Generic Name (active ingredient): Fosfomycin
Brand Name: Monurol

Fosfomycin is an antibacterial broad-spectrum drug, which exerts bactericidal effects. The preparation is a produced by a certain Streptomyces species. The preparation is normally used in short term therapy as in long-term bacterial resistance forms in a high number of patients.

How does the medication work?
The preparation is a structural analogue of phosphoenolpyruvate. The drug works by non-reversibly inhibiting a certain enzyme in the bacterial cell thus affecting the primary stage of bacterial cellular wall formation. The drug also exerts anti-adhesive properties, thus preventing the adhesion of bacteria to the epithelial walls of the urogenital tract.

In oral administration the drug is rapidly absorbed through the GI tract. Bioavailability of the preparation varies from 34% to 65%. The drug does not bind to plasma proteins. Half-life of the drug is 4 hours. The preparation is not metabolized. The drug is distributed all over the organism, however the highest concentrations have been registered in the kidneys, prostate gland and urinary bladder wall. The minimal effective concentration in the urine can be registered for 24-48 hours. The drug is eliminated primarily via the kidney route and only 18-28% with fecal masses.

When Fosfomycin is prescribed?

• The preparation is normally prescribed in treatment of susceptible urinary tract infections.
• The drug is used orally in treatment of the following conditions:
  • Cystitis
  • Bacterial urethritis
  • Bacteriuria during pregnancy
  • Infection prophylaxis in urogenital surgery
• The preparation is prescribed parenterally in treatment of susceptible bacteria in the following conditions:
  • Septicemia
  • Brochitis
  • Bronchiolitis
  • Acute and chronic penumonia
  • purulent pneuritis
  • Peritonitis
  • Cystitis
  • Adnexitis
  • Lower bowel infections
  • Bartonilitis

In treatment of severe infections concomitant use of beta-lactam antibiotics may be prescribed.

What should I know before taking Fosfomycin?
Do not use this medication if you are allergic to Fosfomycin or to any other medicines such as:

Do not take Fosfomycin if any of the below conditions apply to you:

• Hypersensitivity to any components of the preparation
• Renal failure
• Liver failure
• Lactation period
• Young age prior to 5 years
• Elderly patients after 75 years

Before taking Fosfomycin, tell your health care provider about any other medicines you take or if you have any of the following disorders:

• Pregnancy
• Cardiovascular disorders

If you are pregnant, plan to become pregnant, or breastfeed, you should take Fosfomycin only under a strict control of your doctor. Fosfomycin belongs to a pregnancy category B meaning that the use in pregnancy is allowed in cases when the potential effects of the therapy outweigh the risk to the fetus.

How to take Fosfomycin:
Fosfomycin is available in the forms of tablets and intravenous injections.
The dosage of the preparation is normally prescribed individually by the physician.
In patients with renal impairment the dosages are decreased and the intervals between administrations are prolonged.
Take the entire amount of Fosfomycin prescribed by your doctor, even if you feel better before the end of the treatment. If you stop taking medication too early, symptoms may return.
If you missed the scheduled dose, take the medication as soon as you remember, but skip the dose if it is almost the time for the following dose. Do not take two doses at once.

What are the side effects of Fosfomycin?
Fosfomycin may cause the following side effects:

• CNS: headaches, dizziness, weakness, insomnia, somnolence, migraines, nervousness, paresthesia, seizures
• GI tract: diarrhea, nausea, dyspepsia, anorexia, constipation, xerostomia, nausea, meteorism, abdominal pain, liver impairment,
• Cardiovascular disease: chest discomfort, increased heart-rate, agranulocytosis, anemia, phlebitis, thrombocytopenia, anemia, eosinophilia.
• Allergic reactions: anaphylactic shock, erytema, rash, hives.
• Other: vaginitis, rhinitis, dysmenorrhea, pharyngitis, back pain, rash, coughing, bronchospasm.

If you experience any side effect that last long or becomes bothersome, please inform your doctor as dose adjustment or treatment discontinuation may be required.

Which are Fosfomycin overdose symptoms?
If you overdose Fosfomycin, seek immediate medical attention. The treatment includes drinking plenty of fluids to increase diuresis and symptomatic therapy.

Which other medicines may affect Fosfomycin?
Fosfomycin may interact with the following groups of drugs:

• Antiemetics
• Other antibiotics
• Drugs affecting liver function
• Drugs affecting renal function.

For a complete list of possible interactions ask your doctor or pharmacist. Before taking Fosfomycin, let your doctor know what other medicines, including OTC, you currently take.

How should I store Fosfomycin?
The drug should be stored at temperatures not exceeding 25C, kept away from children and direct sunlight.