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Fosfomycin Disease Interactions

There are 3 disease interactions with fosfomycin.


Antibiotics (applies to fosfomycin) colitis

Major Potential Hazard, Moderate plausibility. Applicable conditions: Colitis/Enteritis (Noninfectious)

Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.


  1. "Product Information. Omnipen (ampicillin)." Wyeth-Ayerst Laboratories PROD (2002):
  2. "Product Information. Ceftin (cefuroxime)." Glaxo Wellcome PROD (2002):
  3. "Product Information. Zinacef (cefuroxime)." Glaxo Wellcome PROD (2002):
  4. "Product Information. Cleocin (clindamycin)." Pharmacia and Upjohn PROD (2002):
  5. "Product Information. Macrobid (nitrofurantoin)." Procter and Gamble Pharmaceuticals PROD (2002):
  6. "Product Information. Macrodantin (nitrofurantoin)." Procter and Gamble Pharmaceuticals PROD (2002):
  7. "Product Information. Amoxil (amoxicillin)." SmithKline Beecham PROD (2001):
  8. "Product Information. Merrem (meropenem)." Astra-Zeneca Pharmaceuticals PROD (2001):
  9. "Product Information. Coly-Mycin M Parenteral (colistimethate)." Parke-Davis PROD (2001):
  10. "Product Information. Lincocin (lincomycin)." Pharmacia and Upjohn PROD (2001):
  11. "Product Information. Cubicin (daptomycin)." Cubist Pharmaceuticals Inc (2003):
  12. "Product Information. Xifaxan (rifaximin)." Salix Pharmaceuticals (2004):
  13. "Product Information. Doribax (doripenem)." Ortho McNeil Pharmaceutical (2007):
  14. "Product Information. Penicillin G Procaine (procaine penicillin)." Monarch Pharmaceuticals Inc (2009):
  15. "Product Information. Vibativ (telavancin)." Theravance Inc (2009):
  16. "Product Information. Teflaro (ceftaroline)." Forest Pharmaceuticals (2010):
  17. "Product Information. Penicillin G Sodium (penicillin G sodium)." Sandoz Inc (2022):
  18. "Product Information. Dalvance (dalbavancin)." Durata Therapeutics, Inc. (2014):
  19. "Product Information. Orbactiv (oritavancin)." The Medicines Company (2014):
  20. "Product Information. Bicillin C-R (benzathine penicillin-procaine penicillin)." A-S Medication Solutions (2017):
  21. "Product Information. Baxdela (delafloxacin)." Melinta Therapeutics, Inc. (2017):
  22. "Product Information. Polymyxin B Sulfate (polymyxin B sulfate)." AuroMedics Pharma LLC (2022):
  23. "Product Information. Zemdri (plazomicin)." Achaogen (2018):
  24. "Product Information. Seysara (sarecycline)." Allergan Inc (2018):
  25. "Product Information. Nuzyra (omadacycline)." Paratek Pharmaceuticals, Inc. (2018):
  26. "Product Information. Aemcolo (rifamycin)." Aries Pharmaceuticals, Inc. (2018):
  27. "Product Information. Fetroja (cefiderocol)." Shionogi USA Inc (2019):
  28. "Product Information. Biaxin (clarithromycin)." AbbVie US LLC SUPPL-61 (2019):
  29. "Product Information. Zithromax (azithromycin)." Pfizer U.S. Pharmaceuticals Group LAB-0372-7.0 (2021):
  30. "Product Information. E.E.S.-400 Filmtab (erythromycin)." Arbor Pharmaceuticals SUPPL-74 (2018):
  31. "Product Information. Priftin (rifapentine)." sanofi-aventis SUPPL-18 (2020):
  32. "Product Information. Xerava (eravacycline)." Tetraphase Pharmaceuticals, Inc (2021):
  33. "Product Information. Xacduro (durlobactam-sulbactam)." La Jolla Pharmaceutical ORIG-1 (2023):
  34. "Product Information. Exblifep (cefepime-enmetazobactam)." Allecra Therapeutics ORIG-1 (2024):
  35. "Product Information. Maxipime (cefepime)." Hospira Inc SUPPL-46 (2021):
View all 35 references

Fosfomycin (applies to fosfomycin) hemodialysis

Moderate Potential Hazard, High plausibility.

Fosfomycin is removed by hemodialysis and should be administered after dialysis sessions.


  1. Fernandez Lastra C, Marino EL, Dominguez-Gil A, Tabernero JM, Grande Villoria J "Pharmacokinetics of phosphomycin during haemofiltration." Br J Clin Pharmacol 17 (1984): 477-80
  2. Dalet F, Bade G, Roda M "Pharmacokinetics of fosfomycin during hemodialysis." Chemotherapy 23(suppl 1 (1977): 210-6
  3. Revert L, Lopez J, Pons J, Olay T "Fosfomycin in patients subjected to periodic hemodialysis." Chemotherapy 23(suppl 1 (1977): 204-9
  4. Bouchet JL, Quentin C, Albin H, Vincon G, Guillon J, Martin-Dupont P "Pharmacokinetics of fosfomycin in hemodialyzed patients." Clin Nephrol 23 (1985): 218-21
  5. "Product Information. Monurol (fosfomycin)." Forest Pharmaceuticals PROD (2001):
View all 5 references

Fosfomycin (applies to fosfomycin) renal dysfunction

Minor Potential Hazard, Moderate plausibility.

Fosfomycin is eliminated unchanged by the kidney (38%) and in the feces (18%). The excretion of fosfomycin is significantly decreased and the half-life prolonged in patients with compromised renal function. Side effects (e.g., diarrhea, headache, nausea, vaginitis) may be prolonged in patients with renal impairment.


  1. Gobernado M, Garcia J, Santos M, Panadero J, Diosdado N "Renal insufficiency and fosfomycin." Chemotherapy 23(suppl 1 (1977): 200-3
  2. "Product Information. Monurol (fosfomycin)." Forest Pharmaceuticals PROD (2001):

Fosfomycin drug interactions

There are 12 drug interactions with fosfomycin.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.