More elderly patients at risk for congestive heart failure are getting aggressive statin therapy when they need it. Researchers from Kaiser Permanente Center for Health Research in Portland, Oregon, say that the 2004 update to the National Cholesterol Education Program Adult Treatment Panel III guidelines and the corresponding revision of internal guidelines in the large health maintenance organization they studied resulted in more patients receiving minimal-guideline statin therapy.

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In a new study, tamoxifen citrate (Nolvadex drags, AstraZeneca), best known as a treatment for breast cancer, dramatically reduced symptoms of the manic phase of bipolar disorder more quickly than many standard medications for the mental illness. By the end of the study, 63% of the patients taking tamoxifen had reduced manic symptoms, compared with only 13% of those taking a placebo. Patients taking tamoxifen responded by the fifth day.

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Shire has announced the voluntary market withdrawal of a limited amount of its Daytrana patch, which is used to treat attention-deficit hyperactivity disorder.

Only Daytrana packages with an expiration date of March 31, 2009, or earlier and packages with lot numbers 2563511, 2563611, and 2570411 are affected.

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Cephalon has issued two “Dear Health Care Professional” letters to inform prescribers and other health care providers of important safety information regarding fentanyl buccal tablets (Fentora). Fentanyl buccal tablets are indicated only for breakthrough pain in patients with cancer who are already receiving and who are tolerant to opioid therapy for underlying persistent cancer pain.

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The FDA has announced that the prescribing information for haloperidol (Haldol, generic versions) has been revised to include a new cardiovascular subsection in the Warnings section.

Life-threatening generic arrhythmias (e.g., sudden death, QT prolongation, torsades de pointes) have been reported in patients treated with haloperidol, especially when the drug is administered intravenously or at doses higher than recommended.

Injectable haloperidol is approved only for intramuscular injection, although IV administration is known to be a fairly common off-label clinical practice. A minimum of 28 cases of QT prolongation and torsades de pointes have been reported following intravenous administration, and some have resulted in death.

(Sources: FDA)

Important revisions have been made to the Contraindications, Warnings, and Dosage and Administration sections of the full prescribing information for ceftriaxone (Rocephin, Roche).

This new information addresses the interaction of ceftriaxone with calcium-containing products based on reports of fatal cases in neonates. Although no cases of ceftriaxone-calcium precipitates in patients other than neonates have been reported, the potential for this interaction exists in patients of any age.

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For the first time in a decade, the National Asthma Education and Prevention Program has updated clinical guidelines for the diagnosis and management of asthma. New features include:
• an expanded section on asthma for children 5 to 11 years of age.
• information on medications.
• recommendations for patient education other than in a physician’s office.
• advice for controlling environmental factors that can cause symptoms of asthma.

The guidelines reaffirm that patients with persistent asthma need both long-term control and quick-relief medications. Also included are new recommendations:
• inhaled corticosteroids: considered the most effective long-term control medication for all age groups.
• leukotriene receptor antagonists and cromolyn: for long-term control.
• long-acting beta agonists: as adjunct therapy with inhaled corticosteroids.
• omalizumab (Xolair, Genentech): for severe asthma.
• albuterol, levalbuterol, and corticosteroids: for acute exacerbations.

(Source: National Heart, Lung, and Blood Institute, August 29, 2007.)