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Compare Fosfomycin vs. Nitrofurantoin

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Fosfomycin (Monurol) and nitrofurantoin (Macrobid) are both antibiotics used to treat urinary tract infections (UTIs). However, they belong to different medication classes and have distinct characteristics. Fosfomycin is an antibacterial that is typically taken as a single oral dose, making it convenient for treating uncomplicated UTIs in women. It is also used off-label for UTIs in men and prostate infections. Nitrofurantoin, a nitrofuran antibiotic, is used for both treating and preventing UTIs and is taken more frequently, usually twice a day for 7 days. Fosfomycin is available only as a powder mixed with water, while nitrofurantoin comes in capsules and oral suspension forms. Common side effects of fosfomycin include diarrhea, nausea, and headache, whereas nitrofurantoin may cause nausea, headache, and gas. Fosfomycin has fewer drug interactions, while nitrofurantoin can interact with antacids and certain supplements. Additionally, nitrofurantoin is not recommended for use in the last weeks of pregnancy due to potential risks to the unborn baby, whereas fosfomycin is considered safe during pregnancy.

  • Fosfomycin (Monurol)
    Nitrofurantoin (Macrobid)
  • Fosfomycin (Monurol)
    Nitrofurantoin (Macrobid)

  • Summary of Fosfomycin vs. Nitrofurantoin

    Summary for Antibacterial
    Prescription only

    Fosfomycin (also known by its brand name, Monurol) is an antibiotic that's used for treating urinary tract infections (UTIs) in women, including those who are pregnant. It's a powder that's mixed with water before it's taken by mouth. Fosfomycin (Monurol) is a convenient option because you only need to take one dose to treat your infection and it doesn't have many drug interactions. Side effects include diarrhea, nausea, and headache.

    Summary for Nitrofuran antibiotic
    Prescription only

    Nitrofurantoin (Macrobid) is an antibiotic used to treat or prevent a urinary tract infection (UTI). Some side effects include nausea, headache, and gas. It can also make your urine turn dark yellow or brown. Nitrofurantoin (Macrobid) doesn't have many interactions with other medications. There's a lower-cost generic version of nitrofurantoin (Macrobid) available.

  • Indications of Fosfomycin vs. Nitrofurantoin

    Indications for
    •Urinary tract infections (UTIs) in women
    Indications for
    •Treatment or prevention of urinary tract infections

  • Pros and Cons of Fosfomycin vs. Nitrofurantoin

    Pros and Const for Antibacterial
    Pros
    •Works well at treating UTIs, including those caused by resistant bacteria that are hard to treat with other antibiotics
    •Only need to take one dose to treat a UTI
    •Can use if you have kidney or liver problems
    Cons
    •Can cause diarrhea
    •Only used to treat UTIs that don't have complications
    •Hasn't been studied in children age 12 years and younger
    Pros and Const for Nitrofuran antibiotic
    Pros
    •Works well to treat and prevent UTIs
    •Available as both a capsule and a flavored oral suspension
    •Safe to take if you're allergic to other antibiotics like penicillin or sulfa medications (e.g., Bactrim, Septra (sulfamethoxazole / trimethoprim))
    Cons
    •Might need to take up to four times a day (depending on the formulation)
    •Can interact with certain types of antacids, travel vaccines, and lab tests
    •Can harm your lungs, liver, and nerves if taken for a long period of time

  • Common Side Effects of Fosfomycin vs. Nitrofurantoin

    Common Side Effects for
    •Diarrhea (9%)
    •Vaginal inflammation (pain, redness, swelling, warmth; 6%)
    •Nausea (4%)
    •Headache (4%)
    Common Side Effects for
    •Nausea (8%)
    •Headache (6%)
    •Gas (2%)

  • Warnings of Fosfomycin vs. Nitrofurantoin

    Common Side Effects for
    •Diarrhea from Clostridioides difficile infection
    Common Side Effects for
    •Lung damage
    •Liver damage
    •Nerve damage (neuropathy)
    •Breakdown of red blood cells (hemolytic anemia)
    •Severe diarrhea

  • Prices with our coupons for Fosfomycin vs. Nitrofurantoin

    Learn more about Fosfomycin
    Learn more about Nitrofurantoin

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