Monural: instructions for use in children and adults, powder composition, analogues
Monural powder for cystitis treatment – instructions
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Monural is a modern, broad-spectrum phosphomycin-based antibacterial agent. The drug is used to control inflammatory processes of urinary tract, prevent exacerbation of chronic pathologies. Additional ingredients – mandarin or orange flavor, sugar and sucrose.
Form of production – small white granules that dissolve quickly in water. The drug is packed in multi-layer paper sachets of 2 or 3 g, in a cardboard box is 1-2 units of medicine. Pills, suspensions, injectable solutions do not release the drug. The average price – 420-550 rubles, depending on the dosage. You can buy it at the pharmacy by prescription.
Vazhno! Monural contains sucrose, which should be considered for people with diabetes.
Monural medicine is effective against Gram-positive and Gram-negative bacteria, which cause the development of inflammatory processes of the urinary system, affects even pathogenic microorganisms that are resistant to other antibacterial drugs.
That's why the antibiotic helps:
- cystitis in the acute phase, exacerbation of the chronic form of the disease;
- the inflammation of the urinary tract of acute and chronic nature;
- abundant bacteriuria – release of pathogenic microorganisms with urine;
- Urinary tract inflammation after surgery;
- for the prevention of infectious complications after surgery or diagnostic activities;
- as part of a comprehensive therapy for pyelonephritis.
It's important! Monural's a fast-paced drug. After ingestion it is easily absorbed in the digestive tract. The maximum concentration of active substance in urine is observed after 2 hours. The drug is in the body for about 48 hours, which allows you to get rid of the main signs of inflammation, is mainly excreted by the kidneys.
Montural granules are designed for oral use. Which water does the drug need to be dissolved in? The medicine should be diluted in 70 ml of purified non-carbonated water at room temperature.
How to take it? After the pellets in one bag have dissolved completely, the drink should be drunk 2 hours after the meal so as not to slow down the absorption process in the body. The medicine is better to drink before going to bed, after emptying the bladder. One dose for adults – 3 g, for children – 2 g. In case of renal failure it is necessary to reduce the dosage.
How many packets do you need per course? Usually, a single dose of Monural antibiotics is enough to eliminate the inflammation. Can I take two bags at once? Exceeding the recommended dosages is not allowed, it will not lead to a speedy recovery, but may cause strong side effects.
Can I drink 2 times? The doctor may decide to take the drug again, but you should not make this decision yourself.
- frequent relapses of bacterial infections in chronic cystitis, urethritis;
- severe forms of disease;
- non-therapeutic effect after the first use of the drug.
Twice you need to take the Monural and for the prevention of infectious complications after surgery or diagnostic activities – 3 hours before the procedure and 24 hours after the first dose of medication. How long before the cystitis goes away after taking the antibiotic? All negative symptoms disappear within 1-2 days.
Essential! Children over 5 years of age are prescribed the drug once, regardless of the severity of the inflammatory process.
Monural in pregnancy and lactation
Because of weakened immunity, urinary tract inflammation in pregnant women is often diagnosed. Monural should be used with caution when pregnant.
Physician can prescribe it only because there is no reliable data on the effect of antibiotics on pregnancy, but it has been shown that the active ingredient can penetrate the placental barrier.
Therefore, Monural can only be taken if the effect of therapy significantly exceeds the possible risks to the fetus.
If it is necessary to take the antibacterial drug during lactation, breastfeeding should be stopped for 48 hours, because the active substance penetrates into the breast milk.
Importantly! If during pregnancy there was an exacerbation of chronic cystitis, then Monural may not help. It needs to be combined with other drugs.
Negative reactions during Monural treatment are rare when the instructions for use are followed. The most common dyspeptic disorders are heartburn, diarrhoea, nausea and vomiting. Allergic reactions in the form of itching and rash may occur in case of hypersensitivity to the ingredients. Overdose increases the severity of all the negative symptoms.
Antibiotic Monural is a modern and safe tool with minimal contraindications. The drug should not be given to children under 5 years of age, because at this age, the system of filtration in the kidneys is not yet sufficiently developed, patients with severe renal failure and individual intolerance to the components of the drug.
Monural can not be taken simultaneously with Metoklopramid, because the anti-emetics reduces the concentration of active substance in the plasma and urine, the effect of therapy will be minimal.
Importantly! For 48 hours after taking Monural, you should refrain from drinking any alcoholic beverages.
What to do if Monural didn't help? If there is no effect, even after repeated administration of antibiotics, the doctor will select a drug with similar therapeutic effect. Structural analogues of the drug are Urophosphabol, Fosmicin, Monuril.
What to replace Monural:
Name of the drug Characteristics Price (rub.) Furadonin Antimicrobial tablets 110-170 Nolicin Antibiotic from the fluoroquinolone group 200 Nitroxolin Antimicrobial tablets 100-150
Monural or Nolitsyn – what is better? Nolicin has a wider range of effects. It is prescribed for various diseases of the upper and lower urinary tract, is cheaper than Monural. But Nolitsyn needs to be drunk from 3-5 days to several weeks, while Monural is taken once, the drug is categorically contraindicated to children and pregnant women.
Monural is a modern effective antibiotic that is used to treat various forms of cystitis and urethritis. It is enough to take the medicine once to get rid of the unpleasant symptoms of the disease. Before starting treatment, it is necessary to study the abstract, not to exceed the recommended dosages, in order to avoid the development of severe consequences of therapy.
Monural – instructions for use for children and adults, active ingredient, contraindications and feedback
Annotation to the medicinal powder Monural – the instructions for use – warns of possible side effects when taking the drug in the form of diarrhoea, heartburn and nausea.
Also the information leaflet describes the mechanism of action of modern antibiotics of new generation.
Treatment of bladder infections with the help of antibacterial preparations, but it is necessary to keep in mind their negative influence on the stomach microflora.
Antibiotics of the group of phosphonic acid derivatives, to which Monural belongs, have a wide antibacterial spectrum of action.
Effect after taking phosphomycin-based drugs is rapid, so their use in the treatment of urinary tract diseases relieves the unpleasant symptoms of the disease after the first use of the drug.
According to the instructions, the drug has antibacterial properties that are due to its ability to reach high concentrations in the urine.
Phosphomycin concentration is detrimental to 99% of bladder bacterial infections, so this group of antibiotics is effective for severe, acute infections. Probiotics are recommended to prevent the side effects of antibiotic drugs, but not earlier than one day after Monural.
Monural composition and form
Monural is produced in the form of pellets (compressed powder), packaged in paper bags, the inner part of which is laminated with polyethylene.
Thanks to this type of packaging, pellets retain their properties.
The suspension obtained by dissolving the powder is quickly absorbed after entering the gastrointestinal tract, which provides a higher start rate than the tablets.
Information about granule composition is given in the instructions for use, a brief description is given in the table:
name Number, gram Description, prescription Tromethamol phosphomycin (in t.ч. phosphomycin – 53%) 3,754 or 5,631 The main active ingredient, an analogue of a liaze-class enzyme that catalyzes the reaction of cleavage, resulting in an antiadhesive effect (the property of bacteria to stick to the epithelium of the urogenital tract is lost) Aromatizers (orange, mandarin) Flavor improvement. They are obtained in a natural way by extraction of essential oils from orange and mandarin peels Saharin Sugar surrogate, gives the drug a pleasant taste Saccharose Disaccharide, consisting of fructose and glucose, a natural sweetener
Antibacterial effect of Monural is achieved by suppressing the initial stage of the process of mureinobrazovaniya (synthesis of the shells of bacterial walls). Phosphomycin reduces the ability of attracting a number of bacteria to the epithelium lining the urinary tract.
This effect is achieved by blocking the condensation of the main structural element of pathogenic microorganisms (uridindiphosphate-N-acetylglucosamine). These reactions ensure that there is no cross-resistance with other antibiotics classes.
The directions for use of the drug indicate that the spectrum of the bactericidal action of phosphomycin extends to the majority of Gram-positive bacteria that cause infectious diseases.
The concentration of Monural required to inhibit infectious agents is maintained for at least 80 hours, then excreted virtually unchanged with the urine, without contacting the blood plasma proteins.
Monural: instructions for use, analogues and reviews, prices in pharmacies in Russia
Monural is a new generation antibiotic with high antimicrobial activity. The drug has a good bactericidal effect, which is applicable to most gram-positive (enterococcus, staphylococcus) and gram-negative (cytobacteria, enterovirus, klebsiella, morganella, proteus, pseudomonas) pathogens.
The drug is a broad-spectrum antibiotic derived from phosphonic acid, has a bactericidal effect, the mechanism of which is associated with the suppression of the first stage of bacterial cell wall synthesis. It is a structural analogue of pyruvate phosphoenol, enters into a competitive interaction with the enzyme N-acetyl-glucosamine-3-o-enolpyruvil-transferase.
The result is a specific, selective and irreversible inhibition of this enzyme, which ensures the absence of cross-resistance to other classes of antibiotics and the possibility of synergies with other antibiotics (in vitro note the synergies with amoxicillin, cephalexin, pipemide acid).
A single dose of 3 g in urine achieves a high concentration (from 1053 to 4415 mg/l), 99% bactericidal for most common urinary tract infections. MPC (128 mg/l) is maintained in urine for 24-48 hours (which implies a course of treatment with one tablet).
Monural is produced in the form of granules to prepare a solution for oral administration: white, with a tangerine smell (2 or 3 g in laminated multi-layer bags, 1 or 2 packages in a cardboard pack). The composition of 1 g of granules includes:
- active substance: phosphomycin – 2 or 3 g (in the form of phosphomycin thrommetamol – 3,754 or 5,631 g, respectively);
- Auxiliary components: saccharine, mandarin and orange flavors, sucrose.
Phosphomycin is quickly absorbed from the intestine, Cmax in plasma is observed after 180 minutes (30-35 µg/ml). The half-life of the drug is 2 hours. It is eliminated by kidneys in unchanged (not metabolized), biologically active form due to glomerular filtration (90%). The remaining 10% are excreted with faeces.
Monural is accumulated mainly in renal tissue (concentration – 2500 – 3500 µg/ml at a minimum overwhelming concentration for E. coli 128 µg/ml).
The drug is relatively safe because it has a rather specific effect on bacterial enzymes, so it does not have cross drug resistance (a condition in which the resistance of pathogens to a single drug extends to related products).
What does the Monural help with? Prescribe an antibiotic for the following diseases or conditions:
- acute bacterial cystitis;
- acute attacks of recurrent bacterial cystitis;
- bacterial nonspecific urethritis;
- unsymptomatic massive bacteriuria in pregnant women;
- postoperative urinary tract infections;
- Prophylaxis of urinary tract infections during surgical intervention and transurethral diagnostic tests.
Monural and dosage instructions
The drug is taken orally on an empty stomach, 2 hours before a meal or 2 hours after a meal (preferably before bedtime), once a day, after emptying the bladder. Immediately before taking the contents of the package dissolved in 1/3 of a glass of water.
Adult Monural administered in a dose of 3 g (phosphomycin) once. If necessary (e.g. for elderly people, in case of recurrent or severe infections), the drug can be taken again after 24 hours in the same dose.
For the prevention of urinary tract infection, the drug is taken in a dose of 3 g 3 hours before surgery or transurethral diagnostic procedures, and in the same dose 24 hours after the first dose.
For children over 5 years of age, prescribe 2 g of phosphomycin once. Kidney failure patients are reduced or the interval between doses is increased.
In case of kidney failure, the dose is reduced and the intervals between doses are lengthened.
Monural is clinically proven to be effective in treating cystitis. The drug destroys most of the bacteria that cause the disease. In addition to its bactericidal properties, it can reduce the ability of microorganisms to fix themselves on the walls of the bladder.
In the treatment of acute cystitis, Monural needs to be used immediately to prevent the disease from becoming chronic. In case of exacerbation, it is necessary to use antibiotics in the first day. The antibacterial effect of the drug affects the entire urinary tract, not just the bladder.
- This should be avoided concomitantly with methoclopramide, as it may lead to a decrease in the concentration of Monural in serum and urine.
- A simultaneous meal slows down the absorption of Monural, so it is necessary to use the drug 2 hours before or after the meal.
- Bolny diabetes mellitus should be taken into account that 1 package of Monural 2 g contains 2.1 g of sucrose, and 3 g of Monural contains 2.213 g of sucrose.
High safety of the product minimizes undesirable consequences of its use. But Monural can still provoke side effects, because it belongs to the group of antibiotic drugs. Patients most often experience:
- allergies (itching and redness of the skin, swelling of the mucous membranes);
- nausea, vomiting, heartburn;
- intestinal disorder.
In case of unpleasant reactions, it is recommended to drink a few glasses of water: this will help the active substance to leave the gastrointestinal tract more quickly, which will make the condition easier.
In case of allergies, you can take the antihistamine preparation.
Monural in pregnancy
According to the instructions, the drug may be used in pregnancy if necessary. Although animal studies have not shown that the drug may harm the fetus, it should be remembered that even safe medication is undesirable at an early stage.
In 2 trimesters and 3 trimesters, the medicine is taken according to a standard scheme: 1 sachet of 3 g and then another one – one day after the first dose.
If it is necessary to stop breastfeeding during lactation.
Monural Analogues, Drug List
If necessary, the Monural can be replaced by analogues by field of application, the list of drugs:
When choosing analogues, it is important to understand that the Monural instructions for use, price, and feedback do not apply to medicines with similar effects. It is important to consult a doctor and not to make an independent replacement of the drug.
In contrast to many antibiotics that exhibit bacteriostatic action (inhibit the growth of microorganisms), the drug Monural disrupts the synthesis of the cell wall, harmful bacteria die.
Most urologists consider a phosphomycin-based antibiotic the most effective drug for acute cystitis.
A wide range of actions allows it to be used in severe cases of infectious disease, even before the results of the test for sensitivity to antibiotics.
Average price of Monural in the pharmacy chain: 360 – 500 rubles.
Store in a place inaccessible to children in normal conditions. Shelf life – 3 years.
Monural: instructions for use, analogues, reviews, prices
Monural belongs to the next generation of antibiotics. The drug has high antimicrobial and antibacterial activity. Effective in a number of diseases caused by microorganisms, gram-positive and gram-negative bacteria, but most often prescribed for urinary tract infections, such as cystitis of various etymologies.
- Form and composition of the monural, analogues of the drug
- Pharmacodynamics and pharmacokinetics
- Monural: indications
- Relimitations and contraindications
- Method of administration and dosage
- Probable side effects
- Interaction with other drugs
- Monural: Cystitis reviews
- Monural in pregnancy: reviews
- Conditions, shelf life, price
Form and composition of monural, analogues of the drug
Active substance: trometamol phosphomycin, which is a derivative of phosphonic acid. Additional components: sucrose and saccharine. In industrial production, citrus flavouring is added for taste.
Active substance and sucrose in one sachet by 2 and 3 grams is distributed as follows:
- Monural, 2 g: phosphomycin – 3.755 g, sucrose – 2.100 g
- Monural, 3 g: phosphomycin – 5.632 g, sucrose – 2.212 g.
The form of the drug is a white granule with a distinctive smell. In drugstores it is sold in the form of the powder packed in the sealed foil bags “sachets” on 2 or 3 gramme.
Tablet forms at present are not present. The powder is much more effective than the tablet when absorbed into cells and tissues. Before use, the drug is diluted with water according to the instructions for use.
Youngness up to 36 months from the date of manufacture. Produced by the Zambon group of Swiss and Italian affiliated structures. Numerous pharmaceutical studies and patient testimonials prove its therapeutic efficacy in 90% of cases and safety in 98% of cases.
The following drugs are considered to be monural analogues:
- sodium phosphomycin;
- tromethamol phosphomycin
Particles with similar therapeutic effects but different compositions are as follows:
Pharmacodynamics and pharmacokinetics
Monural belongs to the group of phosphonic acid antibiotics for a wide range of applications. The mechanism of its effect on pathogenic flora is to suppress the synthesis of bacterial cell tissue.
Monural effectively copes with a number of pathogens, preventing their reproduction and impact on the human body. These include both aerobic gram-negative and aerobic gram-positive: Morganella Morgan, Klebsiella, Proteus Mirabilis, Proteus Vulgaris, Escherichia coli, Citrobacteres, Pseudomonads, Enterococcus, Staphylococcus, Streptococcus.
At the time of the test it was noted that the environment created by the active substance phosphomycin is fatal for 98% of infectious agents causing infections of the urogenital system.
The property of monural to enter into irreversible inhibition with the enzyme of transferase provides it with no cross-resistance with antibiotics of other groups, which allows during treatment with the drug if necessary to strengthen its effect with amoxicillin-type antibiotics.
Maximum concentration of phosphomycin in plasma is reached 2.5-3 hours after administration. Monural does not give chemical reaction of binding to plasma proteins, at the same time provides high solubility in lipids.
This promotes good penetration of the drug into organs and tissues. The concentration remains high for two days, which allows you to actively remove the pathogenic flora from the body with only small doses of drugs.
Absorbed quickly. A significant part of the drug is excreted with urine, and less – up to 20% – with faeces.
The drug contains sucrose and saccharine – substances that are undesirable for people with high blood sugar index.
Monural: indications for use
Wide spectrum of action associated with exposure to urinary tract microorganisms, allows the drug to be used in the treatment of severe and moderate cases of the following diseases in men and women:
- acute and chronic forms of bacterial cystitis;
- pyelonephritis; in tonnesч. its gestational form in pregnant women;
- urinary tract inflammation and urethritis;
- asymtomatic bacteriuria;
- genital infections, including cervicitis and endometritis;
for prophylaxis purposes prior to certain transurethral procedures, such as cystoscopy of the bladder.
Constraints and contraindications
This is to be taken into account that the drug is selected with special care for people from the following risk groups:
- in diabetes mellitus or blood glucose above 6.2 mmol/l;
- in kidney failure in creatinine clearance index below 10 ml/min.
In the presence of these diseases, monural is possible to use, but only after careful laboratory tests of blood/ urine composition and with direct consultation of nephrologist and / or endocrinologist.
Special conditions of taking Monural powder are preserved for women during pregnancy. Phosphomycin can penetrate the placenta and affect the development of the fetus. Therefore, when prescribing the drug for pregnant and lactating women, first of all, it is necessary to assess the risk of using the drug and the possible effect of its treatment. If the risk is greater than the effect, it is better to abstain from the monural
for prophylaxis purposes prior to certain transurethral procedures, such as cystoscopy of the bladder.