Fosfomycin Tromethamine and Tramacet

• Generic Name: fosfomycin
• Dosage Forms: n.a.
• Other Brand Names: Monurol

Treatment of uncomplicated UTIs (acute cystitis) in women caused by susceptible Escherichia coli or Enterococcus faecalis (formerly Streptococcus faecalis).

Oral fosfomycin (single 3-g dose) is one of several preferred anti-infectives for empiric treatment of uncomplicated cystitis in women. Considered a good choice for such infections since incidence of fosfomycin resistance among uropathogens (e.g., E. coli) is low to date and the single-dose regimen is well tolerated and has not been associated with selection of drug-resistant bacteria or colonization/infection with multidrug-resistant strains.

Has been used (single dose or multiple doses) for treatment of UTIs caused by multidrug-resistant bacteria and some clinicians suggest it may be a viable option for treatment of such infections; however, additional study needed.

Do not use for treatment of pyelonephritis or perinephric abscesses. Avoid if diagnostic uncertainty exists regarding cystitis versus early pyelonephritis (e.g., cystitis symptoms accompanied by subjective fever [not verified at time of examination] and/or vague flank pain or tenderness, cystitis symptoms present for >5–7 days).

Has been effective when used in a limited number of men for treatment of chronic prostatitis caused by multidrug-resistant Enterobacteriaceae (e.g., E. coli). However, treatment failures also reported and further study needed to evaluate efficacy and safety of oral fosfomycin for treatment of chronic prostatitis and to identify optimal dosage and duration of fosfomycin treatment for such infections.

Has been effective when used for perioperative prophylaxis in men undergoing transrectal biopsy of the prostate.

Has been effective when used for perioperative prophylaxis in men undergoing transurethral resection of the prostate for benign prostatic hyperplasia.

Additional study needed to evaluate efficacy and safety and optimal timing for perioperative prophylaxis in men undergoing transrectal biopsy of the prostate or transurethral resection of the prostate.

• Generic Name: acetaminophen / tramadol
• Dosage Forms: n.a.
• Other Brand Names: Ultracet

Tramadol and acetaminophen combination is used to relieve acute pain severe enough to require an opioid treatment and when other pain medicines did not work well enough or cannot be tolerated. When used together, the combination provides better pain relief than either medicine used alone. In some cases, you may get relief with lower doses of each medicine.

Tramadol belongs to the group of medicines called opioid analgesics (narcotics). It acts in the central nervous system (CNS) to relieve pain. When tramadol is used for a long time, it may become habit-forming (causing mental or physical dependence). Mental dependence (addiction) is not likely to occur when narcotics are used for this purpose. Physical dependence may lead to side effects when you suddenly stop taking the medicine. Since this medicine is only used for short-term relief of pain, mental and physical dependence will probably not occur.

Acetaminophen is used to relieve pain and reduce fever in patients. It does not become habit-forming when taken for a long time. But acetaminophen may cause other unwanted effects when taken in large doses, including liver damage. Although rare, use of acetaminophen has been reported to lead to liver transplantation and death, usually at high doses and when multiple acetaminophen-containing products have been used.

This medicine is available only under a restricted distribution program called the Opioid Analgesic REMS (Risk Evaluation and Mitigation Strategy) program.