Monurol (fosfomycin trometamol) is an antibiotic given for uncomplicated acute cystitis in women as a single sachet taken as one dose. The dose is set by your doctor or pharmacist. Dissolve it in half a glass of cold water and drink it immediately on an empty stomach. It takes 2–3 days to work. It is not enough on its own if you have fever or flank pain, if you are pregnant, if you are a man, or if the infection keeps coming back.
What is Monurol and when is it prescribed?
Monurol is listed in the ClinicsJo directory as Monurol. Its active ingredient is fosfomycin trometamol. It comes as a powder in a 3-gram sachet, and the directory indicates that it is available in Jordan.
According to the directory, the drug is prescribed in the following cases:
- Uncomplicated acute cystitis in women, as a single dose.
- Selected cases of bacteria in the urine that are resistant to several antibiotics. A specialist decides on these cases, and repeated doses may be used.
- Prevention before certain procedures performed on the urinary tract.
Fosfomycin belongs to the "epoxide" class of antibiotics and works by killing the bacteria that cause the infection. MedlinePlus notes that it is used to treat urinary tract infections in certain cases [1]. This page discusses the intravenous form (injection), which differs from the oral sachet discussed in this article. The single-dose and oral use information comes from the drug directory.
Medicines in Jordan, including their advertised prices, are regulated by the Jordan Food and Drug Administration (JFDA). Therefore, get your medicine from a licensed pharmacy, and ask the pharmacist about any detail that is unclear to you.
How do I know whether what I have is a bladder infection?
Cystitis is a type of urinary tract infection. The urinary tract also includes the urethra and kidneys [2]. Common symptoms include:
- Pain or burning when urinating.
- Needing to urinate more than usual, at night, or with sudden urgency.
- Cloudy urine or urine containing blood.
- Pain in the lower abdomen [2].
These symptoms are very common. Urinary tract infections are the second most common type of infection in the body, and they affect women about four times as often as men [3]. The NHS explains this by the fact that the urethra in women is shorter, so bacteria can reach the bladder or kidneys more easily [2].
Not every pain in the bladder is a bacterial infection. Pain can persist with negative test results. You can read an explanation in the article on interstitial cystitis and in the FAQ on the difference between interstitial cystitis and urinary tract infection. For a broader list, see common symptoms of bladder conditions. You can also read more about urinary tract infection and the bladder.
How do I use Monurol step by step?
These are general steps taken from the drug directory. Your doctor's or pharmacist's instructions remain the reference for your case. Do not start or stop any antibiotic on your own.
- Dose: One sachet (3 grams) as a single dose. This is the usual dose set by your doctor or pharmacist. Do not repeat it unless they direct you to.
- Timing: On an empty stomach, or two to three hours after eating, because food delays the absorption of the drug and weakens it.
- Preparation: Dissolve the contents of the sachet in half a glass of cold water. Do not use hot water.
- Drinking: Drink the solution immediately after dissolving it.
- Other medicines: Tell your pharmacist about everything you are taking. Metoclopramide (Primperan) speeds up intestinal movement, which reduces the absorption of Monurol, so they should not be taken at the same time.
If you vomit after the dose, or if you are unsure whether you took the full dose, contact your pharmacist or doctor. Do not repeat the sachet on your own.
Note that a single dose differs from antibiotics taken for several days. With the latter, the full course must be completed even if you feel better, because stopping early may leave the infection without full treatment and bacteria may become resistant [1][2]. With Monurol, the full dose is one sachet.
What should I expect after the dose?
The drug takes 2–3 days to work, so do not judge it by the morning after. The burning may gradually ease during this period.
Side effects are usually mild and short-lived. According to the drug directory, they include:
- Temporary diarrhea, which is the most common.
- Mild nausea and headache.
- Possible dizziness on the day of the dose.
- Rare skin reactions.
MedlinePlus lists nausea, vomiting, diarrhea, and headache for intravenous fosfomycin. It warns that watery diarrhea with abdominal cramps and fever requires contacting your doctor immediately [1].
The following measures can help relieve discomfort during the first few days [2]:
- Rest and drink enough fluids until the urine becomes clear and you urinate regularly during the day.
- Avoid juices, coffee, and alcohol because they may irritate the bladder.
- Paracetamol can be used to relieve pain. The NHS mentions up to 4 times a day. Your appropriate dose is set by your doctor or pharmacist, and paracetamol is not a treatment for the infection.
If symptoms worsen quickly, or do not improve within 48 hours of starting treatment, request an urgent appointment with a doctor [2]. The drug directory sets a limit: if symptoms persist after 3 days, a urine culture and a review are necessary.
What warnings and interactions should I know about before use?
Inform your doctor or pharmacist of the following before taking the drug:
- Kidney failure: Clear kidney failure weakens the concentration of the drug in the urine, and this is a contraindication in the drug directory. MedlinePlus asks patients to tell their doctor about any kidney or liver disease before intravenous fosfomycin [1].
- Allergy: If you have previously had an allergic reaction to fosfomycin, do not use it. Also tell your doctor about any other drug allergies and the symptoms that appeared [1]. For more, see drug allergy.
- Pregnancy: The drug is used when needed and at the doctor's discretion. Its data are relatively reassuring among the available options. Pregnancy alone is a reason to consult a doctor when a urinary tract infection is suspected [2].
- Concurrent medicines: Metoclopramide, as mentioned above. MedlinePlus advises informing your doctor and pharmacist about all your medicines and supplements, and carrying a written list of them [1].
If a rash, itching, or swelling of the face, lips, or throat, or difficulty breathing appears after the dose, go to the emergency room immediately [1].
Is Monurol sufficient for every case of bladder infection?
No. The drug is prescribed as a single dose for "uncomplicated" cystitis in women, meaning when there are no signs of a deeper infection or factors that make treatment more difficult. In the following cases, a doctor's assessment is needed, and you may need a different plan:
| Situation | Why one sachet may not be enough | What is needed? |
|---|---|---|
| Fever, chills, or pain in the flank or lower back below the ribs | May indicate a kidney infection, which is dangerous if untreated and can lead to sepsis [2] | Urgent review, urine culture, and the doctor decides on treatment |
| Men | The NHS recommends an urgent appointment for men, and the drug directory's single dose applies to women [2] | Medical assessment before any medicine |
| Pregnancy | Pregnancy is a reason for urgent review [2], and the drug is used at the doctor's discretion | The doctor chooses the treatment and requests a culture |
| Diabetes, weakened immunity, age 65 or older, or having a urinary catheter | The NHS recommends urgent assessment for all of these conditions [2] | Doctor review |
| Recurrent infections | Two infections within 6 months, or three within 12 months [2] | Assessment and tests instead of repeating the antibiotic |
| Symptoms persisting after 3 days | The bacteria may not be sensitive to the drug, or the diagnosis may be different | Urine culture and doctor review |
| Visible blood in the urine | Needs assessment even if it appears only once | See the article on blood in urine |
Other factors that increase the likelihood of infection or complicate it include stones in the urinary system, and difficulty emptying the bladder, as in enlarged prostate in men [2]. You can find details in the article on benign prostatic hyperplasia.
What is the role of a urine culture, and when is it requested?
A doctor can often identify a urinary tract infection from a urine test [3]. The article on urinalysis explains what appears in it. The NHS notes that testing is not always required in simple cases [2].
A urine culture grows bacteria in a laboratory to determine their type and the antibiotics suitable for them. MedlinePlus lists the "bacterial culture test" among diagnostic tests [3]. It is usually requested in these cases:
- Symptoms persisting after treatment.
- Fever or flank pain.
- Pregnancy.
- Men.
- Recurrent infection.
Ask your doctor: Is it preferable to take the urine sample before the dose? And how should the sample be collected in a clean way?
Symptoms may persist while tests are normal. The NHS says some chronic infections do not always appear in urine tests, and recommends referral to a specialist if symptoms remain after treatment [2].
When should I see a doctor, and when should I go to the emergency room?
See a doctor as soon as possible if:
- You are pregnant, a man, aged 65 or older, or have diabetes, weakened immunity, or a urinary catheter [2].
- Symptoms have not improved within 48 hours of treatment or have worsened quickly [2], or have persisted after 3 days of Monurol.
- Blood appears in the urine, or there is pain in the lower abdomen or in the back below the ribs [2].
- Symptoms have recurred twice within 6 months or three times within 12 months [2].
- The patient is a child: children who develop a high fever, general fatigue, refusal to eat, or sudden bedwetting need medical assessment [2]. They should not be given a dose estimated by guesswork. The dose is based on weight and given by prescription or pharmacist guidance.
Call 911 or go to the nearest emergency room immediately if:
- Confusion, extreme drowsiness, or difficulty speaking appears [2].
- A rash or swelling of the face, tongue, or lips, or difficulty breathing appears [1].
- High fever with shaking and rapid deterioration in general condition appears.
Do not drive yourself in these cases. Ask someone to take you or call an ambulance.
What if bladder infection recurs, and how can I reduce the chance of it returning?
If the infection returns after treatment, or two infections occur within 6 months or three within 12 months, the required step is a doctor's assessment, not repeating the same medicine. The NHS notes that the doctor may prescribe a different antibiotic, or a low dose for a period that may last up to 6 months, or vaginal estrogen treatment after menopause, or refer you to a specialist for additional tests [2]. Tests may sometimes include a cystoscopy, depending on the doctor's opinion.
According to the NHS, these habits help with prevention [2]:
- Wiping from front to back after using the toilet.
- Drinking plenty of water and not holding in urine.
- Emptying the bladder completely without rushing.
- Urinating after sexual intercourse and washing the area with water.
- Wearing cotton underwear and avoiding perfumed soap.
- Avoiding spermicides if they cause you infections.
As for cranberry and D-mannose, the NHS indicates some evidence of their benefit in preventing recurrent infection. There is no evidence that they treat an infection that has already started. Pregnant women should consult a doctor before using them, and those taking warfarin should avoid cranberry products [2].
How do I find the right doctor or clinic in Jordan?
For a first simple bladder infection, a general practitioner, family physician, or gynecologist is usually sufficient, and you can also start at the health center run by the Ministry of Health in your governorate. For kidney infections, recurrent infections, infections linked to stones or blood in the urine, or in men, a urology specialty is most suitable. You can view the urinary tract infection treatment service in the directory.
Search the directory of urologists in Jordan by governorate. When reading a doctor's profile, check:
- The specialty and experience listed in the profile.
- The clinic location and working hours.
- The contact or booking method available in the profile.
Appearing in the directory does not mean a doctor has been rated for medical quality, so choose the one that suits your condition and location.
Ask the doctor at the appointment:
- Is my infection "uncomplicated," and is one sachet enough?
- Do I need a urine culture, and when should I collect the sample?
- When should I expect improvement, and what signs should prompt a return visit?
- Is there a reason for the recurrent infection that needs testing?
If your infections are recurrent, book an assessment through ClinicsJo if booking is available in the doctor's profile. To learn more about the drug, see the Monurol page in the drug directory. If you want to make sure your symptoms are not due to another cause, you may also find it helpful to read about bladder stones.
This article is for health education and does not replace the diagnosis and prescription of a doctor. Do not start, stop, or change any medicine without consulting your doctor or pharmacist.
Frequently asked questions
What is Monurol and when is it prescribed?
Monurol (fosfomycin trometamol) is an antibiotic given for uncomplicated acute cystitis in women as a single sachet taken as one dose. It is also prescribed in selected cases of resistant bacteria, and for prevention before certain procedures on the urinary tract. It comes as a powder in a 3-gram sachet, and the directory indicates that it is available in Jordan.
How do I use Monurol correctly?
Dissolve the contents of the sachet in half a glass of cold water. Do not use hot water. Drink it immediately on an empty stomach, or two to three hours after eating. Do not take it with metoclopramide, because that reduces Monurol's absorption. If you vomit after the dose, or are unsure whether you took it fully, contact your pharmacist or doctor and do not repeat the sachet on your own.
What symptoms indicate a bladder infection?
Common symptoms include pain or burning when urinating, needing to urinate more than usual, at night, or with sudden urgency, cloudy urine or urine containing blood, and pain in the lower abdomen. The article notes that not every pain in the bladder is a bacterial infection, as pain can persist with negative test results.
When should I see a doctor immediately?
See a doctor as soon as possible if you are pregnant, a man, aged 65 or older, or have diabetes, weakened immunity, or a urinary catheter, or if symptoms have not improved within 48 hours, or blood appears in the urine. Call 911 immediately if confusion, difficulty breathing, or swelling of the face or lips appears.
Is Monurol enough in every case of bladder infection?
No. The drug is prescribed as a single dose for uncomplicated bladder infection in women only. Fever or flank pain may indicate a kidney infection and requires urgent review. In pregnancy, in men, and in recurrent cases, a doctor's assessment is needed before choosing treatment, and you may need a different plan. One sachet alone is not enough if symptoms persist after three days.
How can I reduce the chance of a bladder infection returning?
The NHS recommends drinking plenty of water and not holding in urine, emptying the bladder completely without rushing, urinating after sexual intercourse, wiping from front to back, wearing cotton underwear, and avoiding perfumed soap. If the infection recurs, the required step is a doctor's assessment rather than repeating the same medicine. Consult a doctor before using cranberry or D-mannose.
Sources and references
- Fosfomycin Injection: MedlinePlus Drug Information — MedlinePlus — U.S. National Library of Medicine. Accessed: 2026-10-26.
- Urinary tract infections (UTIs) — NHS (UK National Health Service). Accessed: 2026-10-26.
- Urinary Tract Infections | UTI | UTI Symptoms — MedlinePlus — U.S. National Library of Medicine. Accessed: 2026-10-26.
