How to treat cystitis during breastfeeding: are Monural, Fitolysin and Cystone allowed for a nursing mother?


In the period of lactation possible exacerbation of the "old" diseases. The trouble is that they can not be treated with all drugs. Monural was hit by this “disgrace” - a drug that copes well with the treatment of cystitis, but is a strong antibiotic. If the doctor prescribes Monural during breastfeeding, it is important for Mom to know how to protect the baby from the negative effects of the antibiotic.

About the drug

This medicine has an antimicrobial, bactericidal action. It is a strong antibiotic. The drug is active against many bacteria:

  • to staphylococcus,
  • to enterococci,
  • to E. coli,
  • to enterobacteria,
  • to proteus
  • to pseudomonads and others.

The period of removal of the antibiotic by the kidneys - from days to three days

How to use

Take before meals, preferably on an empty stomach. At the same time it is necessary to take care of the empty bladder - this is a prerequisite. The powder is diluted in warm water in an amount of 3 g per third of a glass of water. The course is a day. With repeated bouts of the disease, treatment is repeated every other day in the same dosages.

After oral administration of the antibiotic, its maximum concentration in the urine is reached after three hours. And the active substance fosfomycin is excreted by the kidneys after three days.

Antibiotic and lactation

So, is it possible to use this antibiotic during lactation? Specialists rarely prescribed Monural during lactation. This is due to the fact that studies of the effect of this drug on a child with GW were not conducted. There are no data on possible complications either. It is known that the active substance is able to penetrate not only through the placental barrier, but also into breast milk. Therefore, breastfeeding of the child is stopped after taking the antibiotic because of the possible harm to the crumbs. Experts advise for three to four days to feed the children with milk formula, and express breast milk. If the disease progresses strongly, then the medicine is drunk twice. In this case, breastfeeding is prohibited for a period of at least a week. Therefore, it is advisable when breastfeeding to express and freeze the milk beforehand.

Dr. Komarovsky believes that before taking this drug, it is necessary to understand the cause of the disease and identify the causative agent. Then there will be a chance to choose an alternative treatment.

Find the very one pill that will eliminate the disease is quite difficult. All analogues of this drug are most often prescribed courses up to 10 days. What is considered the norm in antibiotic therapy. Structural analogues include:

Analogs that are as close as possible to the mechanism of action with Monural:

  • Dioxidine
  • Cubicin,
  • Sanguirythrine,
  • Zyvox,
  • Zenix and others.

Those patients who took Monural, note its rapid therapeutic effect: pain is reduced, well-being improves, performance is restored.
Whether it is possible to take this medicine during lactation or not, only a specialist should decide. Like other types of antibiotics, this tool is not suitable for self-medication. Insufficient study of the effect of the substance on the body of the crumbs is due to the impossibility of conducting full-fledged research, therefore, when taking the drug, consultation of a medical professional is extremely important.

Monural: impact mechanism, release form

Monural (Fosfomycin) is an antibacterial agent that is active against a wide range of microorganisms. This drug is obtained by chemical reaction from phosphonic acid. Although Fosfomycin was discovered more than half a century ago, it still remains one of the most widely used drugs in the treatment of such diseases:

  • acute and chronic bacterial cystitis,
  • bacteria caused urethritis
  • pyelonephritis (as an additional tool in the general therapy).

According to medicine, it is nursing mothers who are most often at risk for cystitis. This disease is an inflammation of the mucous membrane of the bladder due to exposure to pathogenic microorganisms. In 80–90% of cases, cystitis is caused by E. coli. Also, the disease can develop under the action of staphylococcus, streptococcus, mycoplasma, viruses and fungi. During breastfeeding, factors that can cause microorganisms to multiply are:

  • infection during childbirth,
  • compression and injury of the bladder during the child's passage through the birth canal during birth,
  • reduced immunity.

The concentration of fosfomycin in the urine remains sufficient to inhibit bacteria for two weeks.

The acute phase of cystitis lasts from five to seven days. After that, the severity of painful symptoms is significantly reduced. But the doctors in the course of the research found that if the appropriate therapy was not performed with bacterial cystitis, then the likelihood of relapses and complications is high. Therefore, in order to avoid negative consequences, most doctors recommend to undergo a course of treatment with antibiotics, including Monural.

Inhibition of pathogenic bacteria by phosphomitsin is based on two mechanisms. The first is to suppress the synthesis of the cell wall of microorganisms. The second is to reduce the ability of some types of bacteria to be fixed on the epithelium of the bladder mucosa. The fact is that E. coli has specific villi and secretes an adhesive substance that helps bacteria resist the flow of urine, develop colonies, penetrate up the urinary pathways and infect cells of the human body.

The advantage of Monural over other antibiotics is that bacteria still have not developed resistance to this drug. For example, the sensitivity of Fosfomycin to Escherichia coli is more than 98%, Amoxicillin - 50–55%, Amoxiclav - 60–70%. Nitrofurantoin (Furadonin) and Furazidin (Furagin, Furamag) have the same high sensitivity to these bacteria. But their safety during lactation is not well understood.

Fosfomycin is well absorbed from the digestive tract (35–65%). The amount of substance in the body becomes maximum after two to three hours. Ninety percent of fosfomycin is excreted by the kidneys. Therefore, the components of the drug accumulate mainly in the urine, which contributes to the treatment of such ills as urethritis and cystitis. The minimum amount of fosfomycin to suppress bacteria is stored in the body, according to some data, for three to four days after taking the antibiotic, and according to others for several days longer.

Monural is available in paper bags containing fosfomitsin trometamol weighing 2 and 3 g. The drug itself is a white powder of small granules that quickly dissolve in water. The package contains one or two bags.

Monural comes in the form of white powder packed in paper bags.

Monural safety when breastfeeding

Another advantage of Monural over other antibiotics in the treatment of the urinary tract in a nursing mother is its relative safety for the infant. The instructions indicate that this antibiotic can be used during lactation only if the intended therapeutic effect is higher than the potential risk.

The European Electronic Handbook of Compatibility for Breastfeeding Medicines reports that the use of Fosfomycin is safe for infants. The amount of substance that gets into the mother's milk does not carry any side effects in the baby.

It must be remembered that only a doctor should select an antibiotic for the treatment of a nursing mother.

Rules of reception and dosage

Monural to some extent fulfills the dream of every person about one magic pill. This antibiotic is intended for single treatment. In the last decade, many foreign and Russian studies have shown that the treatment of bladder inflammation with short courses is also effective as well as long. But it does not develop resistance to the antibiotic, and the risk of adverse reactions is reduced. This treatment is easily tolerated by the body.

Of course, single-dose therapy may not be enough for chronic and severe diseases. If necessary, the doctor will prescribe another monural reception a day after the first one. In this case, you may have to stop natural feeding. With recurrent form of cystitis, a treatment course of three months is usually prescribed. Moreover, Monural is administered once every ten days.

A nursing mother should use this antibiotic in the usual adult dosage - 3 g. The contents of one sachet should be dissolved in a glass filled to a third with water. Drinking the resulting mixture is recommended a few hours before or after meals. This is because the process of digesting food impairs the absorption of Monural from the stomach. It is best to take the medicine at night, completely emptying the bladder in advance.

Before taking Monural in the form of a white powder must be dissolved in a glass of water, filled to a third

Contraindications and side effects

Despite the fact that Monural is considered to be a fairly safe drug for breastfeeding, the doctor should prescribe it, given the limitations in use and the possibility of negative reactions from both the mother and the baby.

The active ingredient of the antibiotic is mainly processed by the kidneys. Therefore, in severe renal failure, it can not be used. In diabetes, you need to consider that in one bag with two or three grams of phosphomycin contains about two grams of sucrose.

Since only ten percent of the components of the drug are excreted through the intestinal tract, side effects due to dysbiosis in the form of nausea, diarrhea, constipation, and heartburn occur much less frequently than with most other antibiotics. In the United States at the beginning of the century large-scale studies on the portability of Monural were conducted, in which more than four thousand patients took part, among them were children and pregnant women. So, diarrhea occurred in 3.7% of patients taking an antibiotic, nausea - in 2.4%, pain in the lower abdomen - in 1.9%. In rare cases, with individual intolerance to the components of Monural, patients developed a skin rash.

The effect of the drug on lactation and the child

There have been no large-scale studies on the impact of Monural on the process of production of breast milk. But most doctors agree that the drug does not affect lactation. As noted above, the components of the drug penetrate into breast milk in the amount that can not adversely affect the health of the child. According to the European electronic reference book (, that amount of active substances of the medicinal product, which get into the mother's milk, is successfully blocked by calcium. But still, the nursing mother should carefully observe the reaction of the baby during treatment with Monural. With the appearance of skin rashes, constipation, diarrhea, pain, you should immediately consult a doctor.

Monural Analogs Allowed for Lactation

The following drugs are full analogues of Monural on the active substance:

These antibiotics have identical characteristics, but are produced by different manufacturers and differ in price.

If, for any reason, antibiotics with fosfomycin are not suitable for the treatment of cystitis and urethritis in a nursing mother, the doctor may select other drugs with similar effects. In the Federal Guide for Physicians on the Use of Drugs in Russia, the following drugs are indicated for the treatment of bacterial infection of the urinary tract in adults:

  • Amoxicillin / Clavulanate (Amoxiclav, Augmentin),
  • Norfloxacin (Nolitsin),
  • Nitrofurantoin (Furadonin),
  • Co-trimoxazole.

According to the European electronic reference book (, all these antibiotics are relatively safe for mothers and children when breastfeeding. But the instructions indicate that the above drugs can be used for nursing mothers only for health reasons.

The clinical efficacy of therapy after a single dose of monural was found to be comparable to the effectiveness of therapy with other antibacterial drugs for 3–7 days.

SOUTH. Alyaev, A.Z. Vinarov, V.B. Voskoboynikov

“Acute cystitis. Efficacy of Monural (fosfomycin trometamol) in its treatment. ”

Furadonin exhibits the same high activity for pathogens as Monural. Amoxiclav is well studied and not only used for urinary tract infections. Nolitsin is also effective in the treatment of bacterial lesions of the genital organs. Abroad, Co-trimoxazole is the drug of choice for the treatment of acute cystitis in both adults and children. But according to some reports, resistance to E. coli in Russia is about 50%. These antibiotics are intended for long-term treatment (7-14 days).

Comparing Monural with other drugs shows that this antibiotic has some of the least limitations in use.

Causes of Cystitis

When cystitis on the bladder mucosa under the action of pathogenic microorganisms develops an inflammatory process. With an uncomplicated disease, inflammation occurs only in the mucous membrane, and with a complicated one, it affects other organs of the excretory system, most often the kidney.

During childbirth, the infection is often carried out with a urinary catheter, and the injuries of the birth canal also contribute to the disease. Sometimes the disease develops in conjunction with endometritis (inflammation of the lining of the uterus). The propensity to cystitis is observed in patients with urolithiasis.

Symptoms and diagnosis of the disease

  • frequent urination,
  • urine comes out in small portions, the process is painful,
  • pain, pain in lower abdomen, especially when filling the bladder,
  • temperature may rise
  • feeling of weakness, lethargy.
Weakness, lethargy, and frequent urging indicate the presence of cystitis

For unpleasant symptoms, you need to consult a doctor. The doctor will schedule an examination:

  1. Clinical blood test. When cystitis increased leukocyte count, increased ESR (erythrocyte sedimentation rate).
  2. General urine analysis. Leukocytes from 10 units are characteristic for inflammation, red blood cells, protein appears in the urine, and bacteria can be detected.
  3. To identify the pathogen is performed urine culture. As a result of the study, besides the pathogenic microorganism, its sensitivity to drugs is determined.
  4. Ultrasound procedure. When inflammation of the bladder wall thicken.

Cystitis must be treated, otherwise the infection will rise higher. The inflammatory process can become chronic and lead to renal failure. With adequate therapy, the disease goes away in 3-5 days.

Features of the treatment of cystitis in lactating

Often, breastfeeding moms do not rush to treat cystitis, so as not to stop lactation, but most antibiotics are compatible with HB. In any case, treatment courses are short, so milk can be saved. To do this, a woman decanting as many times a day as a child usually eats, and the baby is transferred to these babies for the day.

The urologist deals with the problems of the excretory system. It is necessary to contact a specialist, be sure to warn about lactation. It is important to follow the recommendations of the doctor. Dr. Komarovsky advises to be sure to conduct an examination in order to identify the specific bacteria that caused the disease. In this case, you can immediately choose the right drug and inflammation will pass quickly and without a trace.

Breast milk can be preserved even in the treatment of cystitis, if you express it until recovery

After the course of treatment, blood and urine tests are repeated. If the indicators are normal, the disease is cured.

At the first manifestations of cystitis, you need to limit salt intake - it enhances swelling of the mucous membranes and aggravates inflammation. It is useful to drink infusions and decoctions of wild rose and lingonberry leaves. These natural products have a gentle diuretic effect and have an antibacterial effect. Also shown is the use of non-carbonated mineral water to saturate the body with iron, magnesium, and potassium.

Drugs for breastfeeding

The first helpers for cystitis in a nursing mother will be herbal preparations, such as:

  • Canephron (we recommend to read: how to use "Canephron" when breastfeeding?). In the composition - the centaury, lovage, rosemary. Despite the exclusively herbal ingredients, the drug has a pronounced antiseptic, antispasmodic, anti-inflammatory effect, a beneficial effect on the kidney function, prevents urolithiasis. The course of treatment is usually about a month. Assign 2 tablets three times a day.
  • Cyston. Comprehensive tool based on a variety of herbal ingredients. It is used for diseases of the excretory system, especially effective for the prevention of urolithiasis. It has an anti-inflammatory effect, eliminates unpleasant symptoms (burning, cracking).
  • Fitolysin. It is a plant diuretic, relieves spasm.Take three times a day for a teaspoon. The drug is available in the form of a paste, which must be dissolved in water before use.

Unfortunately, only herbs can not cure cystitis. Antimicrobial medication is required. It is advisable to first find out the pathogen and pick up the drug purposefully.

If antibiotics from the group of cephalosporins or penicillins are sufficient to suppress the pathogenic flora, then breastfeeding should not be stopped - the drugs are compatible with lactation. If the causative agents are chlamydia or mycoplasma, then it is necessary to take nitrofurans or macrolides, and it is impossible to feed the baby with breast milk during this period. If a woman plans to breastfeed after treatment, be sure to express it.

After the tests, the doctor will prescribe the necessary drugs.

If it is not possible to pass the crop, assume the most likely cause of the disease - E. coli. In this case, prescribe Zinnat (we recommend reading: instructions for the drug "Zinnat" for children), Augmentin, Amoxiclav and the like. The course of treatment is on average five days, it is not necessary to stop HB.

Monural breastfeeding in mild cases copes with the problem during the day of admission, although it usually takes up to 3 days of therapy. At this time, the baby should be transferred to the mixture.

Cystitis during breastfeeding mainly occurs as a complication after childbirth. A common cause of the disease is the ingestion of Escherichia coli. It can also cause a variety of bacteria and fungi, under the action of which inflammation develops in the bladder.

Treatment of cystitis during lactation includes taking herbal preparations to normalize the work of the excretory system (for example, Cyston, Fitolysin) and antibiotics to suppress the causative agents of the disease. When taking certain medications (such as Monural), you should not breastfeed your baby for the duration of therapy.

The composition and action of Monural

Swiss antibiotic Monural is used in the treatment of inflammatory diseases of the urinary tract:

  • cystitis (inflammation of the bladder),
  • urethritis (inflammation of the urethra).

It has an excellent antibacterial effect against the causative agents of these diseases. Suppresses even those bacteria that are resistant to other antibiotics.

The drug is also used for the treatment of postoperative urinary tract infections and for the prevention of infectious diseases before surgery on the urogenital organs.

The active substance of Monural - fosfomycin trometamol. The drug also contains citrus flavors and sweeteners (saccharin and sucrose). For the convenience of taking the drug comes in the form of small granules (powder), which dissolve well in water.

The antibiotic is quickly absorbed and immediately begins work against pathogenic microorganisms of the coke form, intestinal, Pseudomonas aeruginosa and a number of other harmful bacteria. First, it concentrates in the kidney tissues, where it remains active for up to 80 hours, then enters the urine and completely sterilizes it. Excreted naturally by urine.

Important! To speed up the process of washing out the pathogens of cystitis and the antibiotic itself, doctors advise to drink cranberry juice and non-carbonated mineral water. In general, drink plenty of water, at least two liters per day.

When a doctor can prescribe Monural to a nursing mother and how to take it

First of all, a nursing mother should consult with her doctor about her illness. And, of course, pass urine for general analysis. The specialist deciphers the results and determines the number of red blood cells, white blood cells, bacteria and viruses, which caused the inflammatory process in the urinary tract. Monural helps only with bacterial cystitis, with viral cystitis, he can not help.

You can ask for help not only to the therapist, but also to the gynecologist, urologist.

Symptoms of cystitis: pain, cramps, frequent urination

If it turns out that cystitis is caused by bacteria, then the doctor may prescribe this drug to a nursing mother. A single dose of Monural usually relieves the symptoms of the disease.

The drug is applied orally, once, preferably at night before bedtime.

The composition of the 3G package Monural

  1. Fill 1/3 cup with boiled water at room temperature.
  2. Pour Monural's 3 g sachet into the water.
  3. Stir well.

  1. Eat 2 hours before taking the drug.
  2. Empty the bladder before taking.
  3. Take the drug.
  4. Try not to go to the toilet until morning (so that the effect of the antibiotic becomes more pronounced).

For the treatment of cystitis, it is usually sufficient to take Monural once. In some cases (recurrent, severe infections), the doctor may prescribe a second dose of the drug in a dose of 3 grams, but not earlier than 24 hours after the first dose..

Additional tips for women

The appearance of cystitis contribute to:

  • hypothermia (short skirts, thin stockings, thongs, wet feet),
  • violation of female genital hygiene,
  • infections (genital and non-sex),
  • bladder overflow.

Do not allow this in your life, and you will not need drugs for cystitis.

Minimize possible negative effects

The effects of the application of Monural on an infant are still not well understood. Therefore, doctors recommend, after a single dose of Monural, to stop breastfeeding for 3-4 days. If the drug was prescribed again, then lactation will have to be interrupted in the aggregate for a week from the day of the first intake. During this period, when breastfeeding is prohibited, the infant should be fed with a mixture.

It is best to decant in advance and freeze breast milk in case a mother needs to be treated with drugs incompatible with HB.

At the time of treatment Monural breastfeeding is recommended to interrupt

Council of Dr. Komarovsky

The famous pediatrician strongly recommends not treating cystitis with herbs. It will not help. First, you need to do laboratory tests of urine, according to the results of which the doctor will prescribe the right medicine. And be sure to complete the prescribed course in order to prevent the chronic development of the disease. And at the end of the course again to pass the tests.

No herbs in the treatment of cystitis! Weeds only for prevention!

Reviews of women and the opinion of the doctor

Most of the women who took Monural, say that they cured cystitis in one session. For example, such a review:

She took this powder when the baby was breastfed. One pack of Monural saved me from cystitis. The child was not affected by this medication. True, I decanted milk and drank the powder for the night.

T. Larina, nursing mother. September 2017

But for some women the drug did not help:

Go to the urologist. : 4u: I was treated on my own and on the advice of the "knowledgeable" that I brought cystitis to such a stage that it repeated every 1.5–2 months, and the exacerbations lasted 5–7 days. Nothing helped. 😥 Monural helped the first 2 times, and then removed the symptoms for several hours, and then all over again. 😥 I went to 2 gynecologists, on the ultrasound, then to the urologist. And only he prescribed treatment, thanks to which I almost forgot about cystitis.

Mother of Light

Left a review and specialist:

The drug is recommended as a first-line therapy for acute cystitis. Indications for use of the drug are exhausted by acute cystitis. The drug should not be used for recurrent cystitis and exacerbations of chronic cystitis. The drug is unreasonably widely used in the form of self-treatment and treatment according to the recommendations of pharmacy employees. Associated with this is the increase in resistance (resistance) of infectious agents to the drug, and accordingly a gradual increase in the number of cases of no effect on treatment. This drug should be taken only on prescription.

Doctor V.V. Gordeev, urologist from Khabarovsk, PhD, experience of 14 years

Video: what is cystitis and how to treat it

Monural is an effective treatment for cystitis. But, being an antibiotic, this medicine is not suitable for self-treatment, especially repeated. Dear nursing moms, before using the drug, consult with your doctor and strictly follow its recommendations. In this case, Monural will help to forget about the disease to avoid relapses.