Dosing & Uses
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 doses 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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Adverse Effects
1-10%
Anorexia
Diarrhea
Epigastric
Discomfort
Headache
Nausea
Rash
Vomiting
<1%
Dizziness
Drowsiness
Fatigue
Pruritus
Warnings
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.Pharmacology
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
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