Dosing and uses of Monurol (fosfomycin)
Adult dosage forms and strengths
powder for reconstitution
- 3g/packet
Urinary Tract Infection (Acute Cystitis)
Acute cystitis caused by E. coli, E. faecalis
Women >18 years: 3 g PO once
Males >18 years: 3 g every 2-3 days for 3 doses
Preparation: Dissolve 1 packet (3 g) in 3-4 oz water
Prostatitis
3 g PO every 3 days for 21 days
Pediatric dosage forms and strengths
Safety & efficacy not established
Monurol (fosfomycin) adverse (side) effects
1-10%
Anorexia
Diarrhea
Epigastric
Discomfort
Headache
Nausea
Rash
Vomiting
<1%
Dizziness
Drowsiness
Fatigue
Pruritus
Warnings
Contraindications
Hypersensitivity
Pregnancy and lactation
Pregnancy category: B
Lactation: excreted in breast milk; not recommended
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Monurol (fosfomycin)
Absorption: well absorbed
Distribution: Vd: 2 L/kg; high concentrations in urine; well into other tissues; crosses maximally into CSF with inflamed meninges
Protein binding: < 3%
Bioavailability: 34-58%
Half-life Elimination
Normal renal function: 4-8 hr
CrCl <10 mL/min: 50 hr
Other Information
Time to peak, serum: 2 hr
Excretion: urine (38% as unchanged drug); high urinary levels (100 mcg/mL) persist for >48 hr
Mechanism of action
Blocks bacterial cell wall synthesis by inactivating enolpyruvyl transferase; also reduces bacterial adherence to uroepithelial cells
