Drug Info
Brand Name: Monurol
Active Ingredient: Fosfomycin
Manufacturer: Zambon S.p.A.
Monurol and its active substance, Fosfomycin trometamol
Fosfomycin is a bactericidal agent that blocks the MurA enzyme (UDP-N-acetylglucosamine enolpyruvyl transferase), the first committed step in peptidoglycan synthesis. This upstream blockade weakens the bacterial cell wall and causes rapid lysis in susceptible organisms. The trometamol salt improves oral absorption and palatability, while the parent drug is excreted largely unchanged in the urine—exactly where it needs to act for cystitis.
After a 3 g oral dose, serum exposure stays low but urinary levels remain very high for up to two days, covering typical intervoid intervals and bathing the bladder epithelium. Food can reduce absorption and lower peak urinary concentrations, so timing relative to meals matters. Because fosfomycin’s target is distinct from β-lactams and fluoroquinolones, it can retain activity against some multi-drug-resistant E. coli (including ESBL producers) when local data support its use. Stewardship remains important: reserve it for appropriate indications and avoid repeat dosing without medical advice.
Indications for use
Use is determined by your clinician according to regional labeling and individual assessment:
- Acute uncomplicated cystitis in adult women and eligible adolescents
- Asymptomatic bacteriuria in pregnancy (specialist-directed per guidelines)
- Peri-procedural prophylaxis for select urologic procedures (protocol-based)
Monurol is not indicated for pyelonephritis, bacteremia, or complicated UTI unless specifically directed by a specialist.
Treatment regimens and dosages
Follow your prescriber’s instructions. Typical oral regimens (one sachet = 3 g fosfomycin):
- Acute uncomplicated cystitis (adults): 3 g once (single dose).
In selected patients (e.g., recurrent UTI, diabetes, older age), clinicians may advise a second 3 g dose 24–48 hours later. - Adolescents (per regional label): 3 g once in eligible patients (age/weight criteria vary; specialist judgment).
- Peri-procedural prophylaxis: 3 g before the intervention (timing varies by protocol), sometimes followed by 3 g 24 hours after the procedure.
Administration (important):
- Dissolve the entire contents of one 3 g sachet in half a glass of cool water; stir and drink immediately.
- Take on an empty stomach: either 2–3 hours after a meal or 1 hour before a meal.
- A common practice is to take it at bedtime after emptying the bladder to maximize overnight exposure.
Renal function: severe renal impairment (e.g., CrCl <10 mL/min) is typically a contraindication. Moderate impairment requires caution and clinician guidance.
Hepatic impairment: no routine adjustment; follow clinician advice.
Recommendations for use
- Drink regular fluids (avoid overhydration) and void regularly; phenazopyridine or simple analgesics may be used short-term for dysuria if advised.
- If fever, flank pain, nausea/vomiting, or systemic malaise is present, seek medical evaluation—these signs suggest an upper UTI requiring different management.
- For recurrent UTIs, clinicians may evaluate behavioral factors (post-coital voiding, hydration), vaginal estrogen in postmenopausal women, or alternative prophylaxis plans.
Missed Dose
If you forgot to take the sachet at the planned time, take it as soon as you remember on an empty stomach the same day. Do not take two sachets at once. If your prescriber scheduled a second dose, follow the advised interval.
Precautions
- Hypersensitivity: avoid if you have a known allergy to fosfomycin. Seek care for rash, facial swelling, wheeze, or severe dizziness after dosing.
- C. difficile–associated diarrhea: any antibiotic can precipitate it; seek care for persistent watery/bloody diarrhea and cramps.
- Not for invasive infections: do not use for suspected pyelonephritis or urosepsis—systemic therapy is required.
- Diabetes: some sachets contain sucrose—check labeling if carbohydrate control is critical.
- Renal impairment: see dosing cautions above; efficacy depends on achieving high urinary levels.
- Children/pregnancy: follow specialist guidance (see below).
Use during pregnancy
Fosfomycin is often considered when treatment is required for asymptomatic bacteriuria or acute cystitis during pregnancy because of its single-dose convenience and urinary targeting. Decisions are individualized; your obstetric clinician will confirm suitability and arrange follow-up cultures. During breastfeeding, minimal amounts are expected in milk; most authorities consider it compatible, with routine infant observation.
Possible side effects
- Common: diarrhea, nausea, headache, dyspepsia, abdominal discomfort, vaginitis.
- Less common: dizziness, fatigue, back pain, mild transient elevation of liver enzymes.
- Serious—seek medical attention: severe or persistent diarrhea, signs of allergic reaction, fever/flank pain (possible upper UTI), marked weakness or palpitations.
Most effects are short-lived given the one-time dosing. Taking the dose on an empty stomach can improve tolerability and efficacy.
Fosfomycin: interaction with other drugs
- Metoclopramide: can reduce fosfomycin absorption, lowering urinary levels—avoid co-administration near the dose.
- Antacids / calcium–magnesium–aluminum products: may decrease absorption—separate by several hours.
- Probenecid: may increase serum fosfomycin and alter renal excretion; clinical significance varies—use only if directed.
- Other antibiotics/UTI remedies: generally no major interactions at a single dose, but always share your full medication list (including warfarin, herbal products, or OTC remedies).
Analogs & Generics
Same active ingredient (fosfomycin trometamol — international examples)
- Fosfomycin trometamol 3 g sachets (Teva, Sandoz/Hexal, Accord/Actavis, Viatris/Mylan, Aurobindo, Dr. Reddy’s)
- Monural (Zambon) — widely used brand name in many regions
- Generic fosfomycin granules — 2 g (selected pediatric presentations, region-dependent)
Drug analogs (different active ingredient, same therapeutic purpose—chosen by pathogen and local resistance)
- Nitrofurantoin (macrocrystals/MR) — first-line for uncomplicated cystitis in many guidelines
- Trimethoprim–sulfamethoxazole — where local resistance is low and no contraindications
- Pivmecillinam — first-line in many European countries
- Cephalexin or Amoxicillin–clavulanate — selected scenarios per clinician judgment
Storage
Store sachets at 15–25°C in a dry place away from heat and sunlight. Keep in the original packaging until use. Keep out of the reach of children. Do not use after the expiry date printed on the carton/sachet.
Customer Experience – What to Expect
Many patients report rapid symptom easing within 24 hours—less burning, urgency, and frequency—as the bladder irritation settles. Complete relief may take 48–72 hours, especially if symptoms were intense at onset. A temporary loose stool or mild stomach upset can occur on the day of dosing and usually passes quickly. If fever, flank pain, or persistent/worsening symptoms occur after 48 hours, contact your clinician for reassessment and culture guidance.
FAQ
How do I take Monurol correctly?
Dissolve one 3 g sachet in half a glass of water and drink on an empty stomach—ideally before bedtime after emptying the bladder.
Can I take it with food or milk?
Food reduces absorption. Take it 1 hour before or 2–3 hours after meals. Avoid antacids around the dose.
Will I need a second dose?
Some patients (e.g., recurrent UTI, older age, diabetes) are prescribed a second 3 g dose 24–48 hours later. Follow your clinician’s plan.
Does it treat kidney infection?
No—Monurol is for bladder infections (cystitis). Fever or flank pain needs urgent medical evaluation.
Is it safe in pregnancy?
Often chosen when treatment is necessary, but the decision is individualized—follow your obstetric clinician’s advice.
What if symptoms return after a week?
Recurrent symptoms need medical review and usually a urine culture; do not repeat antibiotics without guidance.
The best offer for Monurol online on the market
Right now you can buy Monurol in our online pharmacy. If you are looking for the best place to order Monurol or other medicines containing fosfomycin trometamol, then you have come to the right place.
Advantages of our pharmacy:
- Confidentiality. Discreet packaging and secure delivery across Europe so your treatment stays private.
- Price. Buying Monurol online is often more economical than purchasing at a local pharmacy.
- Quantity. You can order the number of sachets you need according to your treatment plan.
- Convenience. Purchase at a time that suits you—no clinic queues or extra trips.
- Information. On our website, you can find clear guidance on dosing, side effects, safe use, and other details necessary for treatment.
We work hard to provide the best possible customer service and to ensure that our medications help resolve uncomplicated UTIs safely and effectively under medical supervision.
