fosfomycin
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.
What is Fosfomycin (Monurol)?
What is Fosfomycin (Monurol) used for?
- Urinary tract infections (UTIs) in women
How Fosfomycin (Monurol) works
Fosfomycin (Monurol) is a urinary antibiotic. It kills bacteria by preventing them from being able to build their own protective covering.
Drug facts
Side effects of Fosfomycin (Monurol)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Diarrhea (9%)
- Vaginal inflammation (pain, redness, swelling, warmth; 6%)
- Nausea (4%)
- Headache (4%)
Less Common Side Effects
- Dizziness
- Lack of energy
- Upset stomach
Fosfomycin (Monurol) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Allergic reactions: hives; rash; blisters; swelling of the lips, tongue, or face; difficulty breathing
- Infectious diarrhea (C. difficile-related diarrhea): foul-smelling diarrhea, fever, nausea, frequent bowel movements (up to 15 times per day)
More on Fosfomycin (Monurol) side effects
The following Fosfomycin (Monurol) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Rare
Blood in the urine
burning while urinating
cough or hoarseness
difficult or painful urination
fever or chills
lower back or side pain
painful or difficult urination
Incidence not known
Abdominal or stomach pain or tenderness
black, tarry stools
clay-colored stools
dark urine
difficulty with swallowing
dizziness
fast heartbeat
headache
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
light-colored stools
loss of appetite
nausea or vomiting
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
rash
severe abdominal or stomach cramps and pain
shortness of breath
sores, ulcers, or white spots on the lips or in the mouth
swollen or painful glands
tightness in the chest
unpleasant breath odor
unusual bleeding or bruising
unusual tiredness or weakness
vomiting of blood
watery and severe diarrhea, which may also be bloody
worsening of asthma
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Itching of the vagina or genital area
pain during sexual intercourse
thick, white vaginal discharge with no odor or with a mild odor
Less common
Acid or sour stomach
back pain
belching
body aches or pain
congestion
dryness or soreness of the throat
indigestion
lack or loss of strength
runny or stuffy nose
skin rash
stomach discomfort or upset
tender, swollen glands in the neck
trouble with swallowing
voice changes
weakness
Rare
Abnormal stools
absent missed or irregular menstrual periods
blindness
blue-yellow color blindness
blurred vision
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
decreased vision
difficulty with moving
excess air or gas in the stomach or intestines
full feeling
headache, severe and throbbing
joint pain
loss of appetite
muscle aching or cramping
muscle pains or stiffness
nervousness
passing gas
sleepiness or unusual drowsiness
stopping of menstrual bleeding
swollen joints
swollen, painful, or tender lymph glands in the neck, armpit, or groin
trouble sleeping
unable to sleep
Incidence not known
Hearing loss
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Fosfomycin (Monurol)
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
Pharmacist tips for Fosfomycin (Monurol)
- To take fosfomycin (Monurol), mix the powder inside one packet with 3 to 4 ounces (half a cup) of cool water and drink right away. Don't mix with hot water because this can damage the medication and make it not work well to treat your infection. To make sure you get the entire dose, add a little more water to the same glass to get any powder residue left, swirl gently, and drink right away.
- Take fosfomycin (Monurol) with or without food. But taking it with food could help prevent stomach-related side effects (e.g., diarrhea, nausea).
- Your symptoms should get better in about 2 to 3 days after you take fosfomycin (Monurol). Tell your healthcare provider if you don't feel better after 3 days.
- Diarrhea is a common side effect of fosfomycin (Monurol) and is typically mild. But seek medical help right away if you develop watery or bloody diarrhea, fever, fatigue, or stomach cramps anytime during treatment or after stopping fosfomycin (Monurol). These could be signs of a type of serious infectious diarrhea that needs to be treated quickly.
- Let your provider know if you take metoclopramide (Reglan) because it can affect how well fosfomycin (Monurol) is absorbed into your body. Since fosfomycin (Monurol) is just one dose, you'll probably just need to separate when you take these medications.
Common questions about Fosfomycin
In people with healthy kidneys, Fosfomycin can stay in the body for about 30 hours after the dose. But in people with kidney problems, it can take much longer for the body to remove the medication from its system. This means that it's possible any side effects that you have from Fosfomycin could potentially last up until when the medication has completely left your body. Keep in mind that these time frames are estimated based on the half-life of Fosfomycin, which can differ slightly from person to person.
Your UTI symptoms should start to improve within 2 to 3 days of taking Fosfomycin. Contact your healthcare provider if your symptoms haven't improved by the fourth day. You might need further testing to see what bacteria is causing your infection and whether you need treatment with a different antibiotic.
No, Fosfomycin isn't a sulfa medication and can usually be safely taken by people with a sulfa allergy. Be sure to tell your provider if you've had an allergic reaction to any medications in the past.
No, Fosfomycin is a urinary antibiotic. It works differently from penicillin and belongs to a different class of antibiotics. This means that if you're allergic to penicillin, you might be able to safely take Fosfomycin.
Yes. You'll need to dissolve the powder from the Fosfomycin packet with half a cup of water before you take your dose anyway. Once prepared, drink the mixture right away. You can drink more water after you take your dose if needed. In general, drinking water is helpful when you have a UTI because it keeps you hydrated and helps restore any fluids your body might've lost from overheating if you have a fever.
It's recommended that you avoid drinking alcohol while taking antibiotics like Fosfomycin. This is because alcohol can make it harder for your body to recover from an illness and can raise your risk of getting another infection.
While Fosfomycin is FDA-approved in women only, studies show that it also works well for treating UTIs in men as well. Additionally, Fosfomycin is also recommended as an alternative treatment option for prostate infections in men. Keep in mind that Fosfomycin is used "off-label" for treating these infections in men. Speak with your provider about whether Fosfomycin is right for your infection.
Yes. According to the American College of Obstetricians and Gynecologists, Fosfomycin is considered a safe choice and possible treatment option for most UTIs during pregnancy. Speak with your provider if you have a UTI while pregnant to discuss the treatment option that's right for you.
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Risks and warnings for Fosfomycin (Monurol)
Fosfomycin (Monurol) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Diarrhea from Clostridioides difficile infection
Antibiotics, including fosfomycin (Monurol), can raise your risk of getting infected with a bacteria called Clostridioides difficile (C. diff). This infection can cause diarrhea that can sometimes be life-threatening. Antibiotics change the amount of normal bacteria in your stomach and intestines. This can cause C. diff to overgrow in your gut and lead to an infection.
It's important to recognize the difference between diarrhea as a side effect of fosfomycin (Monurol) and this type of infectious diarrhea. C. diff-related diarrhea can cause rapid heart rate, foul-smelling diarrhea, fever, nausea, frequent bowel movements (even up to 15 times per day) and is an emergency. Contact a provider right away if you experience any of these symptoms to get tested for C. diff infection and receive treatment if needed.
Fosfomycin (Monurol) dosage
Packet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 3g | 1 packet | $22.50 | $22.50 |
Typical dosage for Fosfomycin (Monurol)
The typical dose is 3 grams (1 sachet or packet) mixed with about a half cup of water and taken by mouth once.
Interactions between Fosfomycin (Monurol) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Cholera Vaccine, Live
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