Fosfomycin 3g sachets – a reminder

Fosfomycin is a broad spectrum antibiotic, used for the treatment of lower UTIs due to ESBL (extended spectrum beta-lactamase) producing bacteria.

Fosfomycin should only be prescribed on the advice of a microbiologist

A licensed 3g fosfomycin sachet, for the treatment of urinary tract infection on the recommendation of a microbiologist, is now available in the branded form of Monuril®.

This is the only marketed brand of Fosfomycin 3g sachet currently available in the UK, licensed for the treatment of acute lower uncomplicated urinary tract infections, caused by pathogens sensitive to fosfomycin in adults and adolescent females.

Fosfomycin 3g sachets are not yet listed in Part V111 of the drug tariff and there is therefore no consistent standard pricing when prescribed generically. Currently if fosfomycin is prescribed generically the cost of dispensing varies enormously, and there is a risk that an unlicensed “special” is supplied and endorsed.

Prescribing fosfomycin as Monuril® is currently considerably more cost-effective than prescribing it generically.

The price of Monuril® is currently £4.86 for one sachet.  The current average cost across the North East & Cumbria, for generic prescriptions of fosfomycin based on prescribing data (Sept 15 – Aug 16), is £83.00 per item.

When fosfomycin is required, on microbiology advice, please therefore prescribe as Monuril® until notified further.

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