Монурал гранулы для приготовлления растворв для приёма внутрь 3г пак в уп N1

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Монурал - антибиотик широкого спектра действия, производное фосфоновой кислоты, оказывает бактерицидное действие, механизм которого связан с подавлением первого этапа синтеза клеточной стенки бактерий. Является структурным аналогом фосфоэнола пирувата, вступает в конкурентное взаимодействие с ферментом N-ацетил-глюкозамино-3-о-энолпирувил-трансферазой. В результате происходит специфическое, избирательное и необратимое ингибирование этого фермента, что обеспечивает отсутствие перекрестной резистентности с другими классами антибиотиков и возможность синергизма с другими антибиотиками (in vitro отмечают синергизм с амоксициллином, цефалексином, пипемидиновой кислотой).
Активен in vitro в отношении большинства грамположительных микроорганизмов: Enterococcus spp., Enterococcus faecalis, Staphylococcus aureus, Staphylococcus saprophyticus, Staphylococcus spp.; грамотрицательных микрорганизмов: Еsherichia coli, Citrobacter spp., Enterobacter spp., Klebsiella spp., Klebsiella pneumoniae, Morganella morganii, Proteus mirabilis, Pseudomonas spp., Serratia spp. In vitro фосфомицин снижает адгезию ряда бактерий на эпителии мочевыводящих путей.

Показания
– острый бактериальный цистит;
– острые приступы рецидивирующего бактериального цистита;
– бактериальный неспецифический уретрит;
– бессимптомная массивная бактериурия у беременных;
– послеоперационные инфекции мочевыводящих путей;
– профилактика инфекции мочевыводящих путей при хирургическом вмешательстве и трансуретральных диагностических исследованиях.

Противопоказания
– тяжелая степень почечной недостаточности (КК<10 мл/мин);
– детский возраст младше 5 лет;
– повышенная чувствительность к компонентам препарата.

Побочное действие
Cо стороны пищеварительной системы: тошнота, изжога, диарея.
Прочие: кожная сыпь, аллергические реакции.

Беременность и лактация
Применение препарата при беременности и в период лактации возможно только в случае, если предполагаемая польза терапии для матери превышает потенциальный риск развития тератогенного действия.

Особые указания
При назначении Монурала больным сахарным диабетом следует учитывать, что в 1 пакете препарата, содержащего 2 г фосфомицина, содержится 2.1 г сахарозы, а в 1 пакете с 3 г - 2. 213 г сахарозы.

Лекарственное взаимодействие
При одновременном применении с метоклопрамидом возможно снижение концентрации фосфомицина в сыворотке крови и в моче (данная комбинация не рекомендуется). 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