The May update to the AHFS Patient Medication Information (PMI) database has been published. Highlights of the update include:

New PMI Monographs

Ribociclib (Kisqali^®)
- Ribociclib is used in combination with another medication to treat a certain type of hormone receptor–positive, advanced breast cancer breast cancer that depends on hormones such as estrogen to grow) in women who have experienced menopause (change of life; end of monthly menstrual periods).
Niraparib (Zejula^®)
- Niraparib is used to help maintain the response of certain types of ovarian (female reproductive organs where eggs are formed), fallopian tube (tube that transports eggs released by the ovaries to the uterus), and peritoneal (layer of tissue that lines the stomach) cancer to chemotherapy medications after the cancer has returned from previous treatment(s).
Avelumab Injection (Bavencio^®)
- Avelumab injection is used to treat a certain type of skin cancer that has spread to other parts of the body in adults and children 12 years of age and older.

FDA MedWatch Alert Revisions

FDA is restricting the use of codeine and tramadol medicines in children.
- These medicines carry serious risks, including slowed or difficult breathing and death, which appear to be a greater risk in children younger than 12 years, and should not be used in these children.
- Affected Monographs:
  - Acetaminophen and Codeine
  - Acetaminophen, Butalbital, and Caffeine
  - Codeine
  - Tramadol
FDA has approved previously announced label changes regarding the use of general anesthetic and sedation medicines in children younger than 3 years.
- Affected Monographs:
  - Midazolam

The May update to the AHFS Drug Information/Essentials database has been published. Highlights from this month’s update include:

New AHFS/Essentials Monographs

New Full-Length Monographs
- Lumacaftor And Ivacaftor (Orkambi^®) – 48:14.04 (Cystic Fibrosis Transmembrane Conductance Regulator Correctors)
  - Treatment of cystic fibrosis (CF) in patients age 12 years and older who are homozygous for the F508del mutation in the CFTR gene.
- Uridine Triacetate (Xuriden, Vistogard^®) – 92:12 (Antidotes)
  - Xuriden^®: Treatment of hereditary orotic aciduria.
  - Vistogard^®: A separate NDA approved for emergency treatment of fluorouracil or capecitabine overdose or patients who exhibit early-onset, severe or life-threatening toxicity affecting the cardiac or central nervous system, and/or early-onset, unusually severe adverse reactions (e.g., GI toxicity and/or neutropenia) within 96 hours following the end of fluorouracil or capecitabine administration.

New First-Release Monographs
- Ocrelizumab (Ocrevus^®) – 92:20 (Immunomodulatory Agents)
  - Treatment of adult patients with relapsing or primary progressive forms of multiple sclerosis.
- Dupilumab (Dupixent^®) – 84:92 (Skin and Mucous Membrane Agents, Miscellaneous)
  - Treatment of adults with moderate-to-severe eczema (atopic dermatitis) not controlled adequately by topical therapies, or those for whom topical therapies are not advisable.
- Etelcalcetide Hydrochloride (Parsabiv^®) – 92:92 (Other Miscellaneous Therapeutic Agents)
  - A calcium-sensing receptor agonist indicated for secondary hyperparathyroidism (HPT) in adult patients with chronic kidney disease (CKD) on hemodialysis.
- Naldemedine Tosylate (Symproic^®) – 56:92 (GI Drugs, Miscellaneous)
  - Treatment of opioid-induced constipation in adult patients with chronic non-cancer pain.
- Deutetrabenazine (Austedo^®) – 28:92 (Central Nervous System Agents, Miscellaneous)
  - Treatment of chorea associated with Huntington’s disease.