Buy Monural

The broad-spectrum antibiotic, a derivative of phosphonic acid, has a bactericidal effect, the mechanism of which is associated with the suppression of the first stage of bacterial cell wall synthesis. It is a structural analogue of pyruvate phosphoenol, enters into a competitive interaction with the enzyme N-acetyl-glucosamine-3-o-enolpyruvyl transferase. As a result, specific, selective and irreversible inhibition of this enzyme occurs, which ensures that there is no cross-resistance to other classes of antibiotics and the possibility of synergism with other antibiotics (synergism with amoxicillin, cephalexin, pipemidic acid is noted in vitro).

It is active in vitro against most Gram-positive microorganisms: Enterococcus spp., Enterococcus faecalis, Staphylococcus aureus, Staphylococcus saprophyticus, Staphylococcus spp .; Gram-negative microorganisms: Esherichia coli, Citrobacter spp., Enterobacter spp., Klebsiella spp., Klebsiella pneumoniae, Morganella morganii, Proteus mirabilis, Pseudomonas spp., Serratia spp. In vitro phosphomycin reduces the adhesion of a number of bacteria to the epithelium of the urinary tract.

Suction

After oral administration, it is rapidly absorbed from the digestive tract. Bioavailability with a single oral intake of a dose of 3 g is 34-65%. Cmax is achieved in 2-2.5 hours and is 22-32 μg / ml.

Distribution and Metabolism

Fosfomycin trometamol does not bind to plasma proteins, it dissociates into phosphomycin and trometamol (does not have antibacterial properties) and is no longer metabolized, mainly accumulates in the urine. When taken in a single dose of 3 g in urine is reached high concentration (from 1053 to 4415 mg / l), 99% bactericidal for most of the usual pathogens of urinary tract infections. IPC (128 mg / l) is maintained in the urine for 24-48 hours (which implies a one-day course of treatment).

Excretion

T1 / 2 from plasma - 4 h. It is excreted unchanged by kidneys (up to 95%) with the creation of high concentrations in the urine; about 5% - with bile.

Pharmacokinetics in special clinical cases

In patients with a moderate decrease in renal function (CK> 80 ml / min), including its physiological decline in the elderly, T1 / 2 phosphomycin slightly lengthens, but the concentration in the urine remains at the therapeutic level.

- 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 surgery and transurethral diagnostic tests.

- Severe degree of renal failure (CC <10 ml / min);

- children's age is less than 5 years;

- hypersensitivity to the components of the drug.

Adults drug prescribed 3 grams 1 time / day. The course of treatment is 1 day. If necessary (with severe or recurrent infections, the elderly) it is possible to re-take the drug at a dose of 3 g after 24 hours.

In order to prevent infection of the urinary tract during surgery, transurethral diagnostic procedures, the drug is taken at a dose of 3 g for 3 hours before the intervention and 3 g at 24 hours after the first dose.

For children over the age of 5, the drug is prescribed in a dose of 2 g only once.

When appointing the drug to patients with renal insufficiency should reduce the dose and increase the interval between doses.

Before taking the granules, dissolve in 1/3 cup of water. The drug is taken 1 time / day on an empty stomach 2 hours before or after meals (preferably before going to bed), previously emptying the bladder.

From the digestive system: nausea, heartburn, diarrhea.
Other: skin rash, allergic reactions.

The risk of overdose is minimal.

Treatment: forced diuresis.

With simultaneous use with metoclopramide, a decrease in the concentration of phosphomycin in serum and in urine (this combination is not recommended).

When appointing Monural to patients with diabetes should take into account that in 1 package containing 2 g of phosphomycin, contains 2.1 g of sucrose, and in 1 packet containing 3 g of phosphomycin - 2. 213 g of sucrose.

The use of the drug during pregnancy and during lactation is possible only if the intended benefit of therapy for the mother exceeds the potential risk of developing teratogenic effects.

Contraindicated in children under 5 years.

For children over the age of 5, the drug is prescribed in a dose of 2 g only once.

When appointing the drug to patients with renal insufficiency should reduce the dose and increase the interval between doses.

At a severe degree of renal failure (CC <10 ml / min) the drug is contraindicated