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Naltrexone/Bupropion (Contrave) for Weight Loss - STEPS - American Family Physician

Apr 15, 2015 - 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.

American Family Physician : STEPS

https://www.aafp.org/afp/2015/0415/p554.html

Segesterone Acetate and Ethinyl Estradiol Vaginal Ring (Annovera) for Contraception - ...

May 15, 2020 - Annovera is an effective combined progestin/estrogen contraceptive device that can be used for one year.

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0515/p618.html

Hydrogen Peroxide 40% (Eskata) for Seborrheic Keratosis - STEPS - American Family ...

Nov 15, 2019 - Hydrogen peroxide 40% topical solution is not particularly effective for removing seborrheic keratosis lesions, and skin reactions are common.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/1115/p643.html

Esketamine (Spravato) for Treatment-Resistant Depression - STEPS - American Family ...

Mar 15, 2020 - Esketamine is an in-office treatment for patients with a severe major depressive disorder to be used in addition to oral antidepressant therapy.

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0315/p339.html

Ivermectin 1% Cream (Soolantra) for Inflammatory Lesions of Rosacea - STEPS - American ...

Sep 15, 2016 - Ivermectin cream is an effective treatment for moderate to severe pustular rosacea, but it is more expensive than some other available treatments and has not been studied in patients with milder forms of rosacea. Generic metronidazole cream is a less expensive alternative, and long-term...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0915/p512.html

Galcanezumab (Emgality) for Migraine and Cluster Headaches - STEPS - American Family ...

Apr 15, 2020 - In otherwise healthy adults with severe and frequent migraine or cluster headaches, galcanezumab may provide a modest reduction in debilitating headache frequency in the short term.

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0415/p502.html

Revefenacin (Yupelri) for the Treatment of Chronic Obstructive Pulmonary Disease - ...

Jan 15, 2020 - Revefenacin is a once-daily nebulized alternative to metered dose long-acting muscarinic antagonists for patients with moderate to severe COPD. Given its expense, complicated administration process, and lack of evidence that it improves key patient-oriented outcomes, its use should be ...

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0115/p121.html

Dupilumab (Dupixent) for Asthma - STEPS - American Family Physician

Feb 15, 2020 - Dupilumab is an effective injectable drug that decreases asthma exacerbations and the need for an oral glucocorticoid in patients with moderate to severe asthma, particularly those with high eosinophil counts.

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0215/p244.html

Baloxavir Marboxil (Xofluza) for Influenza - STEPS - American Family Physician

Dec 15, 2019 - Single-dose baloxavir should be limited to ill patients who cannot tolerate or comply with a course of oseltamivir. For otherwise healthy adults with confirmed influenza or influenza-like illness, the high cost of baloxavir may not justify the one-day reduction in symptoms of a ...

American Family Physician : STEPS

https://www.aafp.org/afp/2019/1215/p776.html

Elagolix (Orilissa) for Endometriosis Pain - STEPS - American Family Physician

Oct 15, 2019 - Elagolix can decrease pain in women with endometriosis, but it is expensive and has adverse effects similar to those of other medications that decrease estrogen levels.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/1015/p502.html

Secnidazole (Solosec) for Bacterial Vaginosis - STEPS - American Family Physician

Aug 15, 2019 - Secnidazole is much more expensive than generic metronidazole and other available treatments. However, it is a safe option for women who desire a single-dose treatment or for patients in whom treatment compliance is a concern.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0815/p242.html

Glycopyrronium (Qbrexza) Topical Wipes for Hyperhidrosis - STEPS - American Family ...

Sep 15, 2019 - Glycopyrronium wipes are a useful alternative for the topical treatment of hyperhidrosis of the axillae in patients nine years and older who do not respond to or tolerate nonprescription antiperspirants or topical aluminum chloride.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0915/p372.html

Semaglutide (Ozempic) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Jul 15, 2019 - Semaglutide can be added to existing treatment to improve glycemic control and induce weight loss. It may also protect against cardiovascular outcomes in patients with type 2 diabetes and established cardiovascular disease.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0715/p116.html

Erenumab (Aimovig) for Migraine Prophylaxis in Adults - STEPS - American Family Physician

Jun 15, 2019 - Erenumab is a safe option for migraine prophylaxis in adults. However, it is expensive and should be reserved for patients who have experienced intolerable adverse effects while taking oral migraine prophylaxis medication or who have poor adherence to daily preventive treatment.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0615/p781.html

Apixaban (Eliquis) for Stroke Prevention in Atrial Fibrillation - STEPS - American ...

Apr 15, 2014 - 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...

American Family Physician : STEPS

https://www.aafp.org/afp/2014/0415/p672.html

Abaloparatide (Tymlos) for Osteoporosis - STEPS - American Family Physician

Feb 15, 2019 - Abaloparatide is a safe and effective medication used to reduce the likelihood of vertebral and nonvertebral fractures in women at high risk. However, it is expensive and requires daily injections. It has not been evaluated for its effect on decreasing hip fractures.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0215/p260.html

Glycopyrrolate (Lonhala Magnair) for Treatment of Chronic Obstructive Pulmonary Disease...

May 15, 2019 - Glycopyrrolate is a safe alternative to long-acting muscarinic antagonists delivered by metered-dose inhaler for patients with moderate to severe COPD.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0515/p643.html

Lofexidine (Lucemyra) for Treatment of Opioid Withdrawal Symptoms - STEPS - American ...

Mar 15, 2019 - Lofexidine has been shown to be as effective as clonidine at controlling some of the symptoms of withdrawal from opioid use. It may have a small additional benefit for maintaining abstinence in patients switched to buprenorphine or methadone for long-term maintenance.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0315/p392.html

Prasterone (Intrarosa) for Dyspareunia - STEPS - American Family Physician

Jan 15, 2019 - Prasterone is similarly effective to nonprescription options for treating vaginal dryness and itching associated with menopause and may offer a small benefit in the treatment of dyspareunia.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0115/p117.html

Recombinant Zoster Vaccine (Shingrix) for the Prevention of Shingles - STEPS - American...

Oct 15, 2018 - Recombinant zoster vaccine is a relatively new shingles vaccine that has been shown to have greater effectiveness and protection than the existing live vaccine. Local and systemic adverse effects may occur after administration, but have been shown to resolve within one to three days.

American Family Physician : STEPS

https://www.aafp.org/afp/2018/1015/p539.html

Crisaborole (Eucrisa) for Mild to Moderate Atopic Dermatitis - STEPS - American Family ...

Sep 15, 2018 - Crisaborole has been shown to be effective in about one-third of patients who use it, but it is much more expensive than other available products. Although crisaborole is a safe option for patients in whom topical corticosteroids are considered risky (e.g., children at least two years ...

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0915/p379.html

Glecaprevir/Pibrentasvir (Mavyret) for the Treatment of Chronic Hepatitis C - STEPS - ...

Nov 15, 2018 - Glecaprevir/pibrentasvir is an effective treatment for any of six genotypes of HCV infection and has few adverse effects. It can be used to treat more genotypes over a shorter duration (eight weeks for patients without cirrhosis) and is substantially less expensive than other available ...

American Family Physician : STEPS

https://www.aafp.org/afp/2018/1115/p601.html

Oxymetazoline Hydrochloride 1% Cream (Rhofade) for Persistent Facial Erythema ...

Jun 15, 2018 - Oxymetazoline cream has been shown to be safe and effective at reducing erythema in a small portion of treated patients, but research showing its effectiveness relative to other options is lacking.

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0615/p808.html

Lifitegrast Ophthalmic Solution 5% (Xiidra) for Dry Eye Disease - STEPS - American ...

Jul 15, 2018 - Studies have shown that lifitegrast will reduce the symptoms of dry eye disease in some patients, although the benefit is borderline clinically significant. It is much more expensive than over-the-counter ointments, artificial tears, and lubricant eye drops.

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0715/p119.html

Delafloxacin (Baxdela) for Skin Infections - STEPS - American Family Physician

Aug 15, 2018 - Delafloxacin is a new fluoroquinolone antibiotic available in intravenous and oral formulations for the treatment of serious skin and skin structure infections in patients requiring initial intravenous therapy. It is effective for infections caused by MRSA or P. aeruginosa, in addition ...

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0815/p246.html

Implantable Buprenorphine (Probuphine) for Maintenance Treatment of Opioid Use Disorder...

May 15, 2018 - Implantable buprenorphine is an expensive alternative for patients on a stable dosage of transmucosal buprenorphine. Based on current research and guidance, implantable buprenorphine should not be used as initial treatment for opioid dependence or as a substitute for medication-assisted...

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0515/p668.html

Edoxaban (Savaysa) for the Prevention of Thromboembolic Events - STEPS - American ...

Apr 15, 2018 - Edoxaban is an alternative to warfarin and other oral anticoagulants for the prevention of stroke in patients with nonvalvular atrial fibrillation and for the treatment of deep venous thrombosis and pulmonary embolism.

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0415/p529.html

Lesinurad (Zurampic) for Gout - STEPS - American Family Physician

Mar 15, 2018 - Lesinurad taken in addition to a xanthine oxidase inhibitor reduces serum uric acid levels. However, it does not reduce the likelihood of experiencing a gout flare-up or completely resolving tophi.

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0315/p374.html

Nebivolol/Valsartan (Byvalson) for Hypertension - STEPS - American Family Physician

Jan 15, 2018 - Nebivolol/valsartan is an option for the treatment of patients with newly diagnosed or poorly controlled hypertension. Although it offers a new beta-blocker option, no research has demonstrated its benefit over existing treatments.

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0115/p124.html

Dulaglutide (Trulicity) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Oct 15, 2017 - Dulaglutide is an easy-to-use, once-weekly injectable therapy for the treatment of type 2 diabetes in adults. It produces a modest decrease in A1C levels with only a small risk of severe hypoglycemia. The small average weight loss it induces may be an advantage for some patients.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/1015/p540.html

Liraglutide (Saxenda) for Weight Loss - STEPS - American Family Physician

Jul 15, 2016 - Liraglutide, combined with lifestyle counseling, produces a clinically significant and sustained weight loss that continues as long as it is used. Nausea and vomiting, however, are common adverse effects, and about one in 10 patients will discontinue treatment.

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0715/p161.html

Reslizumab (Cinqair) for Eosinophilic Asthma - STEPS - American Family Physician

Nov 15, 2017 - Reslizumab is an expensive treatment option for decreasing exacerbations in patients with severe asthma and pronounced eosinophilia. Because of the risk of anaphylaxis, it should only be administered in an appropriate facility by a medical professional. Reslizumab is best considered ...

American Family Physician : STEPS

https://www.aafp.org/afp/2017/1115/p671.html

Glycopyrrolate (Seebri Neohaler) for Maintenance Therapy in Patients with COPD - STEPS ...

Sep 15, 2017 - Glycopyrrolate is a safe option for maintenance treatment to prevent moderate to severe exacerbations in patients with moderate to severe COPD, with only mild and rare adverse effects.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0915/p395.html

Phentermine/Topiramate (Qsymia) for Chronic Weight Management - STEPS - American Family...

Oct 15, 2014 - 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 ...

American Family Physician : STEPS

https://www.aafp.org/afp/2014/1015/p576.html

Lixisenatide (Adlyxin) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Aug 15, 2017 - ixisenatide is an easy-to-use, once-daily injectable therapy for the treatment of type 2 diabetes in adults. It is at least as effective as exenatide at reducing A1C and body weight, with similar rates of gastrointestinal adverse effects.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0815/p257.html

Sacubitril/Valsartan (Entresto) for Heart Failure - STEPS - American Family Physician

Oct 15, 2016 - Sacubitril/valsartan provides a small mortality benefit and decreases heart failure–related hospitalizations over and above an ACE inhibitor. It may be used in place of an ACE inhibitor in patients receiving optimal doses of guideline-directed medical therapy that includes ACE ...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/1015/p611.html

Idarucizumab (Praxbind) for Dabigatran (Pradaxa) Anticoagulant Reversal - STEPS - ...

Jun 15, 2017 - Idarucizumab is the only anticoagulant reversal agent for dabigatran. Because of its high cost and limited data regarding clinical benefit, therapy should be reserved for patients taking dabigatran who have life-threatening bleeding or are in need of emergency surgery.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0615/p798.html

Empagliflozin (Jardiance) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Dec 15, 2016 - Empagliflozin can be added to existing type 2 diabetes treatment to lower A1C levels, although there are less expensive options. In older patients with preexisting cardiovascular disease, empagliflozin can decrease all-cause mortality, cardiovascular mortality, and hospitalization for ...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/1215/p1014.html

Umeclidinium (Incruse Ellipta) for COPD - STEPS - American Family Physician

Jan 15, 2017 - Umeclidinium is an easy-to-use, once-daily, well-tolerated, and relatively low-cost anti-cholinergic agent for maintenance therapy in patients with moderate to severe COPD.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0115/p120.html

Sofosbuvir/Velpatasvir (Epclusa) for Hepatitis C - STEPS - American Family Physician

May 15, 2017 - Sofosbuvir/velpatasvir is an effective treatment for patients with HCV and has minimal adverse effects. It is the preferred treatment for patients with genotype 2 or 3. As with other curative treatments, it is very expensive.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0515/p664.html

Albiglutide (Tanzeum) for Diabetes Mellitus - STEPS - American Family Physician

Apr 15, 2017 - Reductions in A1C are less with albiglutide than with the first-line therapy metformin, and albiglutide costs significantly more than metformin and sulfonylureas. Albiglutide's ability to reduce diabetes-related morbidity and major cardiovascular events is unknown.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0415/p521.html

Elbasvir/Grazoprevir (Zepatier) for Hepatitis C Virus Infection - STEPS - American ...

Mar 15, 2017 - Elbasvir/grazoprevir is a safe and effective treatment for HCV genotypes 1 and 4, with or without compensated cirrhosis or HIV-1 coinfection. Patients with renal impairment, including those on hemodialysis, can use the medication.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0315/p393.html

Evolocumab (Repatha) for the Treatment of Hyperlipidemia - STEPS - American Family ...

Nov 15, 2016 - Evolocumab is generally safe and effective at lowering serum LDL cholesterol levels for select patients who need marked cholesterol reduction and can tolerate injections. However, it remains unknown whether evolocumab prevents premature death from cardiovascular events.

American Family Physician : STEPS

https://www.aafp.org/afp/2016/1115/p843.html

Vortioxetine (Brintellix) for the Treatment of Depression - STEPS - American Family ...

Mar 1, 2015 - 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 ...

American Family Physician : STEPS

https://www.aafp.org/afp/2015/0301/p325.html

Alirocumab (Praluent) for Treatment of Hyperlipidemia - STEPS - American Family Physician

Aug 15, 2016 - Alirocumab is a novel lipid-lowering therapy that is highly effective at lowering LDL cholesterol when used in addition to statin therapy and diet. Its use should be limited to patients with either heterozygous familial hypercholesterolemia or clinical atherosclerotic cardiovascular ...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0815/p310.html

Suvorexant (Belsomra) for Insomnia - STEPS - American Family Physician

Jun 15, 2016 - Suvorexant effectively increases total sleep time and decreases time to sleep onset. Because of its risk of abuse, significant incidence of next-day impairment, and high cost, it should be reserved for use in patients for whom other insomnia therapies, such as cognitive behavior therapy...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0615/p1016.html

Ivabradine (Corlanor) for Heart Failure - STEPS - American Family Physician

Apr 15, 2016 - In patients with stable systolic heart failure already on maximal medication therapy, adding ivabradine may reduce the number of hospitalizations related to heart failure (NNT for two years = 20), but it does not reduce cardiovascular mortality. In addition, many patients will not ...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0415/p682.html

Flibanserin (Addyi) for Hypoactive Sexual Desire Disorder in Premenopausal Women - ...

May 15, 2016 - Although flibanserin results in a modest improvement in the number of satisfying sexual events (approximately one more per month vs. placebo), it does not improve other measures, is considerably expensive, and has significant adverse effects.

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0515/p826.html

Conjugated Estrogens/Bazedoxifene (Duavee) for Menopausal Symptoms - STEPS - American ...

Feb 15, 2016 - Conjugated estrogens/bazedoxifene is effective for the treatment of menopausal symptoms and may be better tolerated than conjugated estrogens/medroxyprogesterone. It will maintain bone mineral density in the lumbar spine and hip, but its effect on fractures is not known. Cardiovascular ...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0215/p307.html

Timothy Grass Pollen Allergen Extract (Grastek) for Allergic Rhinitis - STEPS - ...

Dec 15, 2015 - Timothy grass pollen allergen extract produces small improvements in allergic rhinitis symptoms and the use of allergy relief medications, with a high rate of adverse effects. It may, however, be an option for patients who desire an alternative to standard allergy symptom relief but who...

American Family Physician : STEPS

https://www.aafp.org/afp/2015/1215/p1096.html

Levomilnacipran (Fetzima) for Major Depressive Disorder - STEPS - American Family ...

Oct 15, 2015 - 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.

American Family Physician : STEPS

https://www.aafp.org/afp/2015/1015/p727.html

Dapagliflozin (Farxiga) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Jun 15, 2015 - 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 ...

American Family Physician : STEPS

https://www.aafp.org/afp/2015/0615/p828.html

Vorapaxar (Zontivity) for the Prevention of Thrombotic Cardiovascular Events - STEPS - ...

Aug 15, 2015 - 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.

American Family Physician : STEPS

https://www.aafp.org/afp/2015/0815/p304.html

Lorcaserin (Belviq) for Weight Loss - STEPS - American Family Physician

Dec 15, 2014 - 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...

American Family Physician : STEPS

https://www.aafp.org/afp/2014/1215/p863.html

Guanfacine (Intuniv) for Attention-Deficit/Hyperactivity Disorder - STEPS - American ...

Feb 15, 2011 - Guanfacine is an effective short-term treatment option for ADHD in children six to 12 years of age. Sedation is a marked problem in many children. Patients should take the medication daily to avoid adverse effects that occur with abrupt discontinuation or when the guanfacine is restarted.

American Family Physician : STEPS

https://www.aafp.org/afp/2011/0215/p468.html

Dapsone (Aczone) 5% Gel for the Treatment of Acne - STEPS - American Family Physician

Feb 15, 2010 - Topical dapsone gel will decrease the percentage of lesions in patients with mild to moderate acne, especially inflammatory lesions. Although not directly compared, dapsone gel has lower response rates than currently available topical treatments that are less expensive.

American Family Physician : STEPS

https://www.aafp.org/afp/2010/0215/p451.html

Ivermectin Lotion (Sklice) for Head Lice - STEPS - American Family Physician

Jun 15, 2014 - 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 ...

American Family Physician : STEPS

https://www.aafp.org/afp/2014/0615/p984.html

Roflumilast (Daliresp) for Chronic Obstructive Pulmonary Disease - STEPS - American ...

Feb 15, 2014 - Roflumilast therapy has a limited role in patients with severe COPD, and no role in patients with mild to moderate COPD. It will not decrease the number of hospitalizations.

American Family Physician : STEPS

https://www.aafp.org/afp/2014/0215/p300.html

Spinosad (Natroba) for Head Lice - STEPS - American Family Physician

Jun 15, 2013 - Spinosad is safe and effective for the treatment of head lice; most patients will be lice-free after a single treatment. Nit combing following treatment is not necessary. These benefits must be weighed against its prescription-only status and higher cost compared with nonprescription ...

American Family Physician : STEPS

https://www.aafp.org/afp/2013/0615/p874.html

Tranexemic Acid (Lysteda) for Cyclic Heavy Menstrual Bleeding - STEPS - American Family...

Oct 15, 2011 - Tranexamic acid is a nonhormonal option that reduces menstrual blood loss and improves quality of life in patients with heavy menstrual bleeding. It is more expensive than nonsteroidal anti-inflammatory drugs and hormonal therapies, but is an option when these treatments are not desired...

American Family Physician : STEPS

https://www.aafp.org/afp/2011/1015/p883.html

Indacaterol (Arcapta) for COPD - STEPS - American Family Physician

Aug 15, 2014 - 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.

American Family Physician : STEPS

https://www.aafp.org/afp/2014/0815/p252.html

Ulipristal (Ella) for Emergency Contraception - STEPS - American Family Physician

Aug 15, 2012 - Ulipristal is a prescription-only emergency contraceptive. It is at least as effective as levonorgestrel when administered within 72 hours of unprotected sexual intercourse, and is more effective than levonorgestrel in the 72- to 120-hour window.

American Family Physician : STEPS

https://www.aafp.org/afp/2012/0815/p365.html

Ticagrelor (Brilinta) for Secondary Prevention of Thrombotic Events Following Acute ...

Dec 15, 2013 - Ticagrelor is an alternative to clopidogrel for secondary prevention of cardiovascular death in patients with acute coronary syndrome. In an international study it was found to be more effective, but patients in the United States did not experience superior outcomes.

American Family Physician : STEPS

https://www.aafp.org/afp/2013/1215/p821.html

Emtricitabine/Tenofovir (Truvada) for HIV Prophylaxis - STEPS - American Family Physician

Oct 15, 2013 - When used with a comprehensive HIV prevention strategy, emtricitabine/tenofovir effectively prevents HIV-1 infection in high-risk patients. Adherence to daily dosing is important to maintain protection. The cost of therapy may limit access, and not all insurance companies currently ...

American Family Physician : STEPS

https://www.aafp.org/afp/2013/1015/p535.html

Vilazodone (Viibryd) for the Treatment of Depression - STEPS - American Family Physician

Aug 15, 2013 - The available evidence does not support the routine use of vilazodone in the treatment of depression. It is significantly more expensive than generic alternatives and is no more effective for moderate to severe depression than selective serotonin reuptake inhibitors or tricyclic ...

American Family Physician : STEPS

https://www.aafp.org/afp/2013/0815/p263.html

Doxepin (Silenor) for Insomnia - STEPS - American Family Physician

Aug 15, 2011 - In older patients with primary insomnia, Silenor can increase duration of sleep without next-day effects. However, it does not significantly decrease the time to sleep onset, and it is less effective in younger adults.

American Family Physician : STEPS

https://www.aafp.org/afp/2011/0815/p453.html

Fidaxomicin (Dificid) for Clostridium difficile Infection - STEPS - American Family ...

Feb 1, 2013 - Fidaxomicin is effective for the treatment of C. difficile infection, but it is much more expensive than traditional therapy. Until it is known that the benefits outweigh the significant cost, metronidazole or oral vancomycin is the preferred treatment for most patients.

American Family Physician : STEPS

https://www.aafp.org/afp/2013/0201/p211.html

Bromocriptine Mesylate (Cycloset) for Type 2 Diabetes Mellitus - STEPS - American ...

May 15, 2013 - Cycloset will lower A1C levels by 0.3 to 0.5 percent when taken alone or in combination with a sulfonylurea, without undesirable adverse effects such as hypoglycemia and weight gain. It will not cause further improvement of glucose control when used with insulin, metformin, or other ...

American Family Physician : STEPS

https://www.aafp.org/afp/2013/0515/p718.html

Linagliptin (Tradjenta) for the Treatment of Diabetes Mellitus - STEPS - American ...

Dec 15, 2012 - Linagliptin reduces A1C levels to a lesser extent than first-line therapy (metformin) and is significantly more expensive than metformin and sulfonylureas. Importantly, its ability to affect diabetes-related morbidity and mortality is not known.

American Family Physician : STEPS

https://www.aafp.org/afp/2012/1215/p1144.html

Rivaroxaban (Xarelto) for Prevention of Thromboembolic Events - STEPS - American Family...

Oct 15, 2012 - In patients at high risk of stroke because of nonvalvular atrial fibrillation, rivaroxaban is as safe and effective as warfarin. However, it should not be used in patients at risk of stroke for reasons other than nonvalvular atrial fibrillation until research shows its relative safety ...

American Family Physician : STEPS

https://www.aafp.org/afp/2012/1015/p768.html

Tapentadol (Nucynta) for Treatment of Pain - STEPS - American Family Physician

May 1, 2012 - Tapentadol is a DEA schedule II opioid medication with a safety profile, duration of action, frequency of dosing, and analgesic effect similar to those of other oral narcotics, although it is more expensive. At low doses, immediate-release tapentadol is better tolerated than oxycodone ...

American Family Physician : STEPS

https://www.aafp.org/afp/2012/0501/p910.html

Dutasteride/Tamsulosin (Jalyn) for Benign Prostatic Hyperplasia - STEPS - American ...

Jun 15, 2012 - Jalyn offers the convenience of taking one medication instead of two. Although monotherapy with dutasteride or tamsulosin is beneficial for many men, the combination drug is slightly better than either component alone at decreasing symptom scores; however, these benefits are of ...

American Family Physician : STEPS

https://www.aafp.org/afp/2012/0615/p1194.html

Adapelene/Benzoyl Peroxide (Epiduo) for Acne Vulgaris - STEPS - American Family Physician

Jun 15, 2011 - Adapalene/benzoyl peroxide is as effective as other combination products for the treatment of acne. Once-daily application is an advantage in terms of simplicity and adherence to therapy, but the cost is much higher than that of the individual components sold separately; this may create...

American Family Physician : STEPS

https://www.aafp.org/afp/2011/0615/p1486.html

Denosumab (Prolia) for Treatment of Postmenopausal Osteoporosis - STEPS - American ...

Feb 15, 2012 - Prolia is an expensive method of preventing osteoporotic hip fractures, and is associated with significant adverse effects. Safer, less expensive options exist for preventing fracture in high-risk women.

American Family Physician : STEPS

https://www.aafp.org/afp/2012/0215/p334.html

Dabigatran (Pradaxa) for Prevention of Stroke in Atrial Fibrillation - STEPS - American...

Dec 15, 2011 - Dabigatran is superior to warfarin for stroke prevention in patients with atrial fibrillation, with similar rates of major bleeding. Because it does not require laboratory monitoring, dabigatran therapy is less complicated than warfarin therapy, but it costs significantly more.

American Family Physician : STEPS

https://www.aafp.org/afp/2011/1215/p1397.html

Tinidazole (Tindamax) for Trichomoniasis and Bacterial Vaginosis - STEPS - American ...

Jan 15, 2009 - Tinidazole is generally an expensive alternative to metronidazole for the treatment of trichomoniasis and bacterial vaginosis. It offers little, if any, advantage with regard to safety, tolerability, and effectiveness; however, its once-daily dosing and shorter course of therapy may be ...

American Family Physician : STEPS

https://www.aafp.org/afp/2009/0115/p102.html

Risperidone (Risperdal) for Management of Autistic Disorder - STEPS - American Family ...

Jun 15, 2009 - Risperidone does not alter the course of autistic disorder, but is effective for controlling irritability and other associated symptoms. Patients taking risperidone should be appropriately monitored for adverse effects, especially abnormal movements.

American Family Physician : STEPS

https://www.aafp.org/afp/2009/0615/p1104.html

Alvimopan (Entereg) for the Treatment of Postoperative Ileus - STEPS - American Family ...

Apr 15, 2011 - Use of alvimopan should be restricted to patients at a higher risk of postoperative ileus following abdominal surgeries, such as hospitalized patients undergoing bowel resection with primary anastomosis. It is an expensive option with limited indications; head-to-head studies with ...

American Family Physician : STEPS

https://www.aafp.org/afp/2011/0415/p978.html

Bivalent HPV Recombinant Vaccine (Cervarix) for the Prevention of Cervical Cancer - ...

Dec 15, 2010 - Cervarix is effective in preventing known cytologic and histologic precursors of cervical cancer, although, as with Gardasil, it has not been shown to decrease rates of cervical cancer. This protection has been shown to last for six years, but it is unclear if a booster dose is needed.

American Family Physician : STEPS

https://www.aafp.org/afp/2010/1215/p1541.html

Methylnaltrexone (Relistor) for Opioid-Induced Constipation - STEPS - American Family ...

Sep 15, 2010 - Methylnaltrexone can temporarily relieve opioid-induced constipation in patients with advanced illness who have not responded to laxative treatment. However, it must be given by injection, is expensive, and has been studied only for short-term use.

American Family Physician : STEPS

https://www.aafp.org/afp/2010/0915/p678.html

Milnacipran (Savella) for Fibromyalgia - STEPS - American Family Physician

Oct 15, 2010 - Milnacipran can decrease the overall pain scores and improve symptoms of fibromyalgia. Safety in patients with severe comorbid medical and psychiatric conditions is unknown because these groups of patients were excluded from the study.

American Family Physician : STEPS

https://www.aafp.org/afp/2010/1015/p901.html

Topiramate (Topamax) for Migraine Prevention - STEPS - American Family Physician

Oct 15, 2005 - Topiramate is more effective than placebo for migraine prevention. Its effectiveness appears to be similar to that of other antiepileptic drugs and beta blockers. Because of the high cost of topiramate and the relative frequency of adverse effects, other approaches to migraine ...

American Family Physician : STEPS

https://www.aafp.org/afp/2005/1015/p1563.html

Febuxostat (Uloric) for Hyperuricemia and Gout - STEPS - American Family Physician

May 15, 2010 - Febuxostat more effectively lowers serum uric acid to goal levels than does allopurinol; however, this benefit is offset by a slightly higher incidence of adverse effects and treatment discontinuation. Until superiority for patient-oriented outcomes is shown in comparative trials with ...

American Family Physician : STEPS

https://www.aafp.org/afp/2010/0515/p1287.html

Sinecatechins (Veregen) for External Genital and Perianal Warts - STEPS - American ...

Dec 15, 2009 - Sinecatechins offers no clear advantage with regard to safety and tolerability. Indirect comparisons with other treatments suggest that sinecatechins may be more effective, with fewer recurrences of warts following successful treatment, but direct comparisons are lacking.

American Family Physician : STEPS

https://www.aafp.org/afp/2009/1215/p1447.html

Saxagliptin (Onglyza) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Jun 15, 2010 - Saxagliptin lowers A1C levels to a lesser extent and is much more expensive than first-line therapy with metformin. Its ability to decrease diabetes-related complications, including mortality, is not known. It is a DPP-4 inhibitor that has a more significant drug interaction profile ...

American Family Physician : STEPS

https://www.aafp.org/afp/2010/0615/p1483.html

Pramipexole (Mirapex) for Restless Legs Syndrome - STEPS - American Family Physician

Apr 15, 2007 - Although many patients with RLS do not need pharmacologic therapy, pramipexole is one option for treating moderate to severe symptoms. As with other agents used to manage RLS, potentially serious adverse reactions are possible.

American Family Physician : STEPS

https://www.aafp.org/afp/2007/0415/p1239.html

Ramelteon (Rozerem) for Insomnia - STEPS - American Family Physician

Apr 15, 2006 - Ramelteon is safe and effective for decreasing the time to persistent sleep in patients with chronic insomnia. It does not have the potential for abuse or dependence that sedative hypnotics have and is not a controlled substance.

American Family Physician : STEPS

https://www.aafp.org/afp/2006/0415/p1437.html

Adalimumab (Humira) for the Treatment of Rheumatoid Arthritis - STEPS - American Family...

Dec 15, 2008 - Adalimumab used alone offers little benefit over the traditional first-line agent, methotrexate. However, it increases remission rates when combined with methotrexate in early aggressive rheumatoid arthritis and when combined with traditional DMARDs in those who have not derived benefit...

American Family Physician : STEPS

https://www.aafp.org/afp/2008/1215/p1406.html

Zoledronic Acid (Reclast) for Osteoporosis - STEPS - American Family Physician

Aug 15, 2008 - Zoledronic acid, in combination with calcium and vitamin D, will reduce the risk of vertebral fractures, and to a lesser extent, hip fractures in women with osteoporosis. It decreases subsequent fractures and mortality in high-risk patients who have had a hip fracture. Zoledronic acid ...

American Family Physician : STEPS

https://www.aafp.org/afp/2008/0815/p508.html

Conivaptan (Vaprisol) for the Treatment of Hyponatremia - STEPS - American Family ...

Oct 15, 2008 - In most cases, patients with hyponatremia can be adequately managed with fluid restriction alone. However, acutely symptomatic patients may require treatment, such as hypertonic saline. In these situations, conivaptan is an expensive alternative.

American Family Physician : STEPS

https://www.aafp.org/afp/2008/1015/p984.html

Selegiline Transdermal Patch (Emsam) for Major Depressive Disorder - STEPS - American ...

Feb 15, 2008 - Transdermal selegiline is an expensive treatment option for patients with major depressive disorder who have not responded to other antidepressants or who cannot swallow or take oral medications. Based on guidelines from the American Psychiatric Association, MAO inhibitor ...

American Family Physician : STEPS

https://www.aafp.org/afp/2008/0215/p505.html

Becaplermin (Regranex) for Diabetic Foot Ulcers - STEPS - American Family Physician

Jul 15, 2008 - Although patients treated with becaplermin are more likely to experience complete and faster ulcer healing than patients continuing good wound care alone, the increased risk of cancer mortality and significant cost outweigh the possible benefits in most patients.

American Family Physician : STEPS

https://www.aafp.org/afp/2008/0715/p255.html

Ranolazine (Ranexa) for Chronic Angina - STEPS - American Family Physician

Feb 15, 2007 - Ranolazine will provide a small benefit in symptom control in patients with chronic angina and persistent symptoms despite medical therapy. It generally should be used in combination with amlodipine, beta blockers, or long-acting nitrates.

American Family Physician : STEPS

https://www.aafp.org/afp/2007/0215/p544.html

Retapamulin (Altabax) 1% Topical ointment for the Treatment of Impetigo - STEPS - ...

Nov 15, 2007 - Retapamulin is an effective alternative to topical mupirocin in the treatment of limited-area impetigo in patients older than nine months. Although it is more expensive, retapamulin does have a dosing advantage over mupirocin; it only requires a twice-a-day application for five days, ...

American Family Physician : STEPS

https://www.aafp.org/afp/2007/1115/p1537.html

Levonorgestrel/Ethinyl Estradiol (Lybrel) for Continuous Contraception - STEPS - ...

Jan 15, 2008 - Lybrel appears to be as safe and effective as other combined oral contraceptives; however, at this time, there is little published data about this specific product. Other combined monophasic oral contraceptives, some of which cost less than Lybrel, can be used continuously and have been...

American Family Physician : STEPS

https://www.aafp.org/afp/2008/0115/p222.html

Sitagliptin (Januvia) for the Treatment of Patients with Type 2 Diabetes - STEPS - ...

Sep 15, 2007 - Sitagliptin may be useful as second-line or third-line therapy in patients with a mildly elevated A1C level (less than 9 percent) who do not reach their A1C goal with first-line therapy (metformin). Sitagliptin will decrease postprandial blood glucose and mildly lower fasting blood ...

American Family Physician : STEPS

https://www.aafp.org/afp/2007/0915/p861.html

Telithromycin (Ketek) for Treatment of Community-Acquired Pneumonia - STEPS - American ...

Dec 15, 2007 - Telithromycin is similar to clarithromycin with regard to dosing, drug interactions, and effectiveness. It has more frequent and severe adverse effects and is more expensive than other macrolides. Telithromycin should only be used in patients with mild to moderate community-acquired ...

American Family Physician : STEPS

https://www.aafp.org/afp/2007/1215/p1857.html

Aliskiren (Tekturna) for the Treatment of Hypertension - STEPS - American Family Physician

Oct 15, 2007 - Aliskiren provides a new pharmacologic approach to treating hypertension; however, short-term studies have not identified a unique role. It is more expensive than commonly used first-line diuretics, and long-term safety has not been demonstrated.

American Family Physician : STEPS

https://www.aafp.org/afp/2007/1015/p1203.html

Acamprosate (Campral) for Treatment of Alcoholism - STEPS - American Family Physician

Aug 15, 2006 - Acamprosate is a safe and well-tolerated treatment for patients with alcoholism and it appears to improve the likelihood that patients will remain abstinent. Most evidence suggests it is as effective as naltrexone but with fewer adverse reactions, and that it may be more effective when ...

American Family Physician : STEPS

https://www.aafp.org/afp/2006/0815/p645.html

Quadrivalent HPV Recombinant Vaccine (Gardasil) for the Prevention of Cervical Cancer -...

Aug 15, 2007 - The HPV vaccine is safe and effective in preventing genital warts and cervical changes that may lead to cervical cancer, and it is recommended as part of the vaccination series in females 11 to 12 years of age. It can be given to females as young as 9 or 10 years of age, and catch-up ...

American Family Physician : STEPS

https://www.aafp.org/afp/2007/0815/p573.html

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