Uses of Fosfomax: - Bacterial infections of urinary tract Uncomplicated urinary tract infections (acute cystitis), Prostatitis Hypersensitivity to fosfomycin.

Intracellular antibiotic

Fosfomycin is a broad spectrum antibiotic that concentrates in kidney and bladder and is used to treat uncomplicated urinary tract infections. Fosfomycin also reduces nephrotoxicity and ototoxicity of platinum-containing anti-tumor agents.Fosfomycin is a phosphoenolpyruvate analogue produced by Streptomyces that irreversibly inhibits enolpyruvate transferase (MurA), which prevents the formation of N-acetylmuramic acid, an essential element of the peptidoglycan cell wall.

How to use Fosfomycin: Take this medicine in the dose and duration as advised by your doctor. Check the label for directions before use. Empty the granules in a glass of water/milk, stir it and consume immediately. Fosfomycin is to be taken empty stomach. Administration: Reconstitution: Oral powd: Dissolve the contents of a single-dose sachet containing 3 g of the drug in 90-120 ml (half cup) of water of water and stir to dissolve. Do not use hot water. This should be taken immediately after dissolving in water. Do not use hot water. Should be taken on an empty stomach. Take on an empty stomach 1 hr before or 2 hr after meals. Adult Dose: Oral Urinary Tract Infection (Acute Cystitis) Acute cystitis caused by E. coli, E. faecalis Women >18 years: 1 sachet (3 g) PO once Males >18 years: 1 sachet (3 g) every 2-3 days for 3 doses Prostatitis 3 g PO every 3 days for 21 days Renal Dose: Renal impairment: No dosage adjustment needed.

Additive or synergistic effect w/ β-lactam antibiotics (e.g. penicillin, ampicillin, cefazolin, carbapenems) and anti-staphylococcal agents (e.g. linezolid, quinupristin/dalfopristin, moxifloxacin). Reduced serum levels w/ drugs which increase GI motility (e.g. metoclopramide).

Hypersensitivity to fosfomycin.

Common - Headache - Dizziness - Vaginal inflammation 1-10% Anorexia,Diarrhea,Epigastric,Discomfort,Headache,Nausea,Rash,Vomiting <1% Dizziness,Drowsiness,Fatigue,Pruritus Potentially Fatal: Anaphylactic shock, antibiotic-associated colitis and pseudomembranous colitis.

Pregnancy Category B. It is not known whether fosfomycin tromethamine is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from Fosfomycin, a decision should be made whether to discontinue nursing or to not administer the drug, taking into account the importance of the drug to the mother.

Precaution: Patient w/ cardiac insufficiency, HTN, hyperaldosteronism, hypernatraemia or pulmonary oedema. Renal impairment (IV). Pregnancy and lactation. Patient Counseling Certain adverse effects may occur which may impair ability to drive or operate machinery. Monitoring Parameters Monitor serum electrolyte levels and water balance; signs and symptoms of UTI. Do not use more than one single dose to treat a single episode of acute cystitis. Sometimes after starting treatment with antibiotics, patients can develop watery and bloody stools (with or without stomach cramps and fever) even as late as two or more months after having taken the last dose of the antibiotic. Lactation: excreted in breast milk; not recommended

In acute toxicology studies, oral administration of high doses of Fosfomycin up to 5 gm/kg were well-tolerated in mice and rats, produced transient and minor incidences of watery stools in rabbits, and produced diarrhea with anorexia in dogs occurring 2-3 days after single dose administration. These doses represent 50-125 times the human therapeutic dose.The following events have been observed in patients who have taken Fosfomycin in overdose: vestibular loss, impaired hearing, metallic taste, and general decline in taste perception. In the event of overdosage, treatment should be symptomatic and supportive.

Store at 25°C; excursions permitted to 15-30°C.

Fosfomycin is a phosphoenolpyruvate (PEP) analogue that irreversibly inhibits enolpyruvate transferase (MurA), which prevents peptidoglycan biosynthesis at an earlier site compared to β-lactams with no cross-resistance with other agents. Thus, it inhibits bacterial cell wall biogenesis & shows bactericidal effects.

Pregnancy Category: B Lactation: excreted in breast milk; not recommended