Monural, 2 g

Monural is a broad spectrum antibacterial, bactericidal.

It suppresses the first stage of synthesis of the bacterial cell wall. It also has a specific action – it inhibits enolpyruvil-trasferase, which provides absence of cross-resistance and possibility of synergism with other antibacterial agents (in vitro synergism with amoxicillin, cephalexin, pipemidic acid is noted).

Pharmacodynamics

The in vitro antibacterial spectrum of phosphomycin trometamol includes most common gram-positive (Enterococcus spp, Enterococcus faecalis, Staphylococcus aureus, Staphylococcus saprophyticus, Staphylococcus spp.) and Gram-negative (Escherichia coli, Citrobacter spp., Enterobacter spp., Klebsiella spp., Klebsiella pneumoniae, Morganella morganii, Proteus mirabilis, Pseudomonas spp., Serratia spp.) pathogens. In vitro fosfomycin trometamol reduces adhesion of a number of bacteria on the epithelium of the urinary tract.

Pharmacokinetics

It is rapidly absorbed from the gastrointestinal tract when taken orally. In the body it dissociates into phosphomycin and trometamol. Tromethamol has no antibacterial properties. The bioavailability of a single oral dose of 3 g is 34 to 65%. Cmax in plasma is reached 2-2.5 hours after oral administration and is 22-32 mcg/ml. T1/2 is 4 hours.

Phosphomycin does not bind to plasma proteins and is not metabolized; it mainly accumulates in the urine. When oral administration of a single dose of 3 g, a high concentration is achieved in the urine (1053 to 4415 mg/L), 99% bactericidal for most common pathogens of urinary tract infections. The minimum inhibitory concentration of phosphomycin for these pathogens is 128 mg/L. It is maintained in the urine for 24-48 h, which suggests a single-dose course of treatment. It is excreted unchanged by the kidneys. About 18-28% of the dose taken is excreted unchanged in the feces.

Indications

Pain, Urinary tract infections, Urethritis

• Acute bacterial cystitis, acute attacks of recurrent bacterial cystitis; bacterial nonspecific urethritis;
• asymptomatic massive bacteriuria in pregnant women;
• postoperative urinary tract infections;
• prevention of urinary tract infection during surgical intervention and transurethral diagnostic studies.

.

Active ingredient

Fosfomycin

Composition

Active ingredient:

Phosphomycin trometamol;

Associates:

Tangerine flavoring;

Orange flavoring;

saccharin;

saccharose

How to take, the dosage

Internal, on an empty stomach, 2 hours before or after a meal, preferably before bedtime, after emptying the bladder, pre-dissolved in 1/3 cup of water, 1 package (3 g); children over 5 years – 2 g only 1 time. The course of treatment is 1 day.

In more severe cases (older age, recurrent infections) take 1 more packet after 24 hours.

To prevent urinary tract infections during surgical interventions and transurethral diagnostic procedures, 1 sachet 3 hours before the intervention and 1 sachet 24 hours after the first administration.

In case of renal insufficiency, the dose is reduced and the intervals between injections are lengthened.

Interaction

Combined administration with metoclopramide should be avoided because it may decrease the serum and urinary concentrations of Monural.

.

Special Instructions

Concurrent intake of food slows down the absorption of Monural, so the drug should be used 2 hours before or after meals.

Patients with diabetes should note that 1 packet of Monural 2 g contains 2.1 g of sucrose, and a packet of Monural 3 g contains 2.213 g of sucrose.

Contraindications

Individual hypersensitivity to phosphomycin trometamol, severe renal insufficiency (creatinine Cl

Side effects

Possible gastrointestinal disorders (nausea, heartburn, diarrhea), skin rash.

.

Overdose

Treatment: it is recommended to increase diuresis with oral fluid intake.

.

Similarities

Monural, Ecofomural, Fosfomycin, Uronormin-F