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Antibiotic (used mainly for urinary infections)

Fosfomycin: uses, side effects & precautions

Also known as Monurol, Monuril.

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What it is used for

  • Uncomplicated urinary tract infections (cystitis), often as a single-sachet treatment
  • Sometimes used for certain resistant urinary infections under specialist advice

How it works

Fosfomycin is an antibiotic that stops bacteria from building their cell walls. It concentrates in the urine, which makes it useful for bladder infections. It is often given as a single dose for simple urinary infections.

How it is taken

Most commonly comes as a powder (granules) in a sachet that is dissolved in water and taken by mouth; an injectable form is used in hospital. Take it exactly as your doctor or pharmacist directs and follow the label. The oral form is often taken on an empty stomach, sometimes at bedtime after emptying the bladder.

No doses here on purpose. The right strength and schedule depend on you — only a doctor or pharmacist should set them. Always follow your prescription and the label.

Common side effects

  • Diarrhoea
  • Nausea
  • Headache
  • Dizziness
  • Mild stomach upset
  • Vaginal irritation or thrush

Serious effects — get help

  • Severe allergic reaction with swelling or breathing difficulty
  • Severe, persistent or bloody diarrhoea
  • Symptoms that do not improve or that worsen after treatment

If a reaction is severe — for example trouble breathing, swelling of the face or throat, or collapse — go to the nearest emergency room now or call your local emergency number. Do not wait for an online consultation.

Interactions to watch

  • Metoclopramide and similar medicines that speed up the gut (may reduce its effect)
  • Some antacids
  • Other medicines should be reviewed by your pharmacist

Who should take care

  • Tell your clinician if your symptoms do not improve after the single dose, as you may need further assessment
  • Tell your clinician if you have kidney problems
  • Discuss pregnancy or breastfeeding with your doctor or pharmacist
  • Mention all other medicines you take
  • Drink fluids as advised

Frequently asked questions

Why is fosfomycin often a single dose?
It builds up to high levels in the urine that last long enough to treat a simple bladder infection with one dose. Always follow the exact instructions you were given.
How do I take the sachet?
The granules are usually dissolved in water and drunk straight away, often on an empty stomach. Follow the label and ask your pharmacist if unsure.
What if I still have symptoms after the dose?
Contact your clinician if symptoms persist or worsen after treatment, as you may need a urine test or a different antibiotic.
Is it safe in pregnancy?
It is sometimes used in pregnancy for urinary infections, but confirm with your doctor or pharmacist for your situation.

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