Monurol (Fosfomycin Trometamol)

• Monurol is indicated for bacterial infections of the urinary tract, specifically targeting uncomplicated infections.
• Uncomplicated urinary tract infections (UTIs): provides a single‑dose eradication of susceptible uropathogens, relieving symptoms and reducing bacterial load.
• Acute uncomplicated cystitis: achieves microbiological cure in most female patients with a single oral dose.
• Prophylaxis of recurrent urinary tract infections: may be used intermittently to prevent recurrence in patients with a history of repeated UTIs.

• Fosfomycin Trometamol inhibits bacterial cell wall synthesis by irreversibly blocking the enzyme MurA (enolpyruvyl transferase), which catalyzes the first step in peptidoglycan formation. This action prevents the construction of a functional cell wall, leading to bacterial lysis and death, particularly against Gram‑negative uropathogens.

Adverse reactions may occur with any antibiotic therapy. Most are mild and self‑limiting.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Diarrhea: loose stools, usually transient.
• Headache: mild cranial discomfort.
• Abdominal pain: cramping or discomfort in the abdomen.
• Dyspepsia: indigestion or heartburn.
• Vomiting: occasional emesis.

Serious or Rare Side Effects

• Allergic reactions: rash, pruritus, or anaphylaxis.
• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Clostridioides difficile infection: colitis associated with antibiotic use.
• Hepatic dysfunction: elevated liver enzymes or jaundice.
• Renal impairment: worsening kidney function in susceptible individuals.
• Hematologic abnormalities: neutropenia or thrombocytopenia.

• Before prescribing Monurol, consider patient‑specific factors and safety measures.
• Renal function: assess severity of impairment and adjust use if necessary.
• Pregnancy: safety category unknown; avoid unless benefits outweigh potential risks.
• Breastfeeding: unknown excretion in milk; consider risk to infant.
• Allergy to fosfomycin: contraindicated in patients with known hypersensitivity.
• Drug interactions: review concomitant medications for potential effects on absorption or efficacy.
• Store at below 25°C: keep in the original pack, protect from moisture.

Fosfomycin may interact with other medicines, requiring attention to avoid reduced effectiveness or increased toxicity.

Major Interactions (Avoid)

• Antacids containing magnesium or aluminum: may significantly decrease fosfomycin absorption.
• Probenecid: can increase serum fosfomycin concentrations, raising risk of toxicity.

Moderate Interactions (Monitor Closely)

• Warfarin: potential potentiation of anticoagulant effect; monitor INR.
• Oral contraceptives: possible reduction in hormonal efficacy; advise additional contraceptive measures.
• Diabetes medications: monitor blood glucose as fosfomycin may affect glycemic control.