To ensure that we are providing our clients with the industry’s best and most current clinical information, we complete a “post-publication” process and receive feedback regarding opportunities to add additional information or, in rare cases, make revisions.
Below is information on revisions, corrections, or modifications to existing monographs that have been identified in the past 12 months.
Pneumococcal Conjugate Vaccine (21-Valent) – March 2026
Revision in the Dosing: Adult field of the Pneumococcal Conjugate Vaccine (21-Valent) monograph in the UpToDate Lexidrug Lexi-Drugs database, available online and in mobile apps.
The monograph previously read:
Dosing: Adult (only portion of field impacted is presented):
Pneumococcal disease prevention:
Pneumococcal Vaccination for Patients 19 to 49 Years of Age with a Cochlear Implant or Cerebrospinal Fluid Leaka,e
| Prior pneumococcal vaccination | Option A | Option B |
| Noneb | PCV20 and PCV21 | PCV15 followed by PPSV23d ≥8 weeks later |
| PPSV23 only | PCV20 and PCV21 administered ≥1 year after PPSV23 | PCV15 administered ≥1 year after PPSV23 |
| PCV13 only | PCV20 and PCV21 administered ≥1 year after PCV13 | |
| PCV13 and 1 dose of PPSV23 | PCV20 and PCV21 administered ≥5 years after last pneumococcal vaccine | |
| PCV15 only | PPSV23 administered ≥8 weeks after PCV15c | |
| PCV20 and PCV21 only | No additional pneumococcal vaccine at this time. | |
| a Vaccine abbreviations: Pneumococcal conjugate vaccine 20-valent = PCV20; Pneumococcal conjugate vaccine 21-valent = PCV21; Pneumococcal conjugate vaccine 15-valent = PCV15; Pneumococcal conjugate vaccine 13-valent = PCV13; Pneumococcal polysaccharide vaccine 23-valent = PPSV23. Refer to individual monographs for additional information. | ||
| b Also applies to patients who previously received PCV7 (at any age) but no other pneumococcal vaccines or unknown vaccination status. | ||
| c Review recommendations again when patient turns 50 years of age. | ||
| d If PPSV23 is not available, then PCV20 or PCV21 may be used. | ||
| e PCV21 is not recommended if the regional prevalence of serotype 4 is ≥30% (ie, Alaska, Colorado, the Navajo Nation, New Mexico, Oregon); PCV20 alone or PCV15 and PPSV23 are preferred in these patients (CDC/ACIP [Kobayashi 2024]). | ||
Pneumococcal Vaccination for Patients 50 to <65 Years of Agea,e
| Prior pneumococcal vaccination | Option A | Option B |
| Noneb | PCV20 and PCV21 | PCV15 followed by PPSV23c ≥1 year laterd |
| PPSV23 only (at any age) | PCV20 and PCV21 administered ≥1 year after PPSV23 | PCV15 administered ≥1 year after PPSV23 |
| PCV13 only (at any age) | PCV20 and PCV21 administered ≥1 year after PCV13 | |
| PCV13 (at any age) and PPSV23 at <65 years of age | PCV20 and PCV21 administered ≥5 years after last pneumococcal vaccination | |
| a Vaccine abbreviations: Pneumococcal conjugate vaccine 20-valent = PCV20; Pneumococcal conjugate vaccine 21-valent = PCV21; Pneumococcal conjugate vaccine 15-valent = PCV15; Pneumococcal conjugate vaccine 13-valent = PCV13; Pneumococcal polysaccharide vaccine 23-valent = PPSV23. Refer to individual monographs for additional information. | ||
| b Also applies to patients who previously received PCV7 (at any age) but no other pneumococcal vaccines or unknown vaccination status. | ||
| c If PPSV23 is not available, then PCV20 or PCV21 may be used. | ||
| d Consider shorter interval (minimum of 8 weeks) for those with an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak. | ||
| e PCV21 is not recommended if the regional prevalence of serotype 4 is ≥30% (ie, Alaska, Colorado, the Navajo Nation, New Mexico, Oregon); PCV20 alone or PCV15 and PPSV23 are preferred in these patients (CDC/ACIP [Kobayashi 2025]). | ||
It has been revised to read:
Dosing: Adult (only portion of field impacted is presented):
Pneumococcal disease prevention:
Pneumococcal Vaccination for Patients 19 to 49 Years of Age with a Cochlear Implant or Cerebrospinal Fluid Leaka,e
| Prior pneumococcal vaccination | Option A | Option B |
| Noneb | PCV20 or PCV21 | PCV15 followed by PPSV23d ≥8 weeks later |
| PPSV23 only | PCV20 or PCV21 administered ≥1 year after PPSV23 | PCV15 administered ≥1 year after PPSV23 |
| PCV13 only | PCV20 or PCV21 administered ≥1 year after PCV13 | |
| PCV13 and 1 dose of PPSV23 | PCV20 or PCV21 administered ≥5 years after last pneumococcal vaccine | |
| PCV15 only | PPSV23 administered ≥8 weeks after PCV15c | |
| PCV20 and PCV21 only | No additional pneumococcal vaccine at this time. | |
| a Vaccine abbreviations: Pneumococcal conjugate vaccine 20-valent = PCV20; Pneumococcal conjugate vaccine 21-valent = PCV21; Pneumococcal conjugate vaccine 15-valent = PCV15; Pneumococcal conjugate vaccine 13-valent = PCV13; Pneumococcal polysaccharide vaccine 23-valent = PPSV23. Refer to individual monographs for additional information. | ||
| b Also applies to patients who previously received PCV7 (at any age) but no other pneumococcal vaccines or unknown vaccination status. | ||
| c Review recommendations again when patient turns 50 years of age. | ||
| d If PPSV23 is not available, then PCV20 or PCV21 may be used. | ||
| e PCV21 is not recommended if the regional prevalence of serotype 4 is ≥30% (ie, Alaska, Colorado, the Navajo Nation, New Mexico, Oregon); PCV20 alone or PCV15 and PPSV23 are preferred in these patients (CDC/ACIP [Kobayashi 2024]). | ||
Pneumococcal Vaccination for Patients 50 to <65 Years of Agea,e
| Prior pneumococcal vaccination | Option A | Option B |
| Noneb | PCV20 or PCV21 | PCV15 followed by PPSV23c ≥1 year laterd |
| PPSV23 only (at any age) | PCV20 or PCV21 administered ≥1 year after PPSV23 | PCV15 administered ≥1 year after PPSV23 |
| PCV13 only (at any age) | PCV20 or PCV21 administered ≥1 year after PCV13 | |
| PCV13 (at any age) and PPSV23 at <65 years of age | PCV20 or PCV21 administered ≥5 years after last pneumococcal vaccination | |
| a Vaccine abbreviations: Pneumococcal conjugate vaccine 20-valent = PCV20; Pneumococcal conjugate vaccine 21-valent = PCV21; Pneumococcal conjugate vaccine 15-valent = PCV15; Pneumococcal conjugate vaccine 13-valent = PCV13; Pneumococcal polysaccharide vaccine 23-valent = PPSV23. Refer to individual monographs for additional information. | ||
| b Also applies to patients who previously received PCV7 (at any age) but no other pneumococcal vaccines or unknown vaccination status. | ||
| c If PPSV23 is not available, then PCV20 or PCV21 may be used. | ||
| d Consider shorter interval (minimum of 8 weeks) for those with an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak. | ||
| e PCV21 is not recommended if the regional prevalence of serotype 4 is ≥30% (ie, Alaska, Colorado, the Navajo Nation, New Mexico, Oregon); PCV20 alone or PCV15 and PPSV23 are preferred in these patients (CDC/ACIP [Kobayashi 2025]). | ||
These changes have been automatically posted to online and mobile app databases. Please update your mobile UpToDate Lexidrug application to get the updated monograph.
Pneumococcal Conjugate Vaccine (15-Valent) – March 2026
Revision in the Dosing: Adult field of the Pneumococcal Conjugate Vaccine (15-Valent) monograph in the UpToDate Lexidrug Lexi-Drugs database, available online and in mobile apps.
The monograph previously read:
Dosing: Adult (only portion of field impacted is presented):
Pneumococcal disease prevention:
Pneumococcal Vaccination for Patients 19 to 49 Years of Age with a Cochlear Implant or Cerebrospinal Fluid Leaka,e
| Prior pneumococcal vaccination | Option A | Option B |
| Noneb | PCV20 and PCV21 | PCV15 followed by PPSV23d ≥8 weeks later |
| PPSV23 only | PCV20 and PCV21 administered ≥1 year after PPSV23 | PCV15 administered ≥1 year after PPSV23 |
| PCV13 only | PCV20 and PCV21 administered ≥1 year after PCV13 | |
| PCV13 and 1 dose of PPSV23 | PCV20 and PCV21 administered ≥5 years after last pneumococcal vaccine | |
| PCV15 only | PPSV23 administered ≥8 weeks after PCV15c | |
| PCV20 and PCV21 only | No additional pneumococcal vaccine at this time. | |
| a Vaccine abbreviations: Pneumococcal conjugate vaccine 20-valent = PCV20; Pneumococcal conjugate vaccine 21-valent = PCV21; Pneumococcal conjugate vaccine 15-valent = PCV15; Pneumococcal conjugate vaccine 13-valent = PCV13; Pneumococcal polysaccharide vaccine 23-valent = PPSV23. Refer to individual monographs for additional information. | ||
| b Also applies to patients who previously received PCV7 (at any age) but no other pneumococcal vaccines or unknown vaccination status. | ||
| c Review recommendations again when patient turns 50 years of age. | ||
| d If PPSV23 is not available, then PCV20 or PCV21 may be used. | ||
| e PCV21 is not recommended if the regional prevalence of serotype 4 is ≥30% (ie, Alaska, Colorado, the Navajo Nation, New Mexico, Oregon); PCV20 alone or PCV15 and PPSV23 are preferred in these patients (CDC/ACIP [Kobayashi 2024]). | ||
Pneumococcal Vaccination for Patients 50 to <65 Years of Agea,e
| Prior pneumococcal vaccination | Option A | Option B |
| Noneb | PCV20 and PCV21 | PCV15 followed by PPSV23c ≥1 year laterd |
| PPSV23 only (at any age) | PCV20 or PCV21 administered ≥1 year after PPSV23 | PCV15 administered ≥1 year after PPSV23 |
| PCV13 only (at any age) | PCV20 or PCV21 administered ≥1 year after PCV13 | |
| PCV13 (at any age) and PPSV23 at <65 years of age | PCV20 or PCV21 administered ≥5 years after last pneumococcal vaccination | |
| a Vaccine abbreviations: Pneumococcal conjugate vaccine 20-valent = PCV20; Pneumococcal conjugate vaccine 21-valent = PCV21; Pneumococcal conjugate vaccine 15-valent = PCV15; Pneumococcal conjugate vaccine 13-valent = PCV13; Pneumococcal polysaccharide vaccine 23-valent = PPSV23. Refer to individual monographs for additional information. | ||
| b Also applies to patients who previously received PCV7 (at any age) but no other pneumococcal vaccines or unknown vaccination status. | ||
| c If PPSV23 is not available, then PCV20 or PCV21 may be used. | ||
| d Consider shorter interval (minimum of 8 weeks) for those with an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak. | ||
| e PCV21 is not recommended if the regional prevalence of serotype 4 is ≥30% (ie, Alaska, Colorado, the Navajo Nation, New Mexico, Oregon); PCV20 alone or PCV15 and PPSV23 are preferred in these patients (CDC/ACIP [Kobayashi 2025]). | ||
It has been revised to read:
Dosing: Adult (only portion of field impacted is presented):
Pneumococcal disease prevention:
Pneumococcal Vaccination for Patients 19 to 49 Years of Age with a Cochlear Implant or Cerebrospinal Fluid Leaka,e
| Prior pneumococcal vaccination | Option A | Option B |
| Noneb | PCV20 or PCV21 | PCV15 followed by PPSV23d ≥8 weeks later |
| PPSV23 only | PCV20 or PCV21 administered ≥1 year after PPSV23 | PCV15 administered ≥1 year after PPSV23 |
| PCV13 only | PCV20 or PCV21 administered ≥1 year after PCV13 | |
| PCV13 and 1 dose of PPSV23 | PCV20 or PCV21 administered ≥5 years after last pneumococcal vaccine | |
| PCV15 only | PPSV23 administered ≥8 weeks after PCV15c | |
| PCV20 and PCV21 only | No additional pneumococcal vaccine at this time. | |
| a Vaccine abbreviations: Pneumococcal conjugate vaccine 20-valent = PCV20; Pneumococcal conjugate vaccine 21-valent = PCV21; Pneumococcal conjugate vaccine 15-valent = PCV15; Pneumococcal conjugate vaccine 13-valent = PCV13; Pneumococcal polysaccharide vaccine 23-valent = PPSV23. Refer to individual monographs for additional information. | ||
| b Also applies to patients who previously received PCV7 (at any age) but no other pneumococcal vaccines or unknown vaccination status. | ||
| c Review recommendations again when patient turns 50 years of age. | ||
| d If PPSV23 is not available, then PCV20 or PCV21 may be used. | ||
| e PCV21 is not recommended if the regional prevalence of serotype 4 is ≥30% (ie, Alaska, Colorado, the Navajo Nation, New Mexico, Oregon); PCV20 alone or PCV15 and PPSV23 are preferred in these patients (CDC/ACIP [Kobayashi 2024]). | ||
Pneumococcal Vaccination for Patients 50 to <65 Years of Agea,e
| Prior pneumococcal vaccination | Option A | Option B |
| Noneb | PCV20 or PCV21 | PCV15 followed by PPSV23c ≥1 year laterd |
| PPSV23 only (at any age) | PCV20 or PCV21 administered ≥1 year after PPSV23 | PCV15 administered ≥1 year after PPSV23 |
| PCV13 only (at any age) | PCV20 or PCV21 administered ≥1 year after PCV13 | |
| PCV13 (at any age) and PPSV23 at <65 years of age | PCV20 or PCV21 administered ≥5 years after last pneumococcal vaccination | |
| a Vaccine abbreviations: Pneumococcal conjugate vaccine 20-valent = PCV20; Pneumococcal conjugate vaccine 21-valent = PCV21; Pneumococcal conjugate vaccine 15-valent = PCV15; Pneumococcal conjugate vaccine 13-valent = PCV13; Pneumococcal polysaccharide vaccine 23-valent = PPSV23. Refer to individual monographs for additional information. | ||
| b Also applies to patients who previously received PCV7 (at any age) but no other pneumococcal vaccines or unknown vaccination status. | ||
| c If PPSV23 is not available, then PCV20 or PCV21 may be used. | ||
| d Consider shorter interval (minimum of 8 weeks) for those with an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak. | ||
| e PCV21 is not recommended if the regional prevalence of serotype 4 is ≥30% (ie, Alaska, Colorado, the Navajo Nation, New Mexico, Oregon); PCV20 alone or PCV15 and PPSV23 are preferred in these patients (CDC/ACIP [Kobayashi 2025]). | ||
These changes have been automatically posted to online and mobile app databases. Please update your mobile UpToDate Lexidrug application to get the updated monograph.
Fluorouracil Injection – March 2026
Revision in the Dosage Adjustment field of the Fluorouracil Injection monograph in the Facts and Comparisons database, available online and in mobile apps.
The monograph previously read:
Dosage Adjustment (only portion of field impacted is presented):
Adults
Note: Other concomitant anticancer therapies may also require treatment interruption, dosage reduction, and/or discontinuation.
Withhold treatment for the following (may resume at a reduced dose following resolution or improvement to grade 1)
Withhold treatment for the following (there is no recommended dose for resumption)
Dermatologic toxicity
Grade 2 or 3 palmar-plantar erythrodysesthesia (hand-foot syndrome [HFS]); initiate supportive care for symptomatic relief of HFS.(2, 3, 73, 74)
GI toxicity
Grade 3 or 4 diarrhea (administer fluids, electrolyte replacement, and/or antidiarrheal treatments as necessary); grade 3 or 4 mucositis.(2, 3, 73, 74)
Hematologic toxicity
Grade 4 myelosuppression.(2, 3, 73, 74)
Cardiovascular toxicity
Angina, MI/ischemia, arrhythmia, or heart failure (in patients with no history of coronary artery disease or myocardial dysfunction).(3)
CNS toxicity
Acute cerebellar syndrome, confusion, disorientation, ataxia, or visual disturbances.(3)
Hyperammonemic encephalopathy
Initiate ammonia-lowering therapy.(3)
It has been revised to read:
Dosage Adjustment (only portion of field impacted is presented):
Adults
Note: Other concomitant anticancer therapies may also require treatment interruption, dosage reduction, and/or discontinuation.
Withhold treatment for the following (may resume at a reduced dose following resolution or improvement to grade 1)
Dermatologic toxicity
Grade 2 or 3 palmar-plantar erythrodysesthesia (hand-foot syndrome [HFS]); initiate supportive care for symptomatic relief of HFS.(2, 3, 73, 74)
GI toxicity
Grade 3 or 4 diarrhea (administer fluids, electrolyte replacement, and/or antidiarrheal treatments as necessary); grade 3 or 4 mucositis.(2, 3, 73, 74)
Hematologic toxicity
Grade 4 myelosuppression.(2, 3, 73, 74)
Withhold treatment for the following (there is no recommended dose for resumption)
Cardiovascular toxicity
Angina, MI/ischemia, arrhythmia, or heart failure (in patients with no history of coronary artery disease or myocardial dysfunction).(3)
CNS toxicity
Acute cerebellar syndrome, confusion, disorientation, ataxia, or visual disturbances.(3)
Hyperammonemic encephalopathy
Initiate ammonia-lowering therapy.(3)
These changes have been automatically posted to online and mobile app databases. Please update your mobile UpToDate Lexidrug application to get the updated monograph.
Dupilumab – March 2026
Revision in the Administration: Pediatric field of the Dupilumab monograph in the UpToDate Lexidrug Lexi-Drugs and Pediatric and Neonatal Lexi-Drugs databases, and the Missed Dose field of the Facts and Comparisons database, available online and in mobile apps.
The monograph previously read:
Administration: Pediatric (only portion of field impacted is presented):
Missed dose:
For every-other-week dosing: If a dose is missed, administer within 7 days from the missed dose and then resume the original schedule. If the missed dose is not administered within 7 days, wait until the next dose on the original schedule.
It has been revised to read:
Administration: Pediatric (only portion of field impacted is presented):
Missed dose:
For every-other-week dosing: If a dose is missed, administer within 7 days from the missed dose and then resume the original schedule. If the missed dose is not administered within 7 days, administer the dose and start a new schedule based on that date.
These changes have been automatically posted to online and mobile app databases. Please update your mobile UpToDate Lexidrug application to get the updated monograph.
Azithromycin (Systemic) – January 2026
Revision in the Dosing: Pediatric field of the Azithromycin (Systemic) monograph in the UpToDate Lexidrug Lexi-Drugs, Pediatric and Neonatal Lexi-drugs, and Facts and Comparisons databases, available online and in mobile apps, as well as the following print publication: Pediatric & Neonatal Dosage Handbook, 31st edition.
The monograph previously read:
Dosing: Pediatric (only portion of field impacted is presented):
Diarrhea, infectious:
Shigellosis:
Patients without HIV: Infants, Children, and Adolescents:
5-day regimen: Oral: 12 mg/kg once on day 1 (maximum dose: 500 mg/dose), followed by 5 mg/kg/dose once daily on days 2 to 5 (maximum dose: 250 mg/dose) (Basualdo 2003).
It has been revised to read:
Dosing: Pediatric (only portion of field impacted is presented):
Diarrhea, infectious:
Shigellosis:
Patients without HIV: Infants, Children, and Adolescents:
5-day regimen: Oral: 12 mg/kg once on day 1 (maximum dose: 500 mg/dose), followed by 6 mg/kg/dose once daily on days 2 to 5 (maximum dose: 250 mg/dose) (Basualdo 2003).
These changes have been automatically posted to online and mobile app databases. Please update your mobile UpToDate Lexidrug application to get the updated monograph.
Guselkumab – December 2025
Revision in the Dosing: Pediatric field of the Guselkumab monograph in the UpToDate Lexidrug Lexi-Drugs, Pediatric and Neonatal Lexi-Drugs, and Facts and Comparisons databases, available online and in mobile apps.
The monograph previously read:
Dosing: Pediatric (only portion of field impacted is presented):
Plaque psoriasis, moderate to severe:
Children ≥6 years and Adolescents, weighing ≥40 kg: Prefilled syringe/pen, One-Press injector: SUBQ: 100 mg at week 0 and week 4, then 100 mg every 8 weeks, beginning 4 weeks after last induction dose; in pediatric trials, clinical response evaluated at week 16 (Prajapati 2025; manufacturer’s labeling).
Psoriatic arthritis, active:
Note: May be used as monotherapy or in combination with a disease-modifying antirheumatic drug (DMARD) (eg, methotrexate).
Children ≥6 years and Adolescents, weighing ≥40 kg: Prefilled syringe/pen, One-Press injector: SUBQ: 100 mg at week 0 and week 4, then every 8 weeks, beginning 4 weeks after last induction dose.
It has been revised to read:
Dosing: Pediatric (only portion of field impacted is presented):
Plaque psoriasis, moderate to severe:
Children ≥6 years and Adolescents, weighing ≥40 kg: Prefilled syringe/pen, One-Press Injector: SUBQ: 100 mg at week 0 and week 4, then 100 mg every 8 weeks thereafter (Prajapati 2025, manufacturer's labeling).
Psoriatic arthritis, active:
Note: May be used as monotherapy or in combination with a disease-modifying antirheumatic drug (DMARD) (eg, methotrexate).
Children ≥6 years and Adolescents, weighing ≥40 kg: Prefilled syringe/pen, One-Press injector: SUBQ: 100 mg at week 0 and week 4, then every 8 weeks thereafter.
These changes have been automatically posted to online and mobile app databases. Please update your mobile UpToDate Lexidrug application to get the updated monograph.
Paclitaxel (Protein Bound) – November 2025
Revision in the Administration field of the Paclitaxel (Protein Bound) monograph in the UpToDate Lexidrug Lexi-Drugs and Facts and Comparisons databases, available online and in mobile apps.
The monograph previously read:
Administration: IV (only portion of field impacted is presented):
Administration sequence (for combination therapy):
Pancreatic cancer (metastatic): When administered in combination with carboplatin, administer paclitaxel (protein bound) first, followed immediately by gemcitabine (manufacturer’s labeling).
It has been revised to read:
Administration: IV (only portion of field impacted is presented):
Administration sequence (for combination therapy):
Pancreatic cancer (metastatic): When administered in combination with gemcitabine, administer paclitaxel (protein bound) first, followed immediately by gemcitabine (manufacturer’s labeling).
These changes have been automatically posted to online and mobile app databases. Please update your mobile UpToDate Lexidrug application to get the updated monograph.
Cinnarizine – October 2025
Revision in the Dosing: Adult field of the Cinnarizine monograph in the UpToDate Lexidrug Lexi-Drugs Multinational database, available online and in mobile apps.
The monograph previously read:
Dosing: Adult (only portion of field impacted is presented):
Peripheral circulatory disorders:
Oral: 50 to 75 mg 3 times daily. Maximum dose: 255 mg/day.
It has been revised to read:
Dosing: Adult (only portion of field impacted is presented):
Peripheral circulatory disorders:
Oral: 50 to 75 mg 3 times daily. Maximum dose: 225 mg/day.
These changes have been automatically posted to online and mobile app databases. Please update your mobile UpToDate Lexidrug application to get the updated monograph.
Palopegteriparatide – October 2025
Revision in the Dosing: Adult field of the Palopegteriparatide monograph in the UpToDate Lexidrug Lexi-Drugs and Facts and Comparisons databases, available online and in mobile apps.
The monograph previously read:
Dosing: Adult (only portion of field impacted is presented):
Hypoparathyroidism:
Titration of Palopegteriparatide, Active Vitamin D, and Calcium Supplements Based on Albumin-Corrected Serum Calcium.
| Albumin-corrected serum calcium | Palopegteriparatide dose adjustmenta | Calcitriol and calcium supplement dose adjustment |
| 10.7 to 11.9 mg/dL (2.68 to 2.98 mmol/L) and not on active vitamin D or calcium supplements | Decrease by 3 mg/day | No supplements.b |
It has been revised to read:
Dosing: Adult (only portion of field impacted is presented):
Hypoparathyroidism:
Titration of Palopegteriparatide, Active Vitamin D, and Calcium Supplements Based on Albumin-Corrected Serum Calcium.
| Albumin-corrected serum calcium | Palopegteriparatide dose adjustmenta | Calcitriol and calcium supplement dose adjustment |
| 10.7 to 11.9 mg/dL (2.68 to 2.98 mmol/L) and not on active vitamin D or calcium supplements | Decrease by 3 mcg/day | No supplements.b |
These changes have been automatically posted to online and mobile app databases. Please update your mobile UpToDate Lexidrug application to get the updated monograph.
Donidalorsen – September 2025
Revision in the Administration: Pediatric field of the Donidalorsen monograph in the UpToDate Lexidrug Lexi-Drugs and Pediatric and Neonatal Lexi-Drugs databases, available online and in mobile apps.
The monograph previously read:
Administration: Pediatric (only portion of field impacted is presented):
Autoinjector: Remove autoinjector from refrigerator and allow to sit at room temperature for 30 minutes; do not warm in any other way. Solution should be clear and colorless to yellow. Discard if device is damaged or if solution is discolored, cloudy, or contains particles. Administer SUBQ into the upper thigh or abdomen (avoid 2 cm area around navel).
It has been revised to read:
Administration: Pediatric (only portion of field impacted is presented):
Autoinjector: Remove autoinjector from refrigerator and allow to sit at room temperature for 30 minutes; do not warm in any other way. Solution should be clear and colorless to yellow. Discard if device is damaged or if solution is discolored, cloudy, or contains particles. Administer SUBQ into the upper thigh or abdomen (avoid 2 inch area around navel).
These changes have been automatically posted to online and mobile app databases. Please update your mobile UpToDate Lexidrug application to get the updated monograph.
Calcium Sodium Hydrogen Citrate – July 2025
Revision in the Dosing: Adult field of the Calcium Sodium Hydrogen Citrate monograph in the UpToDate Lexidrug Lexi-Drugs Multinational database, available online and in mobile apps.
The monograph previously read:
Dosing: Adult (only portion of field impacted is presented):
Acidosis:
Initial: Oral: 10 to 15 g two to three times daily for 3 to 5 days or until pH normalization; adjust dose as needed based on pH.
Maintenance: Oral: 2.5 g once daily or 5 g two times daily, based on severity of initial acidosis.
It has been revised to read:
Dosing: Adult (only portion of field impacted is presented):
Acidosis:
Initial: Oral: 5 g two or three times daily until normalization of blood-pH (generally 3 to 5 days); adjust dose as needed based on pH.
Maintenance: Oral: 2.5 g once or twice daily, based on severity of initial acidosis.
These changes have been automatically posted to online and mobile app databases. Please update your mobile UpToDate Lexidrug application to get the updated monograph.
Respiratory Syncytial Virus (Recombinant [Adjuvanted]) – July 2025
Revision in the Dosing: Adult field of the Respiratory Syncytial Virus (Recombinant [Adjuvanted]) monograph in the UpToDate Lexidrug Lexi-Drugs and Facts and Comparisons databases, available online and in mobile apps.
The monograph previously read:
Dosing: Adult (only portion of field impacted is presented):
Respiratory syncytial virus (RSV)–associated lower respiratory tract disease prevention:
Adults 60 to 74 years of age who are at increased risk of severe RSV disease: IM: 0.5 mL as a single dose. Note: Persons who have previously received RSV vaccination are NOT recommended to receive another dose at this time (CDC 2025, CDC/ACIP [Briton 2024], manufacturer’s labeling).
It has been revised to read:
Dosing: Adult (only portion of field impacted is presented):
Respiratory syncytial virus (RSV)–associated lower respiratory tract disease prevention:
Adults 50 to 74 years of age who are at increased risk of severe RSV disease: IM: 0.5 mL as a single dose. Note: Persons who have previously received RSV vaccination are NOT recommended to receive another dose at this time (CDC 2025, CDC/ACIP [Briton 2024], manufacturer’s labeling).
These changes have been automatically posted to online and mobile app databases. Please update your mobile UpToDate Lexidrug application to get the updated monograph.
Perflutren Protein Type A – June 2025
Revision in the Administration: IV field of the Perflutren Protein Type A monograph in the UpToDate Lexidrug Lexi-Drugs database, available online and in mobile apps.
The monograph previously read:
Administration: IV (only portion of field impacted is presented):
For IV use only; do not administer intra-arterially. While allowing the vial to come to room temperature, invert and gently rotate to resuspend the microspheres; solution should appear opaque and milky-white. Do not use if solution is clear. Vent vial with a sterile vent spike or 18-gauge needle. Do not inject air into vial. Within 1 minute of resuspension, remove dose from the vial and inject using a ≥20-gauge angiocatheter into a peripheral vein at a rate ≤1 mL/second. Flush line with D5W or NS immediately after injection. Repeat resuspension prior to injection if more than 1 minute elapses.
It has been revised to read:
Administration: IV (only portion of field impacted is presented):
For IV use only; do not administer intra-arterially. While allowing the vial to come to room temperature, invert and gently rotate to resuspend the microspheres; solution should appear opaque and milky-white. Do not use if solution is clear. Vent vial with a sterile vent spike or 18-gauge needle. Do not inject air into vial. Within 1 minute of resuspension, remove dose from the vial and inject using a 20-gauge or larger angiocatheter into a peripheral vein at a rate ≤1 mL/second. Flush line with D5W or NS immediately after injection. Repeat resuspension prior to injection if more than 1 minute elapses.
These changes have been automatically posted to online and mobile app databases. Please update your mobile Lexi-Drugs application to get the updated monograph.
Fedratinib – May 2025
Revision in the Dosing: Altered Liver Function: Adult field of the Fedratinib monograph in the UpToDate Lexidrug, Lexi-Drugs, and Facts and Comparisons databases, available online and in mobile apps.
The monograph previously read:
Dosing: Altered Liver Function: Adult (only portion of field impacted is presented):
Hepatic impairment prior to treatment initiation:
Mild (total bilirubin ≤ ULN and AST > ULN or total bilirubin 1 to 1.5 times ULN and any AST) to moderate (total bilirubin 1.5 to 3 times ULN and any AST) impairment: There are no dosage adjustments provided in the manufacturer’s labeling; however, mild or moderate impairment did not have a clinically meaningful effect on fedratinib pharmacokinetics.
Severe impairment (total bilirubin >3 times ULN and any AST): Avoid fedratinib use.
It has been revised to read:
Dosing: Altered Liver Function: Adult (only portion of field impacted is presented):
Hepatic impairment prior to treatment initiation:
Mild, moderate, or severe impairment (Child-Turcotte-Pugh class A, B, or C): There are no dosage adjustments provided in the manufacturer’s labeling; however, mild, moderate, or severe impairment did not have a clinically meaningful effect on fedratinib pharmacokinetics.
These changes have been automatically posted to online and mobile app databases. Please update your mobile UpToDate Lexidrug application to get the updated monograph.
Midazolam – May 2025
Revision in the Dosing: Adult field of the Midazolam monograph in the UpToDate Lexidrug Lexi-Drugs and Facts and Comparisons databases, available online and in mobile apps, as well as the following print publication: Adult Drug Information Handbook 33rd edition.
The monograph previously read:
Dosing: Adult (only portion of field impacted is presented):
Seizures:
Status epilepticus (convulsive and nonconvulsive):
Buccal (may use injectable solution) (off-label route): Initial: 10 mg. May repeat dose if needed; maximum total dose: 30 mg (Nakken 2011, NCS [Brophy 2012]).
It has been revised to read:
Dosing: Adult (only portion of field impacted is presented):
Seizures:
Status epilepticus (convulsive and nonconvulsive):
Buccal (may use injectable solution) (off-label route): Initial: 10 mg. May repeat dose if needed; maximum total dose: 20 mg (Nakken 2011, NCS [Brophy 2012]).
These changes have been automatically posted to online and mobile app databases. Please update your mobile UpToDate Lexidrug application to get the updated monograph.