Hypertension Combination Available
Metoprolol succinate extended-release/hydrochlorothiazide (Dutoprol) is now approved for the management of hypertension. Dutoprol is not approved as a first-line therapy.
The FDA's approval was based on data from clinical trials showing that the medications in the combination pill both contributed to changes from baseline in sitting diastolic and systolic blood pressure at 8 weeks. Decreases in blood pressure were seen within 2 weeks of the start of therapy with Dutoprol and were sustained throughout the entire study. About 98% of the peak antihypertensive effect of the medication was maintained at 24 hours.
Consult labeling for dosing recommendations, precautions, and contraindications.
Posaconazole Prevents Invasive Fungal Infections
The FDA approved posaconazole (Noxafil, Schering-Plough Corporation) 40 mg/mL oral suspension to prevent fungal infections caused by invasive Aspergillus and Candida infections in high-risk, severely immunocompromised patients 13 years of age and older. The medication is indicated in hematopoietic stem-cell transplant recipients with graft versus host disease and those with hematologic malignancies with prolonged neutropenia from chemotherapy.
The safety and efficacy of posaconazole were shown in clinical trials of 1,844 patients. Patients who were taking posaconazole had comparable or lower rates of invasive Aspergillus and Candida infections than patients who were taking other antifungal medications.
The most common side effects in patients taking posaconazole were nausea, vomiting, diarrhea, rash, decreased potassium blood levels and platelet counts, and abnormalities in liver function tests.
This medication must be taken with a full meal or liquid nutritional supplement. Consult product labeling for full dosing instructions, which detail possible drug-drug interactions that are potentially serious.
CFC-Free Asthma Medication Approved
GlaxoSmithKline's fluticasone propionate plus salmeterol xinafoate inhalation aerosol (Advair HFA) has been approved for the long-term maintenance treatment of asthma in patients 12 years of age and older. The new formulation is propelled using hydrofluoroalkane (HFA) rather than chlorofluorocarbons (CFCs), which deplete the ozone layer. Recommended doses are lower for the HFA product compared with the CFC-powered fluticasone plus salmeterol inhaler product (Advair Diskus) because of differences in delivery characteristics.
The new HFA product is available in 45 mcg/21 mcg, 115 mcg/21 mcg, and 230 mcg/21 mcg formulations.
Use of this medication, like other long-acting beta2-agonists, should be limited to patients not adequately controlled while taking other asthma-controller medications or those whose disease severity clearly warrants initiation of two maintenance therapies. It should not be used as a first-line therapy or to treat acute symptoms, nor started in patients with significantly worsening or acutely deteriorating asthma.
CDC Panel Recommends HPV Vaccine for Girls
The Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) recommend that three doses of the quadrivalent human papillomavirus (HPV) recombinant vaccine (Gardasil) be given to girls between ages 11 and 12 years. The committee noted, however, that the vaccination series can be started as early as age 9 at the discretion of the healthcare provider. The recommendation also includes girls and women 13 to 26 years of age because they will benefit from the vaccine. The vaccine should be administered before sexual activity begins, the ACIP notes, but females who are sexually active should still be vaccinated.
According to the CDC, Gardasil is highly effective against four types of HPV, including two that cause about 70% of cervical cancers.