Monural - instructions for using the antibiotic

Monural is a new generation antibiotic with high antimicrobial activity. The drug is prescribed for urinary tract infections. The main difference from other drugs is that to achieve a therapeutic effect, a single dose of an antibacterial agent is needed.

For what diseases is the antibiotic Monural effective? Is the modern product suitable for children? Are there any restrictions for prescribing Monural? Instructions for use contain useful information about the antibacterial agent.

Composition and release form

Fosfomycin trometamol is an active substance with a broad spectrum of action, a derivative of phosphonic acid. Granules with a characteristic odor, color – white. Other ingredients: saccharin, orange or tangerine flavoring, sucrose. The drug Monural suppresses pathogenic flora in many pathologies of the bladder, kidneys, and ureters.

The drug is supplied to pharmacies in powder form. The drug is packaged in laminated paper bags, 2 or 3 g each. Based on the composition, a suspension is prepared with the addition of boiled water. An antibacterial agent in powder form acts more delicately on the gastric mucosa than tablets and exhibits antibacterial activity more quickly.

Dosages for children and adults

The instructions for using the monural antibiotic are very simple. The contents of one package are poured into an appropriate container and filled with a third of a glass of water. After complete dissolution, the liquid can be taken orally. It is advisable to empty your bladder before taking the drug.

The active elements of the drug Monural for prostatitis are best absorbed on an empty stomach; the minimum time that should pass after eating before taking the antibiotic is 2 hours.

For adults, the recommended daily dose is 3 grams. For persons under 18 years of age, the dose is reduced to 2 grams. The duration of the course of therapy depends on the complexity of the disease, the age of the patient and some other factors. The duration of treatment and dosage should be determined by the attending physician.

The action of a modern antibiotic

Monural is a modern antibiotic for the treatment of inflammation in the urinary tract. After ingestion, the drug is actively absorbed into the blood and penetrates to the sites of infection. The specific action of fosfomycin excludes the resistance of infectious agents to other antibiotics: Ampicillin, Cephalexin, compounds with pipemidic acid.

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Characteristic features of the drug:

• fosfomycin quickly suppresses the action of pathogenic microorganisms (gram-positive and gram-negative), destroys, and prevents the proliferation of dangerous bacteria;
• for urothelium, the antibiotic reduces the adhesion of many pathogenic microorganisms;
• Staphylococci, Morganella morgani, enterococci, Escherichia coli, Klebsiella, pseudomonas, Citrobacter, Proteus mirabilis are sensitive to the action of Monural;
• after consuming a single dose, the drug breaks down into fosfomycin and trometamol;
• bioavailability of the drug is 35–65%. The maximum concentration of the active substance was observed after 2.5 hours, the half-life was 4 hours;
• fosfomycin is not metabolized, there is no binding to plasma proteins, accumulation of the active substance occurs in the urine;
• Taking 3 g of the drug Monural leads to a high concentration of the active substance. Such an environment is destructive for 99% of infectious agents that provoke inflammation in the organs of the genitourinary system;
• A single dose of the drug Monural leads to the accumulation of fosfomycin in the urine at a level of 128 mg/l. The high concentration lasts from a day to two, which ensures an active antimicrobial effect;
• unchanged, most of fosfomycin is excreted from the body by the kidneys, a smaller part (up to 28%) is excreted in the feces.

Important! Unlike many antibiotics that exhibit a bacteriostatic effect (inhibit the growth of microorganisms), the drug Monural disrupts the synthesis of the cell wall, causing harmful bacteria to die. Most urologists and nephrologists consider the fosfomycin-based antibiotic to be the most effective medicine for acute cystitis. A wide spectrum of action allows Monural to be used in severe cases of infection, even before the results of an antibiotic sensitivity test.

Description of the drug

Being a broad-spectrum antibiotic, Monural has bactericidal properties, i.e.
kills the bacterial pathogen (unlike bacteriostatic drugs that inhibit growth and reproduction). This mechanism of action is due to the ability of the antibiotic to suppress the synthesis of the bacterial cell wall, as a result of which the growing cell loses the ability to build new components and dies.

The spectrum of antimicrobial action includes most gram-positive (enterococci, staphylococci, streptococci) and gram-negative (klebsiella, proteus, serration, pseudomonas and Escherichia coli) bacteria. A special effect of the drug is to reduce the adhesion (attachment) of bacteria to the epithelial cells of the mucous membrane of the urinary tract.

Indications for use

The modern antibiotic Monural is prescribed for the treatment of acute bacterial cystitis. In most cases, a single dose is sufficient to suppress the activity of infectious agents.

The drug is effective in other cases:

• exacerbation of chronic bacterial cystitis;
• in the postoperative period to reduce the risk of inflammatory processes;
• gestational pyelonephritis in pregnant women;
• urethritis or inflammation of the urethra;
• asymptomatic bacteriuria.

In case of renal failure, the antibiotic Monural is prescribed with caution. The nephrologist selects the dosage on an individual basis. In case of diabetes mellitus, it is important to consult with an endocrinologist and urologist to clarify the dosage for safe use: the medicine contains sucrose and saccharin.

special instructions

When prescribing Monural to patients with diabetes mellitus, it should be taken into account that 1 package containing 2 g of fosfomycin contains 2.1 g of sucrose, and 1 package containing 3 g of fosfomycin contains 2.213 g of sucrose.

Before you start taking Monural, you should tell your doctor if:

• you are allergic to any components of the medication;
• you have ever had asthma or liver disease;
• if you are pregnant, breastfeeding or think you may be pregnant;
• you are taking any medications, especially cisapride (Propulsid) and metoclopramide (Cerucal), as well as over-the-counter medications, herbs, dietary supplements, and vitamins.

It should also be borne in mind that monural can increase diarrhea, although usually the patient's diarrhea is not an obstacle to prescribing this drug.

Instructions for use and dosage

Patients must strictly adhere to the dosage and take the antibiotic correctly to prevent side effects. The drug is available in pharmacies with a prescription.

Use in adults

Recommendations:

• standard single dosage – 3 g;
• the best option is to take the drug 2 hours after dinner, always after urination;
• Dissolve the granules in warm water, volume – a third of a glass;
• course of therapy – 1 day;
• in case of recurrent infection, in old age, take Monural again every other day;
• in case of renal failure, the interval between doses of a potent antibiotic is increased, and the dosage is reduced according to the doctor’s recommendation.

Many patients ask whether Monural can be taken again. Another single dose (3 g of powder) is prescribed to adults when a relapse occurs, in case of severe cystitis, if there is no positive result after a single dose. The patient should drink the suspension twice for prophylactic purposes before urological procedures, for example, cystoscopy of the bladder. One package – 3 hours before the test, the second – 24 hours after taking the first dose. You should not shorten the interval between taking potent medications.

Admission rules for children

Recommendations:

• an effective antibacterial agent is allowed to be used only after five years;
• children's Monural - bags of granules of 2 g;
• 1 packet is enough for one appointment;
• the rules for preparing the suspension and taking the drug are the same as for adults;
• Children are given Monural only once.

Contraindications

The antibiotic, despite such high effectiveness and relative safety, still has a number of contraindications:

• Monural should not be taken up to 5 years of age, since in such patients the development of the renal pelvis apparatus has not yet completed and the filtration functions are not fully performed.
• Women who are breastfeeding should not take antibiotics because they pass into breast milk.
• The drug should not be prescribed if there is hypersensitivity to fosfomycin and other components of the drug.
• Severe renal failure is also a contraindication for the use of antibiotics.

Possible side effects

The instructions indicate possible reactions from organs and systems:

• epigastric discomfort, nausea, diarrhea, vomiting;
• skin rashes, itching.

Important! Do not exceed the dosage or use a suspension prepared from several packets: stool upset and allergic reactions are possible. If negative signs appear, drinking plenty of fluids and taking sorbents is recommended. If the negative symptoms intensify, the condition worsens, you will need to call an ambulance.

Indications

A detailed list of diseases for the treatment of which Monural is used is contained in the package insert (instructions). But still, self-medication is unacceptable and the drug should only be prescribed by a doctor.

Self-medication and drinking Monural without first consulting a doctor is prohibited.

According to the annotation, the indications for use of the medication are as follows:

1. Urethritis, cystitis of bacterial etiology (both acute forms of illness and attacks of relapse of the disease).
2. Massive bacteriuria (asymptomatic), detected in pregnant women.
3. Stopping the development of urinary system infections in the pre- and postoperative period.
4. Prevention of urinary tract diseases during transurethral procedures.

The described antibiotic has a number of side effects, and incorrect therapy can lead to a worsening of the patient’s condition.

Monural during pregnancy

An antimicrobial agent is one of the few that is allowed to be used by women for gestational pyelonephritis, cystitis, and other urinary tract infections. For comparison: the effective antibacterial drug Nolitsin is prohibited for use during pregnancy. The dosage is determined by a urologist, and a consultation with a gynecologist is required.

In case of pyelonephritis, fosfomycin acts in the urinary tract and actively suppresses the development of bacteria. For optimal results, doctors recommend the Monural regimen + other medications approved for pregnant women. During lactation, this potent drug should not be taken.

Which is better: Nolitsin or Monural?

Nolicin is a quinolone bacterial agent with a broad spectrum of action, which is used for the treatment of infectious diseases of the upper and lower urinary tract (complicated or uncomplicated, occurring in acute or chronic form).

Indications for its use are pyelitis, pyelonephritis, cystitis, chronic prostatitis, infectious diseases associated with urological operations, neurogenic bladder, as well as nephrolithiasis caused by pathogens sensitive to Norfloxacin (the active substance of Nolicin).

The course of treatment with Norfloxacin lasts, depending on the severity of the patient’s condition and the nature of the disease, from 3-5 days (for uncomplicated cystitis) to several weeks (for chronic bacterial prostatitis).

Unlike Monural, Nolitsin cannot be used in pediatrics and pregnant women.

Cost and storage conditions

The price of Monural is quite high - 490 rubles (1 sachet of 2 or 3 g). Considering the duration of therapy (only 1 day), the pronounced effectiveness of the drug, the cost of treatment is no higher than a course of taking many antibacterial compounds for 7–10 days.

Keep laminated paper bags with granules at room temperature in a dry place. It is important to ensure that children do not accidentally swallow the powder. The antimicrobial composition is valid for 36 months.

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Price for Monural

Prices are approximate for November 2020. May vary in different pharmacies and cities.

Monural: analogues

An antibacterial agent for the treatment of inflammatory diseases of the genitourinary system is selected by a nephrologist or urologist. The best option is to find structural analogues with maximum antimicrobial activity if you are intolerant to the drug Monular.

Effective compositions:

• Forteraz.
• Cystoral.
• Fosmicin.
• Espa-Focin.

Medicines with similar effects:

• Nitroxoline.
• Dioxidine.
• Zyvox.
• Amizolid.
• Kubitsin.
• Zenix.
• 5-NOK.

Analogues of the drug

If it is impossible to use Monural due to contraindications, possible side effects or high cost, then experts prescribe more gentle analogues. What is hidden under this word? This is a product with an international code, which contains a similar active composition, but in a different quantity or with other auxiliary components. The difference may be the purification of the drug, the release form and the price. Analogues and generics are most often in no way inferior to their “twin”.

You can replace the monural:

• Phosphoral . The composition is completely identical, made in India. The dosage and duration of the course remained unchanged. The average cost in the country is 500 rubles;
• Fosmural . Like the original, it produces the same effect - it reaches maximum concentration in a short time and is eliminated from the body for a long time. Price 700-800 rubles.

You can replace the original with similar products only after consultation with a therapist. In different variations, the amount of active ingredient may differ, which may reduce the effectiveness of use. This is dangerous due to the transition from the acute to the chronic stage.

Reviews

Monural is an effective antimicrobial agent, a salvation for patients who dream of getting rid of a bacterial infection in the urinary tract after taking one tablet. In most cases, Monural actually eliminates the pathological process and has a detrimental effect on gram-negative and gram-positive microorganisms.

Sometimes the effectiveness of therapy is weak, but such cases are rare. Side effects are rare; Monural, unlike most antibiotics, can be used for infectious diseases in pregnant women.

“One tablet for cystitis,” is how patients often call the antibacterial drug Monural. In most cases, it is enough to take the medicine once, and the dangerous inflammation in the urinary tract recedes. In case of chronic pyelonephritis, cystitis, urethritis, it is not advisable to use an antibiotic with fosfomycin: the medicine is prescribed once, for the treatment of an acute form of a bacterial infection.

Video - description of the drug Monural and recommendations for use:

Monural's analogs

Monural for men is one of the best remedies for prostatitis. In terms of the main active ingredient, analogues of Monural are trometamol fosfomycin, fosfomycin sodium and urophosphabol. Furadonin, urolesan, amoxicillin, nolicin, and phytolysin have a similar mode of action. The analogue of Monural that is optimally suitable for the treatment of acute forms of prostatitis is nitroxoline.

It is worth understanding that there are many drugs for the treatment of diseases of the pelvic organs that can significantly increase the effectiveness of Monural. For prostatitis, during the course of treatment with this remedy, it will be good to undergo various physical procedures, as they help get rid of congestion in the prostate and improve blood supply to the proper organs. With the help of these procedures, the absorption period of Monural and the time of its action will noticeably increase, which will contribute to a speedy cure.

Signs of side effects

Medical literature describes various cases of negative effects of the drug on the body.

Since the medication is an antibacterial agent, the most common cases of negative effects are disruption of the gastrointestinal tract.

The use of the medicine may be accompanied by the occurrence of:

• attacks of nausea, vomiting;
• pain behind the sternum (heartburn);
• diarrhea.

In order to eliminate these symptoms, you should drink fluids more often (preferably in increased volumes).

When taking the medical product Monural, side effects also appear in the form of allergic reactions:

• itching;
• rashes on the skin.

As soon as the above symptoms begin to appear, they should be reported to your doctor without delay. The specialist will adjust the therapeutic regimens by eliminating the drug from them.

What do the reviews say?

Doctors' reviews of the drug indicate the high effectiveness of the drug against UTI pathogens and its speed of action.

Reviews of Monural for cystitis allow us to conclude that most patients feel a significant improvement within the first hours after taking the solution.

The undoubted advantages of the drug over analogues are the possibility of using it for a short course and the absence of serious side effects. Moreover, the duration of the relapse-free period after treatment with Monural is at least 6-12 months.

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Overdose, contraindications

If a medication is accidentally used in the wrong dosage, forced diuresis is used as a detoxification method: in a hospital setting, the patient is given diuretics and given plenty of fluids to drink.

Contraindications to the use of Monural are:

• the patient has a history of a disease such as renal failure (in severe forms);
• individual intolerance to the components included in the medical product;
• childhood (treatment with the drug can be started only after the child reaches the age of five).

It is recommended to use Monural during pregnancy and lactation only under the strict supervision of a doctor.