November 17, 2008
Correction: In the Clinical Studies section, the complete response rate with chlorambucil for CLL was 2% (not 24%).

View the updated online version of this article.

CT Colonography
The Medical Letter • Volume 50, December 1, 2008
Correction: In table 1, "Invasive" should be "less" and "more" rather than "no" and "yes" for CT colonography and colonoscopy, respectively. In the conclusion, "noninvasive" should be "less invasive."

View the updated online version of this article.

Drugs for Asthma
Treatment Guidelines • Volume 6, December 2008
Correction: In the table on page 86, the last sentence of footnote 7 was incomplete. It now correctly reads: "Zileuton is taken within 1 hour after morning and evening meals."
View the updated online version of this article.