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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

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

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

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

Adefovir (Hepsera) for Chronic Hepatitis B Infection - STEPS - American Family Physician

Dec 15, 2003 - Adefovir offers an effective first-line alternative for the treatment of chronic hepatitis B. It also may prove to be useful in patients who have failed therapy with lamivudine as well as in patients who have difficulty tolerating interferon alfa-2b. How it compares with other agents or...

American Family Physician : STEPS

https://www.aafp.org/afp/2003/1215/p2429.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

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

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

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

Amlodipine/Atorvastin (Caduet) for Preventing Heart Disease - STEPS - American Family ...

Mar 15, 2006 - Amlodipine/atorvastatin offers no added benefit in safety, tolerability, or effectiveness over amlodipine and atorvastatin taken separately. It has not been shown to improve mortality or morbidity in patients who have hypertension with or without dyslipidemia. The only potential ...

American Family Physician : STEPS

https://www.aafp.org/afp/2006/0315/p1067.html

Atomoxetine for ADHD - STEPS - American Family Physician

Nov 1, 2003 - Atomoxetine is more effective than placebo for treating symptoms of ADHD in children and adults, based on short-term studies. Given safety concerns (growth retardation, potential adverse effects in slow metabolizers) and its high cost, atomoxetine should be considered only as an ...

American Family Physician : STEPS

https://www.aafp.org/afp/2003/1101/p1827.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

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

Colesevelam (WelChol) for Reduction of LDL Cholesterol - STEPS - American Family Physician

Jul 15, 2005 - Colesevelam lowers LDL cholesterol levels a small amount (7 to 16 percent) when used alone and provides additional cholesterol lowering when added to statin therapy. It has a slightly beneficial effect on HDL cholesterol levels, has no effect on triglyceride levels, and is well tolerated.

American Family Physician : STEPS

https://www.aafp.org/afp/2005/0715/p321.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

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

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

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

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

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

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

Desloratadine for Allergic Rhinitis - STEPS - American Family Physician

Nov 15, 2003 - Desloratadine is somewhat effective for the treatment of seasonal allergic rhinitis and may decrease nasal congestion. It also is effective for chronic urticaria. Desloratadine is similar in effectiveness to fexofenadine and would be expected to produce results similar to loratadine and...

American Family Physician : STEPS

https://www.aafp.org/afp/2003/1115/p2015.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

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

Duloxetine (Cymbalta) for Treatment of Major Depressive Disorder - STEPS - American ...

Sep 15, 2005 - Duloxetine is safe and effective for the treatment of major depressive disorder. Because of its expense and the lack of data supporting its superiority over other antidepressants, it should be used as an alternative if other agents are ineffective or are not tolerated.

American Family Physician : STEPS

https://www.aafp.org/afp/2005/0915/p1099.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

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

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

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

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

Eplerenone (Inspra) for Hypertension - STEPS - American Family Physician

Feb 15, 2004 - Compared with other commonly used antihypertensive medications, eplerenone is effective in lowering blood pressure when used alone or as add-on therapy. However, mortality benefits related to antihypertensive treatment have not yet been shown, so it should not be considered a first-line...

American Family Physician : STEPS

https://www.aafp.org/afp/2004/0215/p915.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

Escitalopram (Lexapro) for Depression. - STEPS - American Family Physician

Dec 1, 2003 - While escitalopram has proved to be an effective treatment for major depression, it has not been shown to be significantly more effective, safer, or better tolerated than citalopram or other antidepressants.

American Family Physician : STEPS

https://www.aafp.org/afp/2003/1201/p2235.html

Eszopiclone (Lunesta) for Treatment of Transient and Chronic Insomnia - STEPS - ...

Jun 15, 2005 - Similar to other hypnotic drugs, eszopiclone treats the symptom of insomnia and not the underlying cause. It offers no advantage over other nonbenzodiazepine hypnotic agents for transient insomnia and it therefore should be considered a second-line agent.

American Family Physician : STEPS

https://www.aafp.org/afp/2005/0615/p2359.html

Ethinyl Estradiol/Drospirenone (Yasmin): A Newer Oral Contraceptive - STEPS - American ...

May 15, 2004 - An effective oral contraceptive, ethinyl estradiol/drospirenone can elevate potassium levels when given in combination with other potassium-elevating agents and offers no advantage over traditional oral contraceptives.

American Family Physician : STEPS

https://www.aafp.org/afp/2004/0515/p2425.html

Ethinyl Estradiol/Levonorgestrel (Seasonale) for Oral Contraception - STEPS - American ...

Apr 15, 2005 - Women using ethinyl estradiol/levonorgestrel can expect similar or improved effectiveness and fewer menstrual cycles. Due in part to an increased incidence of unexpected bleeding in the first six months of use, a greater percentage of women will discontinue this regimen than will those ...

American Family Physician : STEPS

https://www.aafp.org/afp/2005/0415/p1581.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

Exenatide Injection (Byetta): Adjunctive Therapy for Glycemic Control - STEPS - ...

Jun 15, 2006 - Exenatide is an injectable treatment for type 2 diabetes. Its use requires patient education and strict monitoring of glucose levels because of the difficulty of its administration; therefore, it may not be a safe or practical option for patients who are not willing or able to ...

American Family Physician : STEPS

https://www.aafp.org/afp/2006/0615/p2213.html

Ezetimibe for Hypercholesterolemia. - STEPS - American Family Physician

Oct 15, 2003 - Ezetimibe is safe and effective for lowering LDL cholesterol and triglyceride levels, but has not been shown to affect patient-oriented outcomes. It can be used as monotherapy or in combination with a low-dose statin, although the combination is more expensive than the maximum dose of ...

American Family Physician : STEPS

https://www.aafp.org/afp/2003/1015/p1595.html

Ezetimibe/Simvastatin (Vytorin) for Hypercholesterolemia - STEPS - American Family ...

Nov 15, 2005 - Low doses of ezetimibe/simvastatin provide greater improvements in lipid profile than simvastatin or atorvastatin monotherapy. Ezetimibe/simvastatin may be useful in patients who are unable to tolerate high-dose statin therapy. Combination ezetimibe-simvastatin is less expensive than ...

American Family Physician : STEPS

https://www.aafp.org/afp/2005/1115/p2081.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

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

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

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

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

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

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

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

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

Ibandronate (Boniva) for Treatment and Prevention of Osteoporosis in Postmenopausal ...

Jan 15, 2006 - Ibandronate is a bisphosphonate that can be taken daily or monthly. The daily dosage has been shown to decrease vertebral fractures in women with osteoporosis and a history of previous vertebral fractures. Neither formulation has been shown to reduce the risk of hip fracture or other ...

American Family Physician : STEPS

https://www.aafp.org/afp/2006/0115/p305.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

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

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

Insulin Detemir (Levmir) for Diabetes Mellitus - STEPS - American Family Physician

Jul 15, 2006 - Insulin detemir is suitable as basal insulin in a basal-bolus regimen. In limited research, it has been shown to cause slightly fewer episodes of minor hypoglycemia and no weight gain in patients with type 1 and 2 diabetes, which is a benefit that must be balanced against its higher ...

American Family Physician : STEPS

https://www.aafp.org/afp/2006/0715/p323.html

Insulin Inhalation Powder (Exubera) for Diabetes Mellitus - STEPS - American Family ...

May 15, 2007 - Inhaled insulin provides an alternative route of administration for rapid-acting insulin but offers no other benefit over available insulin therapy. It may reduce, but not eliminate, the need for self-injection in patients with type 1 diabetes. In patients with type 2 diabetes, the risk...

American Family Physician : STEPS

https://www.aafp.org/afp/2007/0515/p1546.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

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

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

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

Levalbuterol Tartrate (Xopenex HFA) for the Treatment of Bronchospasm - STEPS - ...

Jan 15, 2007 - Levalbuterol tartrate appears to be no more effective and offers no improvement in the side-effect profile compared with albuterol. The higher cost may make it appropriate for only a limited group of patients.

American Family Physician : STEPS

https://www.aafp.org/afp/2007/0115/p247.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

Levonorgestrel-Releasing Intrauterine System (Mirena) for Contraception - STEPS - ...

May 15, 2006 - The levonorgestrel-releasing intrauterine system is a reliable, reversible, low-maintenance method of long-term contraception. Rates of failure are similar to those of female sterilization, and the risk of expulsion is minimal for most users.

American Family Physician : STEPS

https://www.aafp.org/afp/2006/0515/p1799.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

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

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

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

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

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

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

Lubiprostone (Amitiza) for Chronic Idiopathic Constipation - STEPS - American Family ...

Oct 15, 2006 - Although bulk or osmotic laxatives are less expensive first options for treating patients with chronic idiopathic constipation, lubiprostone is an alternative for those who do not tolerate or respond to these agents, or in patients older than 65 years in whom tegaserod use is not ...

American Family Physician : STEPS

https://www.aafp.org/afp/2006/1015/p1380.html

Memantine (Namenda) for Moderate to Severe Alzheimer's Disease - STEPS - American ...

Mar 15, 2004 - Memantine is well tolerated, but its clinical benefits for the treatment of moderate to severe AD appear modest. The reduction in caregiver time requires confirmation in another trial. As with other drugs for AD, memantine does not reverse deterioration.

American Family Physician : STEPS

https://www.aafp.org/afp/2004/0315/p1491.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

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

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

Nesiritide (Natrecor) for Acute Decompensated Heart Failure - STEPS - American Family ...

Feb 15, 2006 - Nesiritide improves short-term hemodynamics in hospitalized patients with acute decompensated heart failure who have not benefited from aggressive treatment with standard care. However, nesiritide may cause renal function to worsen and may increase the risk of death within 30 days.

American Family Physician : STEPS

https://www.aafp.org/afp/2006/0215/p687.html

Omalizumab (Xolair) for Treatment of Asthma - STEPS - American Family Physician

Jan 15, 2005 - Omalizumab is an immunomodulatory therapy for the control of symptoms in patients with moderate to severe allergic asthma uncontrolled with conventional therapy. Given its high cost, the requirement that it be administered in a physician’s office, and side effects, it is appropriate for...

American Family Physician : STEPS

https://www.aafp.org/afp/2005/0115/p341.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

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

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

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

Pregabalin (Lyrica) for the Management of Pain Associated with Diabetic Neuropathy - ...

Dec 15, 2006 - Pregabalin is safe and effective for the management of neuropathic pain associated with diabetic peripheral neuropathy. Drawbacks include the cost and the lack of studies demonstrating equivalence or superiority to other treatments. However, pregabalin’s ease of dosing titration, ...

American Family Physician : STEPS

https://www.aafp.org/afp/2006/1215/p2093.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

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

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

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

Rifaximin (Xifaxan) for Irritable Bowel Syndrome - STEPS - American Family Physician

Feb 15, 2017 - Rifaximin has good overall tolerability. A relatively short course of treatment results in sustained clinical benefit for at least 10 weeks, eliminating the need for continued therapy, with an NNT of 10. However, it is expensive and should be reserved for patients who cannot tolerate or...

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0215/p258.html

Rifaximin (Xifaxan) for Traveler's Diarrhea - STEPS - American Family Physician

Dec 15, 2005 - Rifaximin is safe and effective for treatment in most patients with traveler's diarrhea, but it offers no advantages over ciprofloxacin. At the same cost, it has a less convenient dosage interval than ciprofloxacin and has more limitations.

American Family Physician : STEPS

https://www.aafp.org/afp/2005/1215/p2525.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

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

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

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

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

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

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

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

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

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

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

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

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