Monurol (fosfomycin) dosing, indications, interactions, adverse effects, and more

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Sections fosfomycin
Dosing & Uses
Interactions
Adverse Effects
Warnings
Pregnancy
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

powder for reconstitution

3g/packet

Urinary Tract Infection (Acute Cystitis)

Acute cystitis caused by E. coli, E. faecalis

Acute uncomplicated cystitis: 3 g PO once

Multi-drug resistant UTI: 2-3 g PO every 2-3 days for 3 doses

Preparation: Dissolve 1 packet (3 g) in 3-4 oz water

Prostatitis (Off-label)

3 g PO q2-3 days or 3 g PO qDay for 1 week followed by 3 g q48hr for ≥6 weeks

Limitations of use

Not indicated for the treatment of perinephric abscess or pyelonephritis

Consider alternative agents if bacteriuria persists or reappears

Safety & efficacy not established

Interaction Checker

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<1%

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Pruritus

Contraindications

Hypersensitivity

Cautions

Hepatic injury, including hepatitis and steatosis reported; monitor liver function; effect is reversible upon discontinuation of drug

Prolonged use may result in bacterial or fungal superinfections, which may appear upt to two months postantibiotic treatment

Hypersensitivity reactions, including anaphylactic shock reported; discontinue use at first signs of hypersensitivity reactions and institute supportive measures

Pregnancy & 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.

Mechanism of Action

A phosphoric acid derivative that inactivates the enzyme pyruvyl transferase, which in turn inhibits bacterial wall synthesis and results in bactericidal effects

Absorption

Rapidly absorbed

Bioavailability: 37% (fasting); 30% (with food)

Time to peak: 2 hr (serum)

Distribution:

Vd: 90-180 L; high concentrations in urine; well into other tissues; crosses maximally into CSF with inflamed meninges

Elimination

Half-life: 3-8 hr (Normal renal function); 50 hr (CrCl <10 mL/min)

Excretion: urine (38% as unchanged drug); high urinary levels (100 mcg/mL) persist for >48 hr; feces (18%)

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Patient Handout

Formulary

FormularyPatient Discounts

Adding plans allows you to compare formulary status to other drugs in the same class.

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Adding plans allows you to:

View the formulary and any restrictions for each plan.
Manage and view all your plans together – even plans in different states.
Compare formulary status to other drugs in the same class.
Access your plan list on any device – mobile or desktop.

The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

View explanations for tiers and restrictions

Tier	Description
1	This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2	This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC	NOT COVERED – Drugs that are not covered by the plan.

Code	Definition
PA	Prior Authorization Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL	Quantity Limits Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST	Step Therapy Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR	Other Restrictions Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.

Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.

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Sections fosfomycin
Dosing & Uses
Interactions
Adverse Effects
Warnings
Pregnancy
Pharmacology
Images
Patient Handout
Formulary

fosfomycin (Rx)