Why Urinary Tract Infections Are More Common During Pregnancy — and How to Treat Them
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fosfomycin
Used for Urinary Tract Infection
Used for Urinary Tract Infection
Fosfomycin tromethamine, also known by its brand name Monurol, is an antibiotic. It's used to treat urinary tract infections (UTIs) in women. In some cases, it can be used during pregnancy. Fosfomycin (Monurol) comes as a powder that needs to be mixed with water and taken by mouth. You only need to take one dose to treat the UTI. Side effects include diarrhea, nausea, and headache.
What is Fosfomycin (Monurol)?
What is Fosfomycin (Monurol) used for?
- Urinary tract infection (UTI) in women
How Fosfomycin (Monurol) works
Fosfomycin (Monurol) is a urinary antibiotic. It kills bacteria by blocking them from making the protective covering they need to survive.
When does Fosfomycin (Monurol) start working?Time passed since treatment started:
Drug facts
| Common Brands | Monurol |
|---|---|
| Drug Class | Antibacterial |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
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%)
- Vaginitis (pain, redness, swelling, or warmth of the vagina; 6%)
- Nausea (4%)
- Headache (4%)
Less Common Side Effects
- Dizziness
- Low energy
- Upset stomach
Fosfomycin (Monurol) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Infectious diarrhea (C. difficile-related diarrhea): severe or watery diarrhea, foul-smelling diarrhea, frequent bowel movements (up to 15 times per day), fever, nausea, stomach cramps
When do Fosfomycin (Monurol) possible side effects begin and end?
Time passed since treatment started:
H
D
W
M
Diarrhea
Nausea
Headache
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.
Pros and cons of Fosfomycin (Monurol)
Pros
- Only need to take one dose to treat an uncomplicated UTI
- Can treat some UTIs caused by bacteria that are resistant to other antibiotics
- Can be used during pregnancy in certain situations
Cons
- Only approved for certain uncomplicated UTIs in adult women
- Can cause diarrhea
- Comes as a powder that must be mixed with water before taking
Pharmacist tips for Fosfomycin (Monurol)
- How to take fosfomycin (Monurol): Mix the powder from one packet with 3 to 4 ounces (about half a cup) of cool water. Don't use hot water. Stir to dissolve the powder, then drink the mixture right away.
- You can take fosfomycin (Monurol) with or without food. If the medication upsets your stomach, you can try taking it with food to help.
- Your UTI symptoms should get better within 2 to 3 days after you take fosfomycin (Monurol). Call a healthcare professional if they don't seem to improve by then or get worse.
- Drink plenty of fluids while you're recovering from your UTI. Staying hydrated after taking fosfomycin (Monurol) can help you urinate regularly. Try to limit caffeine, alcohol, and acidic drinks if they can irritate your bladder and make your UTI symptoms worse.
- Mild diarrhea is a common side effect of fosfomycin (Monurol). But get medical help right away if you have severe, watery, or bloody diarrhea, especially with fever or stomach cramps. This could be a sign of a serious gut infection that needs to be treated quickly.
- Tell your prescriber if you take metoclopramide (Reglan). This medication can lower the amount of fosfomycin (Monurol) in your body. This might make the antibiotic not work as well. Your prescriber can tell you how to manage this drug interaction.
- If you're pregnant or planning to become pregnant: Talk to your prescriber. Fosfomycin (Monurol) can be used during pregnancy for certain UTIs. Your prescriber can decide if it's right for you.
- If you're breastfeeding: Tell your prescriber. Studies suggest fosfomycin (Monurol) can pass into breast milk in small amounts, but it's not expected to harm a breastfed baby. Your prescriber can help decide if fosfomycin (Monurol) is right for you.
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 change the normal bacteria in your gut. This can let harmful bacteria called Clostridioides difficile (C. diff) overgrow in your gut and cause a serious infection. This infection can lead to severe diarrhea, even up to 2 months after you stop the antibiotic.
It's important to know the difference between mild diarrhea from fosfomycin (Monurol) and serious diarrhea from C. diff. Signs of a C. diff infection include fever, nausea, severe or watery diarrhea, foul-smelling diarrhea, frequent bowel movements, or bloody stool. Get medical help right away if you have any signs of this infectious diarrhea. This can be a medical emergency and should get treated as soon as possible.
Fosfomycin (Monurol) dosage
The average cost for 1 packet of 3g of Fosfomycin (Monurol) is $32.93 with a free GoodRx coupon. This is 37.95% off the average retail price of $53.07. 
Packet
Packet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 3g | 1 packet | $32.93 | $32.93 |
Interactions between Fosfomycin (Monurol) and other drugs
Fosfomycin (Monurol) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Fosfomycin (Monurol). Please note that only the generic name of each medication is listed below.
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
How much does Fosfomycin (Monurol) cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
What are alternatives to Fosfomycin (Monurol)?
There are a number of medications that your doctor can prescribe in place of Fosfomycin (Monurol). Compare a few possible alternatives below.
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Fosfomycin (Monurol) images
