Monural is an antibiotic that effectively fights most pathogenic bacteria. We will not give the entire extensive list of these gram-positive and gram-negative “cuties”. It is enough to mention only that gram-positive bacteria (they are designated as Gram (+)) include staphylococci and streptococci. But the person whose name appears in this classification should be introduced. This is the Danish scientist Hans Christian Gram , who in 1884 invented a method for staining bacteria, which allows them to be distinguished by the biochemistry of their cell walls. This is necessary for a correct diagnosis.
Release form
One could say that this drug embodies the dream of many patients about “one tablet for cystitis,” but this would be wrong. Because Monural is produced exclusively in the form of granules, which must be dissolved in water before taking. Although formally the dream of people suffering from acute cystitis has come true: in most cases, the result can be achieved after a single dose of Monural.
If the therapeutic effect is insufficient, then you should take the medicine again after 24 hours. This should complete the course of treatment.
In addition to the active ingredient, the granules contain sucrose and citrus flavors. Monural is available in dosages of 2 or 3 g.
Contraindications
There are few contraindications for taking Monural. These include severe and recurrent forms of thrush, renal failure (acute and chronic), accompanied by a decrease in glomerular filtration.
Hypersensitivity to the components of the drug may also occur, in which case it is prohibited to prescribe Monural. The medicine is not intended for children under five years of age. For fungal and bacterial infections occurring simultaneously, Monural should be prescribed together with antifungal agents so as not to cause a deterioration in the patient's condition.
For what diseases is the drug indicated?
This drug is used for the treatment of inflammatory urological diseases, as well as for the prevention of infections during operations and transurethral diagnostics. The range of application is:
- Acute bacterial cystitis.
- Exacerbation of chronic cystitis.
- Bacterial nonspecific urethritis.
- Asymptomatic bacteriuria during pregnancy.
- Postoperative urinary tract infections.
- Prevention of urinary tract infections during surgical operations and transurethral diagnostic studies.
- Acute pyelonephritis.
Description of the manual
The active ingredient of Monural is fosfomycin. The drug contains it in the form of a chemical compound - trometamol. The active component of the drug has a specific effect on cystitis pathogens. Fosfomycin inhibits the synthesis of the bacterial cell wall, which disrupts the vital activity of pathogenic microorganisms and causes their death.
The drug is relatively safe, since it exhibits a rather specific effect in relation to bacterial enzymes, so there is no cross-drug resistance to it (a condition in which the resistance of pathogens to one drug also extends to related drugs).
- The drug Monural is active against most gram-positive and gram-negative bacteria.
- Its spectrum of action includes common pathogens of cystitis - Escherichia coli, Klebsiella, Morganella, and pathogens of sexually transmitted infections.
- The drug interferes with one of the early stages of cell wall synthesis, which is why its spectrum of action is so wide.
How long does it take for Monural to work?
When taking the drug orally, the active substance is absorbed from the digestive tract within an hour. The therapeutic concentration of the drug in the blood is achieved within 2-2.5 hours, in the urine - after 4-5 hours and lasts throughout the day.
A single dose is enough to create a bactericidal concentration of the drug in the blood, so Monural for cystitis helps from the first dose. In urine, the required concentration of the active substance is maintained throughout the day (in some cases, up to 48 hours).
The drug is excreted from the body mainly through urine, only about a quarter of the dose taken is excreted through the intestines.
Release form
- Monural is available in the form of a powder containing white mini-granules with a characteristic fruity odor, which easily dissolve in water.
- A solution for oral administration is prepared from the powder.
- The drug is packaged in multilayer paper bags, laminated with polyethylene, 2 g or 3 g each and 1-2 pieces are placed in cardboard packs.
Monural powder, in addition to the main substance (fosfomycin), contains additional components - sugar, lactose, orange or tangerine flavoring, which make the drug palatable.
There is no such release form as Monural tablets or injection solutions.
Instructions for use
Monural can be used in the morning or evening 2 hours before or 2 hours after meals . There is no fundamental difference in choosing the time of administration, but still many doctors recommend doing it in the evening. The bladder must be empty before taking it.
Before using the drug, the granules must be dissolved in 1/3 cup of warm water. For adults, the dosage of the drug is 3 g . For children 5-18 years old – 2 g . Monural should not be given to children under the age of five, because before the age of five their urinary system is not yet fully developed.
The drug can be used in the second and third trimesters of pregnancy. If you need to take Monural during breastfeeding, then you should stop feeding for a while.
Patients with diabetes mellitus should take the drug with caution, as it contains sucrose. This is not a direct contraindication to its use, but during this period attention should be paid to controlling blood sugar.
Important: you should not drink alcohol during this period.
Adverse reactions
- Adverse reactions when taking Monural can be manifested by the appearance of skin rashes (in persons with hypersensitivity) or disorders of the digestive system (nausea, heartburn, vomiting or diarrhea).
- If such symptoms are severe, then it is advisable to replace Monural with analogues that do not cause such side effects.
- In less severe cases, to eliminate dyspepsia it is enough to increase the amount of fluid consumed.
Overdose of the drug is extremely rare. If it does occur, the patient is prescribed forced diuresis - increasing the amount of fluid consumed along with taking diuretics. There is no specific antidote, and there is usually no need for hospitalization or resuscitation.
Reviews
- Maxim, 43 years old, urologist. I consider Monural one of the best remedies for acute cystitis. I often prescribe it to patients. But when it comes to relapses of a chronic disease, I always recommend that patients undergo additional examination. After all, simply stopping the inflammatory process is not enough. We need to understand why the disease became chronic in the first place.
- Alexandra, 28 years old. This drug helped me a lot: in a couple of hours it relieved the pain, which even prevented me from sleeping at night. But, to be honest, I would like to try to avoid getting acquainted with medicines, even such modern ones. In the sense that it is better not to get sick at all. Now in the cold season I dress warmer.
- Svetlana, 35 years old . It seems to me that I have never been so happy about my son’s birthday: he finally turned 5 years old! Last winter he caught a bad cold while out for a walk; we got too carried away with cheesecake riding in the park. Since then, cystitis has been a familiar phenomenon to us. And I am very glad that now Monural can be used to treat a child, because pediatricians do not prescribe it until the age of five.
- Sergey, 23 years old . What's the coolest thing about this medicine? The fact that you do not need to undergo a long course of treatment. This is usually how I deal with it: at first I remember to take the pills, but then I forget, and the treatment turns into some kind of chaos. With Monural, such forgetfulness is simply impossible, since the entire treatment course consists of a single dose.
- Anna, 58 years old . I liked that cystitis can be cured so quickly. And yet, if this happens again, I will most likely look for a domestic analogue. For me the price of Monural is too high. I am a pensioner, 520 rubles is expensive for me. Thanks to my daughter: I helped, I bought it with my own money.
What is Monural
Antibacterial drugs based on phosphoric acid, which also include Monural, have a wide spectrum of action, quickly relieve symptoms of urinary tract diseases and promote recovery. This drug is considered relatively safe. It does not cause cross-drug resistance (a decrease in the effectiveness of treatment due to the use of drugs of similar composition), and is often used in pediatric practice.
Unlike other bacteriostatic agents, Monural acts purposefully for cystitis. While some drugs can only inhibit the growth and reproduction of pathogenic flora, this antibiotic provokes cell death. The mechanism of action of a highly effective drug is realized due to the ability of the active component to disrupt the production of protein in bacterial cells, the result is that the development of the microorganism stops and the bacterium dies.
Tablets or powder for cystitis monural are based on the substance fosfomycin, which is a broad-spectrum antibacterial drug from the group. Monural is a patented trade name for fosfomycin. It is produced by the Swiss company. The drug is used to treat infectious and inflammatory processes of the urinary tract.
Monural acts bacteriostatically, i.e. suppresses further proliferation of microorganisms by blocking a special enzyme that is needed to build the bacterial wall. Monural is also capable of attaching to the walls of the urinary tract, protecting it from the effects of the causative agent of cystitis or urethritis. An important property of monural is its ability to influence the immune system, increasing its resistance.
Monural cystitis powder is better than the tablet form, because... acts faster and does not affect the stomach.
Use during pregnancy
Currently, there is no specific data on the effects of the drug on the fetus. There are some recommendations for women in an interesting position: the benefits of using Monural are greater for the mother than for the fetus. It should be taken after consultation with a doctor.
But it is important to know that fosfomycin crosses the placenta. If taken during lactation, then in milk. If there is a need to take it at this time, feeding is suspended or stopped if the child’s age allows.
Indications for use of Monural
The decision to start taking Monural should be made by a urologist or gynecologist, since its uncontrolled, incorrect use can cause a worsening of the condition or the development of adverse reactions.
The following indications for its use are distinguished, such as:
- Acute cystitis caused by bacteria.
- The period of exacerbation in chronic cystitis.
- Bacteriuria in women during pregnancy, which does not manifest itself with any symptoms.
- Prevention of cystitis with cystography and placement of a urinary catheter.
- During cystitis, which developed during pregnancy and during the period of feeding the child with breast milk.
Pharmacodynamics and pharmacokinetics
The drug has a bactericidal effect; the mechanism of action of the drug is associated with inhibition of the initial stage of synthesis of the cell wall of microorganisms. The active substance fosfomycin belongs to the structural analogues of phosphoenol pyruvate, interacts with the enzyme acetyl-glucosamino-3-o-enolpyruvil transferase (enolpyruvil transferase), competing with it.
As a result, inhibition of this substance occurs; the process is selective, specific and irreversible. The interaction of fosfomycin with the enzyme affects the absence of cross-resistance (resistance) with other antibiotics, the possibility of synergy (in vitro, an increase in the effects of pipemidic acid, Amoxicillin, Cephalexin was noted).
Monural has an effect against enterococci, staphylococci, fecal coliforms, enterobacteria, klebsiella, proteus, pseudomonads, saprophytic microorganisms, serrations, and citrobacters. Fosfomycin reduces the adhesion of bacterial pathogens to the epithelial tissue (urothelium) of the urinary tract. After administration, the medicine is quickly absorbed in the stomach, has 34-65% bioavailability, and reaches maximum concentration after 2-2.5 hours.
Fosfomycin does not combine with serum plasma proteins, splits into two substances and is no longer metabolized. The bactericidal effect is created after the first dose of the granules and lasts for 1-2 days. The half-life of the remaining dose is 4 hours and is excreted in urine and bile. Withdrawal time may be prolonged in cases of moderate renal failure and in old age.
Monural - is it an antibiotic or not?
The drug contains the active substance fosfomycin, the effect of which is to destroy bacteria and prevent their further reproduction. Due to this, Monural is an antibiotic for men and women. Before using the drug, consultation with a doctor is necessary; self-medication with the drug is prohibited due to the possible development of adverse reactions.
Monural during pregnancy and lactation
During pregnancy, women often experience cystitis. Monural is best suited for the treatment of cystitis in pregnant women, without causing pathologies in the fetus.
A huge advantage of Monural is its single dose, while the course of treatment with other antibiotics lasts at least 5-7 days. The next positive point is that the medicine has virtually no contraindications or side effects. It is usually well tolerated by patients.
But only a doctor can prescribe a single dose of Monural to a pregnant woman after a thorough examination. Because, although targeted studies have not been conducted on the effect of the drug on the development of pregnancy, it is known that fosfomycin can cross the placental barrier. Therefore, Monural is prescribed to pregnant women only for health reasons or in cases where the effect of treatment significantly exceeds the potential risk to the fetus.
It should be noted that for women who have had cystitis before, before pregnancy, Monural may not help. It will have to be combined with other drugs.
In the first trimester of pregnancy, it is generally undesirable to take medications, including Monural. It is during this period that the baby’s internal organs are actively developing.
During lactation, if a nursing mother is prescribed Monural, breastfeeding will have to be stopped for the period of treatment, because fosfomycin may pass into breast milk.
Monural's analogs
Monural is not a universal antibacterial agent. The later treatment begins, the lower the effectiveness of the antibiotic. A common mistake women make is to delay contacting a urologist and try to overcome the disease with home methods. But in most cases, cystitis is a bacterial infection that requires antibiotics first.
But if Monural does not help with cystitis, which is possible, especially in an advanced stage of the disease, it is allowed to use analogues of the drug, but first it is recommended to undergo the necessary tests to determine the sensitivity of microorganisms. Without laboratory diagnostics, it is easy to make a mistake in choosing an antibacterial agent. Contact your doctor, who will select a different medicine.
WHAT DO THE DOCTOR'S SAY?
Doctor of Medical Sciences, Honored Doctor of the Russian Federation and Honorary Member of the Russian Academy of Sciences, Anton Vasiliev:
“I have been treating diseases of the genitourinary system for many years. According to statistics from the Ministry of Health, cystitis in 60% of cases becomes chronic.
The main mistake is delaying!
The sooner you start treating cystitis, the better. There is a remedy that is recommended for self-treatment and prevention of cystitis at home, since many patients do not seek help due to lack of time or shame. This is Ureferon. It is the most versatile. It contains no synthetic components, its effect is mild, but noticeable after the first day of use. It relieves inflammation, strengthens the walls of the bladder, its mucous membrane, and restores general immunity. It is suitable for both women and men. For men there will also be a pleasant bonus - increased potency. " READ THE FULL INTERVIEW"
There are several analogues of Monural, and one of them is Canephron. The drug is a herbal product, also used during pregnancy. But it is inferior in efficiency to Monural.
Fosfomycin is a domestic analogue, a broad-spectrum antibiotic. But it is toxic and cannot be used during pregnancy. A single dose for a woman is 3 g.
Urophosphabol is another analogue of Monural. Available in powder form. Has a detrimental effect on cystitis pathogens. It is used intravenously, which can cause some inconvenience.
Cystitis
Cystitis is often a bacterial inflammation that occurs with damage to the bladder wall.
The disease is extremely common among women, which is due to a number of anatomical features of the structure of the urinary system.
The main feature of the causes of cystitis in women is the length and shape of the urethra - short and wide, which creates conditions for the penetration of bacteria and viruses, which are the main etiological factor in the development of pathology.
Most often, cystitis is caused by bacteria, which determines the choice of antimicrobial agents for control. Viral cystitis accounts for no more than 10% of the number of cases of bladder inflammation.
Cystitis is characterized by the appearance of the following symptoms and disorders of the urinary system and the general reaction of the body:
- Frequent urination. Patients complain that they have frequent urination, which is accompanied by a burning sensation and pain. These sensations vary in intensity, depending on the extent of the pathology and the nature of the inflammation.
- Lower abdominal pain. Inflammation of the bladder, like other inflammatory diseases, is accompanied by the development of pain. At the same time, it intensifies in an upright position and with the accumulation of a large amount of urine.
- General reactions of the body. The disease occurs with an increase in body temperature. Patients experience an increase in temperature up to 38˚C, but there is a certain number of patients who remain within normal limits. In such a situation, pay attention to the immune system, as this is considered an abnormality and is caused by another dangerous disease.
- Hematuria and pyuria. Changes in urine are a sign of disorders in the urinary system. With cystitis, pyuria often appears - the presence of purulent impurities in the urine. Separately, it is worth considering hematuria (blood in the urine), this indicates that the patient is developing hemorrhagic cystitis. The disease is accompanied by damage to the blood vessels located in the mucous membrane.
Separately, it is worth considering the phenomena of enuresis - urinary incontinence. This symptom is observed in women over 40 years of age, as well as in cases where the inflammation is localized in the area of the transition of the bladder to the urethra.
Inflammation of this area of the bladder occurs with damage to the muscular sphincter, which is responsible for controlling urination.
Inflammation causes atony, which manifests itself in the form of slight urine discharge when the abdominal muscles tense during coughing or laughter.
The age pattern is due to the fact that with the onset of menopause, muscle tone decreases.
Analogues, reviews of the drug and its cost
An antibiotic is dispensed in a pharmacy only if there is a prescription from the attending physician. It is stored under normal conditions. The storage location must be protected from direct sunlight; in addition, the storage location must be inaccessible to children and pets.
The shelf life of the antibiotic is three years. At the end of the specified period, its use is prohibited, and the medicine must be disposed of.
The cost of Monural can vary depending on the region and averages from 387 to 520 rubles. The cost of the antibiotic also depends on the size of the package. Two gram bags are cheaper. Than 3 gram bags.
Structural analogues of Monural are Fosfomycin, Fosmitsin, Urophosphabol. Forteraz, Espa-Focin and Cystoral.
The cost of analogues is approximately 300 rubles.
Analogs for the effect on the body can be considered:
- Furadonin;
- Nolitsin;
- Amoxicillin;
- Urolesan;
- Phytolysin.
Most reviews from both patients and medical practitioners about the medicine are positive. This confirms the high effectiveness of the antibiotic in the fight against bacterial pathogenic flora.
Video: Monural instructions for use for cystitis, powder, dosage
Monural instructions for use for cystitis, powder, dosage
Dosage
For adult patients it is 3 g of the drug at a time. In case of a complex course of the disease, the urologist may prescribe the patient a second dose of Monural in the same amount every other day. Children are prescribed 2 g of medication.
Most often, the need to use the drug twice occurs in cases of recurrent bacterial infections or lack of recovery after the first dose of the medication. Persons over 60 years of age may also be prescribed a two-day course of treatment.
In order to prevent the penetration of infections into the urinary system at the time of urological operations and diagnostic procedures, the medicine is taken twice - before the planned intervention and one day after the first use.
special instructions
The instructions for use of Monural indicate its special instructions for use. Some excerpts from the paragraph:
- Patients with diabetes need to remember that one package of granules contains 2.1-2.213 g of sucrose.
- The absorption of the active component of the drug slows down when eating at the same time, so you need to drink the solution on an empty stomach.
- Often, the use of broad-spectrum antibiotics, including Monural, can cause antibiotic-associated or pseudomembranous colitis. Its manifestation is indicated by severe diarrhea during or after use. If the diagnosis is confirmed, symptomatic therapy is prescribed. During treatment, drugs that inhibit intestinal motility are prohibited.
