1
COVID-19 Update: 2025-2026 Vaccine Formulations and Recommendations
The Medical Letter on Drugs and Therapeutics • October 13, 2025; (Issue 1739)
The FDA has licensed new 2025-2026 formulations
of the mRNA COVID-19 vaccines manufactured by
Pfizer/BioNTech (Comirnaty) and Moderna (Spikevax,
mNEXSPIKE) and the adjuvanted protein subunit
COVID-19 vaccine manufactured by Novavax
(Nuvaxovid). The new formulations are indicated
for use in all adults ≥65 years old and in persons
6 months (Spikevax), 5 years (Comirnaty), or 12
years (mNEXSPIKE, Nuvaxovid) through 64 years old
who are at high risk for severe COVID-19 because
of an underlying condition. An Emergency Use
Authorization allowing administration of the Pfizer
vaccine to children 6 months through 4 years old has
been withdrawn.
2
Antiviral Drugs for Seasonal Influenza for 2025-2026
The Medical Letter on Drugs and Therapeutics • October 27, 2025; (Issue 1740)
Influenza is generally a self-limited illness, but complications
including pneumonia, respiratory failure, and
death can occur, especially in persons at increased
risk (see Table 1).
3
Treatment of Allergic Rhinitis and Allergic Conjunctivitis
The Medical Letter on Drugs and Therapeutics • March 31, 2025; (Issue 1725)
Initial treatment of allergic rhinitis (AR) depends
on the severity of symptoms and whether they are
intermittent or persistent (see Table 1).
4
Comparison Chart: Topical Nonsteroidal Drugs for Atopic Dermatitis (online only)
The Medical Letter on Drugs and Therapeutics • March 2, 2026; (Issue 1749)
View the Comparison Chart: Topical Nonsteroidal Drugs for Atopic Dermatitis
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Comparison Chart: Interleukin (IL) Antagonists and Oral JAK Inhibitors for Moderate to Severe Atopic Dermatitis (online only)
The Medical Letter on Drugs and Therapeutics • March 2, 2026; (Issue 1749)
View the Comparison Chart: Interleukin (IL) Antagonists and Oral JAK Inhibitors for Moderate to Severe Atopic Dermatitis
6
In Brief: Extended Duration of Use for Nexplanon
The Medical Letter on Drugs and Therapeutics • March 2, 2026; (Issue 1749)
Nexplanon, a single-rod contraceptive implant
containing the progestin etonogestrel, has now been
approved for prevention of pregnancy for up to 5 years.
It was previously approved for up to 3 years of use.
7
Addendum: Urinary Incontinence with Second-Generation Antipsychotic Drugs
The Medical Letter on Drugs and Therapeutics • March 2, 2026; (Issue 1749)
Our recent article entitled Lumateperone (Caplyta) for Adjunctive
Treatment of Depression should have included
urinary incontinence among the adverse effects associated
with use of second-generation antipsychotic drugs. Urinary
incontinence has been reported with both first- and second-generation antipsychotics. Possible causes include the
anti-alpha-adrenergic, antidopaminergic, and anticholinergic
effects of these drugs, as well as sedation. In an observational
study in 200 women 20-40 years old, urinary incontinence
was reported by 29% of those taking antipsychotic drugs and
by 13% of age-matched controls.
8
Drugs for Migraine
The Medical Letter on Drugs and Therapeutics • June 12, 2023; (Issue 1678)
An oral nonopioid analgesic is often sufficient for
acute treatment of mild to moderate migraine pain
without severe nausea or vomiting. A triptan is the
drug of choice for treatment of moderate to severe
migraine in most patients without vascular disease.
Treatment of pain when it is still mild to moderate in
intensity improves headache response and reduces
the risk of recurrence.
9
In Brief: A Second Subcutaneous Furosemide Infusor (Lasix ONYU) for Heart Failure
The Medical Letter on Drugs and Therapeutics • March 16, 2026; (Issue 1750)
The FDA has approved Lasix ONYU (SQ Innovation),
a subcutaneous formulation of the loop diuretic
furosemide administered via a wearable pump (onbody
infusor), for treatment of edema in adults with
chronic heart failure (HF). A similar product, Furoscix,
is approved for treatment of edema in chronic HF
or chronic kidney disease. Furosemide has been
available for years in oral and IV formulations for
such use.
10
Antibacterial Drugs for Community-Acquired Pneumonia
The Medical Letter on Drugs and Therapeutics • January 25, 2021; (Issue 1616)
Treatment of community-acquired pneumonia (CAP)
is usually empiric, with selected antibiotic regimens
directed against some of the most common causative
pathogens. Recommended empiric regimens are
listed in Table 2; recommended antibiotic dosages for
treatment of CAP are listed in Tables 3 and 4. Joint
guidelines for treatment of CAP by the American
Thoracic Society and the Infectious Diseases Society of
America (ATS/IDSA) were updated in 2019.
