What is the brand name of Fosfomycin (fosfomycin)?

Brand Name of Fosfomycin

The brand name of fosfomycin trometamol is Monuril®, Monurol®, or Monural®, depending on the country where it is marketed.

Details About Fosfomycin

Fosfomycin is available in several formulations:

• Fosfomycin trometamol (also called fosfomycin tromethamine):

  • Oral formulation
  • Available as a 3g single-dose sachet
  • Brand names: Monuril®, Monurol®, Monural® 1, 2, 3
  • FDA approved in 1996 for uncomplicated urinary tract infections

• Fosfomycin calcium:

  • Alternative oral formulation
  • Less commonly used than the trometamol salt 4

• Fosfomycin disodium:

  • Intravenous formulation
  • Used for more serious infections
  • Not widely available in all countries 4

Clinical Use

Fosfomycin trometamol is primarily indicated for:

• Uncomplicated urinary tract infections (UTIs) in women 5
• Asymptomatic bacteriuria in pregnant women 1

It is recommended as a first-line agent for uncomplicated cystitis by several guidelines, including:

• Infectious Diseases Society of America (IDSA) 5
• European Society for Microbiology and Infectious Diseases 5

Key Advantages

• Single-dose therapy: Enhances patient compliance 1, 2
• Broad spectrum activity: Effective against many uropathogens including E. coli and Enterococcus faecalis 2
• Low resistance rates: Resistance to fosfomycin in E. coli remains relatively rare (<1%) 2
• Activity against resistant pathogens: Effective against ESBL-producing, AmpC-producing, and multidrug-resistant organisms 6, 2
• Minimal collateral damage: Limited impact on intestinal flora 5

Pharmacokinetics

After a single 3g oral dose:

• Peak urinary concentration: ~4000 μg/mL
• Maintains concentrations >100 μg/mL for up to 48 hours
• No dosage adjustments required for elderly patients, pregnant patients, or those with renal or hepatic impairment 2

Common Side Effects

• Gastrointestinal symptoms (most common)
• Diarrhea
• Nausea
• Headache 5, 1, 3

Important Considerations

• While bacterial efficacy may be lower than some other first-line agents, clinical efficacy is comparable 5
• Susceptibility testing for fosfomycin is not routinely performed in many clinical laboratories, which may limit targeted use 5
• Despite rapid development of resistance in vitro, clinical resistance during therapy for UTIs is rare 6

Fosfomycin's unique mechanism of action, favorable safety profile, and efficacy against multidrug-resistant pathogens make it an important option in the treatment of uncomplicated UTIs.