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Monurol Side Effects

Generic name: fosfomycin

Medically reviewed by Last updated on Jul 24, 2023.

Note: This document contains side effect information about fosfomycin. Some dosage forms listed on this page may not apply to the brand name Monurol.

Applies to fosfomycin: oral powder for solution.

Serious side effects of Monurol

Along with its needed effects, fosfomycin (the active ingredient contained in Monurol) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking fosfomycin:


Incidence not known

Other side effects of Monurol

Some side effects of fosfomycin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Less common


Incidence not known

For Healthcare Professionals

Applies to fosfomycin: oral granule for reconstitution, oral powder for reconstitution.


Very common (10% or more): Diarrhea (up to 10.4%)

Common (1% to 10%): Nausea, abdominal pain, dyspepsia, retching, stomach ache

Uncommon (0.1% to 1%): Abnormal stools, constipation, dry mouth, flatulence, vomiting

Frequency not reported: Pseudomembranous colitis

Postmarketing reports: Toxic megacolon, antibiotic-associated colitis, oral paresthesias (temporary tingling of mouth, tongue, cheek)[Ref]

Nervous system

Very common (10% or more): Headache (up to 10.3%)

Common (1% to 10%): Dizziness

Uncommon (0.1% to 1%): Dysgeusia, paresthesia, migraine, somnolence, vertigo

Postmarketing reports: Hearing loss, temporary alterations of taste (dysgeusia, hypogeusia)[Ref]


Common (1% to 10%): Vaginitis, dysmenorrhea, vulvovaginitis

Uncommon (0.1% to 1%): Hematuria, dysuria, menstrual disorder[Ref]


Common (1% to 10%): Pain, asthenia, injection site phlebitis

Uncommon (0.1% to 1%): Fatigue, infection, ear disorder, fever, influenza syndrome

Frequency not reported: Facial edema[Ref]


Very rare (less than 0.01%): Anaphylactic shock

Postmarketing reports: Anaphylaxis, anaphylactic reactions (including anaphylactic shock), hypersensitivity[Ref]


Common (1% to 10%): Rhinitis, pharyngitis

Uncommon (0.1% to 1%): Dyspnea

Frequency not reported: Asthmatic attack

Postmarketing reports: Asthma, exacerbation of asthma[Ref]


Angioedema has also been reported during postmarketing experience.[Ref]

Common (1% to 10%): Rash

Uncommon (0.1% to 1%): Pruritus, skin disorder, urticaria

Frequency not reported: Angioedema[Ref]


Common (1% to 10%): Back pain

Uncommon (0.1% to 1%): Myalgia[Ref]


Uncommon (0.1% to 1%): Anorexia, decreased appetite, hypernatremia and/or hypokalemia, increased alkaline phosphatase[Ref]

Increased alkaline phosphatase was generally transient and not clinically significant.[Ref]


Uncommon (0.1% to 1%): Lymphadenopathy

Rare (0.01% to 0.1%): Aplastic anemia, eosinophilia

Frequency not reported: Agranulocytosis, granulocytopenia, leukopenia, pancytopenia, thrombocytopenia, increased eosinophil count, increased or decreased white blood cell count, increased and decreased platelet count, decreased hematocrit, decreased hemoglobin[Ref]

Increased eosinophil count, increased or decreased white blood cell count, increased and decreased platelet count, decreased hematocrit, and decreased hemoglobin were generally transient and not clinically significant.

Aplastic anemia has also been reported during postmarketing experience.[Ref]


Fatty liver was completely reversible after IV fosfomycin (the active ingredient contained in Monurol) was discontinued.

Increased bilirubin, increased ALT, and increased AST were generally transient and not clinically significant.[Ref]

Uncommon (0.1% to 1%): Increased ALT, increased AST

Very rare (less than 0.01%): Fatty liver

Frequency not reported: Increased bilirubin, hepatitis, cholestatic hepatitis, icterus

Postmarketing reports: Cholestatic jaundice, hepatic necrosis[Ref]


Uncommon (0.1% to 1%): Tachycardia

Postmarketing reports: Hypotension[Ref]


Uncommon (0.1% to 1%): Insomnia, nervousness

Frequency not reported: Confusion[Ref]


Very rare (less than 0.01%): Visual impairment

Frequency not reported: Unilateral optic neuritis[Ref]

Frequently asked questions


1. Jardin A. A general practitioner multicenter study: fosfomycin trometamol single dose versus pipemidic acid multiple dose. Infection. 1990;18(suppl 2:s89-93.

2. Naber KG, Thyroff-Friesinger U. Fosfomycin trometamol versus ofloxacin/co-trimoxazole as single dose therapy of acute uncomplicated urinary tract infection in females: a multicentre study. Infection. 1990;18(suppl 2:s70-6.

3. de Jong Z, Pontonnier F, Plante P. Single-dose fosfomycin trometamol (Monuril) versus multiple-dose norfloxacin: results of a multicenter study in females with uncomplicated lower urinary tract infections. Urol Int. 1991;46:344-8.

4. Product Information. Monurol (fosfomycin). Forest Pharmaceuticals. 2001.

5. Cerner Multum, Inc. UK Summary of Product Characteristics.

6. Rosales MJ, Vega F. Anaphylactic shock due to fosfomycin. Allergy. 1998;53:905-7.

Further information

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

Some side effects may not be reported. You may report them to the FDA.