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Fosfomycin

MONUROL

Pronunciation: fos-foe-MYE-sin

Fosfomycin ballicule: receptor binding, kinetics and half-life diagram
Mechanism of action: Fosfomycin ballicule

What it isInhibitor of an early step in cell wall synthesis; uncomplicated cystitis.

Why this oneA single oral dose treats cystitis, and it retains activity against many multidrug-resistant organisms.

What limits itIt concentrates only in urine, so it is useless for pyelonephritis or systemic infection.

Fosfomycin molecular structure (skeletal formula)
Molecular structure: Fosfomycin

FDA-approved for

FDA label

FDA dosingPopulationStartTargetMax
Uncomplicated UTI (acute cystitis)Women ≥18 yOne 3 g sachet single doseOne 3 g sachet single doseOne 3 g sachet single dose

Renal Undefined

Hepatic Undefined

Single-dose therapy; do not use multiple doses to treat a single episode of acute cystitis.

Instructions

Available strengths

Cautions

Adverse reactions

Pregnancy Crosses the placental barrier; not teratogenic in animal studies.

Lactation Undefined

Cost

Fosfomycin (MONUROL)
What pharmacies pay · NADAC 9/30/26
Strength#/mogeneric $/unitCostPlus
3 g/packetsolper unit$26.22/eaoffered

Generic entry2020

NO BOXED WARNINGS

Principal riskUrine only, so useless in pyelonephritis

Classes and tags

Clinical profile

Therapeutic safety burden1 / 4
Overdose danger1 / 4
Weight-gain liability0 / 4
Sedation liability0 / 4
QT / Torsades0 / 4
Direct muscarinic antagonism0 / 4
Embryofetal risk1 / 4

Legacy pregnancy categoryUnknown / historical label unavailable

Defining liabilityGenerally tolerated at therapeutic doses; clinically important risks are agent-specific and increase with interactions or organ impairment.

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