1
Sunscreens
The Medical Letter on Drugs and Therapeutics • June 23, 2025; (Issue 1731)
Excessive exposure to ultraviolet (UV) radiation can
cause erythema, photoaging, and skin cancer.
Sunscreens are widely used to reduce these risks, but
questions remain about their effectiveness and safety.
In 2021, the FDA proposed a rule that would require
additional safety studies for some sunscreen active
ingredients and mandate better UVA protection in
sunscreen products.
2
Treatment of Common Respiratory Tract Infections
The Medical Letter on Drugs and Therapeutics • April 17, 2023; (Issue 1674)
Most respiratory tract infections are caused by
viruses. Bacterial respiratory tract infections are
usually treated empirically with antibiotic therapy
that targets the most probable causative pathogens.
Recommended antibiotic regimens for outpatient
treatment of some common respiratory tract
infections are listed in Table 1 for adults and Table 2
for children.
3
Antiviral Drugs for Seasonal Influenza for 2025-2026
The Medical Letter on Drugs and Therapeutics • October 27, 2025; (Issue 1740)
Influenza is generally a self-limited illness, but complications
including pneumonia, respiratory failure, and
death can occur, especially in persons at increased
risk (see Table 1).
4
Insect Repellents
The Medical Letter on Drugs and Therapeutics • July 7, 2025; (Issue 1732)
The Centers for Disease Control and Prevention
(CDC) and the Environmental Protection Agency (EPA)
recommend using insect repellents to avoid being
bitten by mosquitoes, ticks, and other arthropods
that transmit disease-causing pathogens. Repellents
applied to exposed skin should be used in conjunction
with other preventive measures such as wearing long-sleeved
shirts, pants, and socks and avoiding outdoor
activities during peak mosquito-biting times. Some
insect repellents are listed in Table 1.
5
Ensitrelvir (Xocova) for Post-Exposure Prophylaxis of COVID-19
The Medical Letter on Drugs and Therapeutics • July 20, 2026; (Issue 1759)
The FDA has approved ensitrelvir (Xocova – Shionogi), a SARS-CoV-2 main protease inhibitor, for postexposure prophylaxis
of COVID-19 in patients ≥12 years old who had contact with
an infected individual. Ensitrelvir is the first oral antiviral
drug to be approved in the US for this indication. The parenteral
monoclonal antibody combinations bamlanivimab and
etesevimab and casirivimab and imdevimab (REGEN-COV)
are no longer authorized for postexposure prophylaxis of
COVID-19 in the US.
6
COVID-19 Update: 2025-2026 Vaccine Formulations and Recommendations
The Medical Letter on Drugs and Therapeutics • October 13, 2025; (Issue 1739)
The FDA has licensed new 2025-2026 formulations
of the mRNA COVID-19 vaccines manufactured by
Pfizer/BioNTech (Comirnaty) and Moderna (Spikevax,
mNEXSPIKE) and the adjuvanted protein subunit
COVID-19 vaccine manufactured by Novavax
(Nuvaxovid). The new formulations are indicated
for use in all adults ≥65 years old and in persons
6 months (Spikevax), 5 years (Comirnaty), or 12
years (mNEXSPIKE, Nuvaxovid) through 64 years old
who are at high risk for severe COVID-19 because
of an underlying condition. An Emergency Use
Authorization allowing administration of the Pfizer
vaccine to children 6 months through 4 years old has
been withdrawn.
7
In Brief: Widaplik — Another Three-Drug Combination for Hypertension
The Medical Letter on Drugs and Therapeutics • June 22, 2026; (Issue 1757)
The FDA has approved Widaplik (Azurity), a fixed-dose
combination of the angiotensin receptor blocker (ARB)
telmisartan, the dihydropyridine calcium channel blocker
amlodipine, and the thiazide-like diuretic indapamide, for
treatment of hypertension in adults. Telmisartan, amlodipine,
and indapamide are also available alone and in various
combinations for treatment of hypertension. Two three-drug
combinations containing an ARB, amlodipine, and the thiazide
diuretic hydrochlorothiazide (Exforge HCT and Tribenzor) have
been available for years
(see Table 1).
8
Treatment of Allergic Rhinitis and Allergic Conjunctivitis
The Medical Letter on Drugs and Therapeutics • March 31, 2025; (Issue 1725)
Initial treatment of allergic rhinitis (AR) depends
on the severity of symptoms and whether they are
intermittent or persistent (see Table 1).
9
Baxdrostat (Baxfendy) — An Aldosterone Synthase Inhibitor for Hypertension
The Medical Letter on Drugs and Therapeutics • July 6, 2026; (Issue 1758)
The FDA has approved baxdrostat (Baxfendy – AstraZeneca),
an oral aldosterone synthase inhibitor, for add-on treatment
of hypertension in adults whose blood pressure is not
adequately controlled on other drugs. Baxdrostat is the first
aldosterone synthase inhibitor to become available in the US.
10
In Brief: Apixaban vs Rivaroxaban for Acute VTE
The Medical Letter on Drugs and Therapeutics • June 22, 2026; (Issue 1757)
The direct oral anticoagulants (DOACs) apixaban (Eliquis)
and rivaroxaban (Xarelto, and generics) are frequently used
for treatment of acute venous thromboembolism (VTE)
and are usually continued for at least 3 months. The other
DOACs (edoxaban [Savaysa] and dabigatran [Pradaxa, and
generics]) are alternatives for long-term treatment, but they
require prior treatment with low-molecular-weight heparin
for ≥5 days. Until recently, no large randomized trial directly
comparing the safety of apixaban and rivaroxaban for
treatment of VTE was available.
