After etoricoxib, patients taking oxaprozin experienced the least amount of pain with fewer adverse effects than naproxen. Adverse effects
In October 2020, the U.S. Food and Drug Administration (FDA) required the drug label to be updated for all nonsteroidal anti-inflammatory medications to describe the risk of kidney problems in unborn babies that result in low amniotic fluid. They recommend avoiding NSAIDs in pregnant women at 20 weeks or later in pregnancy. History
Oxaprozin was developed and patented by Wyeth-Ayerst. The US patent 3578671, Oxazoles, was filed November 6, 1967 and published May 11, 1971. Following the filing of the patent, the first description of oxaprozin exhibiting anti-inflammatory properties was outlined in the article Diaryloxazole and diaylthiazolealkanoci acids: two novel series of non-steroidal anti-inflammatory agents. This article was published in Nature in 1968. In December 1988, Wyeth-Ayerst licensed the marketing rights for the US, Canada, Puerto Rico, and the Caribbean to Searle.Daypro became available January 5, 1993. Upon its release, “The Pink Sheet” estimated that the average whole sale price of Searles Daypro was $112.30 for 100 (600 mg) tablets. The price was comparable to other prescription NSAIDs. Society and culture
FDA approval
The oxaprozin new drug application (NDA 18-841) was submitted to the FDA on August 10, 1982. The drug was granted an “NDA Day” review on June 15–16, 1992. After Searle agreed to complete seven Phase IV postmarketing studies on October 22, the FDA approved Daypro on October 29, 1992.Since the approval of Daypro by Searle, other companies have submitted abbreviated new drug applications (ANDAs) to the FDA.
Cysteamine hydrochloride (5%) over-the-counter Mechanism of action seems to involve inhibition of melanin synthesis pathway
Kojic acid (2%) OTC
Flutamide (1%)
Chemical peels
Microdermabrasion to dermabrasion (light to deep)
Galvanic or ultrasound facials with a combination of a topical crème/gel, either in an aestheticians office or as a home massager unit
Laser but not intense pulsed light (which can make the melasma darker)

Effectiveness
Evidence-based reviews found that the most effective therapy for melasma includes a combination of topical agents. Triple combination creams formulated with hydroquinone, tretinoin, and a steroid component have shown to be more effective than dual combination therapy or hydroquinone alone. More recently, a systematic review found that oral medications also have a role in melasma treatment, and have been shown to be efficacious with a minimal number and severity of adverse events. Oral medications and dietary supplements employed in the treatment of melasma include tranexamic acid, Polypodium leucotomos extract, beta‐carotenoid, melatonin, and procyanidin.Oral procyanidin combined with vitamins A, C, and E shows promise as safe and effective for epidermal melasma. In an 8-week randomized, double-blind, placebo-controlled trial in 56 Filipino women, treatment was associated with significant improvements in the left and right malar regions, and was safe and well tolerated.In all of these treatments, the effects are gradual and a strict avoidance of sunlight is required. The use of broad-spectrum sunscreens with physical blockers, such as titanium dioxide and zinc oxide, is preferred,  because UV-A, UV-B, and visible lights are all capable of stimulating pigment production.