Monurol

fosfomycin

(foss-foe-mye-sin) ,

Monurol

(trade name)

Classification

Therapeutic: anti infectives

Pregnancy Category: B

Indications

Uncomplicated urinary tract infections in women (acute cystitis).

Action

Inactivates an enzyme crucial for bacterial cell wall synthesis.

Decreases adherence of bacteria to uroepithelial cells.

Therapeutic effects

Bactericidal action against susceptible bacteria.

Active against: Enterococcus faecalis and Escherichia coli.

Pharmacokinetics

Absorption: Rapidly absorbed and converted to fosfomycin, its active component, resulting in 37% bioavailability.

Distribution: Distributes to kidneys and bladder wall; crosses the placenta.

Metabolism and Excretion: Excreted unchanged in urine (38%) and feces (18%).

Half-life: 5.7 hr.

Time/action profile (bactericidal urine levels†)

ROUTE	ONSET	PEAK	DURATION
PO	rapid	2–4 hr	unknown

†Symptoms may take 24–48 hr to subside

Contraindications/Precautions

Contraindicated in: Hypersensitivity; Pyelonephritis; Lactation: Lactation.

Use Cautiously in: Obstetric / Pediatric: Pregnancy or children <12 yr (safety not established).

Adverse Reactions/Side Effects

Central nervous system

dizziness
headache
weakness

Gastrointestinal

pseudomembranous colitis (life-threatening)
diarrhea
dyspepsia
nausea

Genitourinary

vaginitis

Interactions

Drug-Drug interaction

Urinary excretion and blood levels are decreased by metoclopramide.

Route/Dosage

Oral (Adults and Children ≥18 yr) 3 g single dose.

Availability

Sachet: 3 g

Nursing implications

Nursing assessment

Assess patient for signs and symptoms of cystitis (frequency, urgency, painful urination).
Obtain urine specimen for culture and sensitivity before administration.
Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care professional promptly as a sign of pseudomembranous colitis. May begin up to several weeks following cessation of therapy.

Potential Nursing Diagnoses

Risk for infection (Indications)
Acute pain (Indications)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)

Implementation

Oral: Do not take medication in dry form. Pour entire contents of single sachet into 3–4 oz (½ cup) water and stir to dissolve. Do not use hot water. Drink immediately after mixing. May be administered with or without food.

Patient/Family Teaching

Instruct patient on correct preparation of sachet.
Instruct patient to notify health care professional immediately if diarrhea, abdominal cramping, fever, or bloody stools occur and not to treat with antidiarrheals without consulting health care professionals.
Advise patient to notify health care professional if symptoms have not improved or persist more than 2–3 days after treatment.

Evaluation/Desired Outcomes

Improvement in symptoms of acute cystitis within 2–3 days.

Monurol

^® Fosfomycin tromethamine Infectious disease A single dose antibiotic for treating uncomplicated UTIs. See Urinary tract infection.

References in periodicals archive ?

Mayne Pharma Group Limited is pleased to announce it has received TGA approval for Monurol (fosfomycin trometamol) (3g) granules and has recently launched Urorec (silodosin) (8mg) capsules in Australia.

Monurol is an antibiotic for the treatment of urinary tract infections which is estimated to impact one in two women over their lifetime with 13% of adult women estimated to be diagnosed each year3 .

Australia : Mayne Pharma Adds Two Specialty Products to Its Australian Portfolio

During the symposium, a breakthrough prescription drug called Monurol (generic name is Fosfomycin trometamol) was introduced.

It's all about the shoes

By comparison, a single dose of fosfomycin (Monurol) is expensive and generally placed on tier 3 by insurance companies, or not included at all.

Urinary tract infections: the spectrum ranges from asymptomatic bacteriuria to symptomatic to sepsis

These include the penicillins [all B], cephalosporins [all B], aminoglycosides [C or D], sulfonamides [C], and fosfomycin (Monurol) [B].

Treatment of lower urinary tract disorders

Its important products are Celexa (depression), Aerobid (asthma), Lorcet (pain), Tiazac (hypertension), Monurol (urinary tract infection) and generic drugs using controlled-release technology.

Despite some uncertainties, drugmakers have bright future

Fosfomycin (Monurol) is an effective single-dose drug for acute cystitis due to E.

Nitrofurantoin for 7 days called good choice for cystitis in women. (Expert Advice)

market is fosfomycin (Monurol), which was approved for treating urinary tract infections caused by E.

Empiric use squanders newer fluoroquinolones. (Wider use may Raise Resistance Issues)

In the prescription arena Monurol from Forest Laboratories has been cleared by the Food and Drug Administration as what a spokeswoman calls the first onetime, one-dose antibiotic for uncomplicated UTI.

"As a drug that is taken one time and one time only, Monurol is the most convenient antibiotic for uncomplicated urinary tract infection and should have an extremely high rate of compliance among its users," notes Forest Laboratories medical director Harvey Schneier.

A single oral dose of Monurol provides a urinary concentration of the active ingredient that remains effective for more than three and a half days, well over the minimum necessary to destroy the most common urinary tract disease-causing bacteria, escherichia coli, the spokeswoman says.

An orange-flavor, water-soluble powder, Monurol starts destroying the harmful bacteria in the bladder in two to four hours, she notes.