Application 050717

Type
NDA
Sponsor
ZAMBON SPA

Application Products#

Product, Drug, Ingredient table
ProductDrugIngredientFormStrengthReference drugReference standard
001MONUROLFOSFOMYCIN TROMETHAMINEFOR SOLUTION;ORALEQ 3GM BASE/PACKETYesYes

Orange Book products#

Application-product, Trade name, Ingredient table
Application-productTrade nameIngredientStrengthDosage form / routeTE codesRLD / RSApproval date
N050717-001MONUROLFOSFOMYCIN TROMETHAMINEEQ 3GM BASE/PACKET **Federal Register determination that product was not discontinued or withdrawn for safety or effectiveness reasons**FOR SOLUTION / ORALRLD1996-12-19

openFDA label cross-check#

Cross-check layer: openFDA label JSON enriches search and identifies hydration gaps. The DailyMed Structured Product Label remains the canonical label presentation on FDA.report.

Brand, Generic, Manufacturer table
BrandGenericManufacturerSPL set IDEffective dateAvailable safety fieldsJoin
Fosfomycin TromethamineFOSFOMYCIN TROMETHAMINEAucta Pharmaceuticals, Inc.4f206750-8126-99a3-e063-6294a90ade4c2026-04-09Warnings, Adverse reactionsName fallback
Fosfomycin TromethamineFOSFOMYCIN TROMETHAMINEPrecision Dose, Inc.f44b79d0-a789-46cb-ab70-7eb33a7debaf2025-12-23Warnings, Adverse reactionsName fallback
Fosfomycin TromethamineFOSFOMYCIN TROMETHAMINEAscend Laboratories, LLC48e352bc-52ea-4778-905a-60ef38a5c18a2025-12-17Warnings, Adverse reactionsName fallback
Fosfomycin tromethamineFOSFOMYCIN TROMETHAMINEAurobindo Pharma Limitedf8ec4771-3f8d-473a-a1d0-e42038f61a422025-11-17Warnings, Adverse reactionsName fallback
Fosfomycin TromethamineFOSFOMYCIN TROMETHAMINEKesin Pharma Corporation3fa61bd4-fc55-0987-e063-6394a90abce22025-09-25Warnings, Adverse reactionsName fallback
FOSFOMYCIN TROMETHAMINEFOSFOMYCIN TROMETHAMINECipla USA Inc.d101b5d8-bffc-4ee6-b93b-4589fcb8750d2025-03-17Warnings, Adverse reactionsName fallback
Fosfomycin TromethamineFOSFOMYCIN TROMETHAMINEAmneal Pharmaceuticals NY LLCaacd04a4-f2d5-45a2-b9e7-0e92244a58802024-04-02Warnings, Adverse reactionsName fallback
Fosfomycin TromethamineFOSFOMYCIN TROMETHAMINEA-S Medication Solutions6b9167a9-80e9-44e1-a609-c3eb78960acf2023-11-01Warnings, Adverse reactionsName fallback

Warnings cross-check#

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warnings

WARNINGS Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including fosfomycin tromethamine granules for oral solution, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile . C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents. If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile , and surgical evaluation should be instituted as clinically indicated.

Adverse reactions cross-check#

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adverse reactions

ADVERSE REACTIONS Clinical Trials: In clinical studies, drug related adverse events which were reported in greater than 1% of the fosfomycin-treated study population are listed below: Drug-Related Adverse Events (%) in Fosfomycin and Comparator Populations Adverse Events Fosfomycin N=1233 Nitrofurantoin N=374 Trimethoprim/ sulfamethoxazole N=428 Ciprofoxacin N=455 Diarrhea 9.0 6.4 2.3 3.1 Vaginitis 5.5 5.3 4.7 6.3 Nausea 4.1 7.2 8.6 3.4 Headache 3.9 5.9 5.4 3.4 Dizziness 1.3 1.9 2.3 2.2 Asthenia 1.1 0.3 0.5 0.0 Dyspepsia 1.1 2.1 0.7 1.1 In clinical trials, the most frequently reported adverse events occurring in > 1% of the study population regardless of drug relationship were: diarrhea 10.4%, headache 10.3%, vaginitis 7.6%, nausea 5.2%, rhinitis 4.5%, back pain 3.0%, dysmenorrheal 2.6%, pharyngitis 2.5%, dizziness 2.3%, abdominal pain 2.2%, pain 2.2%, dyspepsia 1.8%, asthenia 1.7%, and rash 1.4%. The following adverse events occurred in clinical trials at a rate of less than 1%, regardless of drug relationship: abnormal stools, anorexia, constipation, dry mouth, dysuria, ear disorder, fever, flatulence, flu syndrome, hematuria, infection, insomnia, lymphadenopathy, menstrual disorder, migraine, myalgia, nervousness, paresthesia, pruritus, SGPT increased, skin disorder, somnolence, and vomiting. One patient developed unilateral optic neuritis, an event considered possibly related to fosfomycin tromethamine therapy. Post-marketing Experience: Serious adverse events from the marketing experience with fosfomycin tromethamine outside of the United States have been rarely reported and include: angioedema, aplastic anemia, asthma (exacerbation), cholestatic jaundice, hepatic necrosis, and toxic megacolon. Although causality has not been established, during post marketing surveillance, the following events have occurred in patients prescribed fosfomycin tromethamine: anaphylaxis and hearing loss. Laboratory Changes: Significant laboratory changes reported in U.S. clinical trials of fosfomycin tromethamine without regard to drug relationship include: increased eosinophil count, increased or decreased WBC count, increased bilirubin, increased SGPT, increased SGOT, increased alkaline phosphatase, decreased hematocrit, decreased hemoglobin, increased and decreased platelet count. The changes were generally transient and were not clinically significant. To report SUS...

adverse reactions table

Drug-Related Adverse Events (%) in Fosfomycin and Comparator PopulationsAdverse EventsFosfomycin N=1233Nitrofurantoin N=374Trimethoprim/ sulfamethoxazole N=428Ciprofoxacin N=455Diarrhea9.06.42.33.1Vaginitis5.55.34.76.3Nausea4.17.28.63.4Headache3.95.95.43.4Dizziness1.31.92.32.2Asthenia1.10.30.50.0Dyspepsia1.12.10.71.1

NDC Listings For This Application#

NDC, Name, Nonproprietary name table
NDCNameNonproprietary nameLabelerMarketing categoryStatus
0456-4300MonurolFosfomycin tromethamineAllergan, Inc.NDACurrent
0456-4300MonurolFosfomycin tromethamineAllergan, Inc.NDACurrent
0456-4300MonurolFosfomycin tromethamineAllergan, Inc.NDACurrent
82036-4274Fosfomycin TromethamineFosfomycin TromethamineZambon USA, LtdNDA AUTHORIZED GENERICCurrent
82036-4274Fosfomycin TromethamineFosfomycin TromethamineZambon USA, LtdNDA AUTHORIZED GENERICCurrent
82036-4274Fosfomycin TromethamineFosfomycin TromethamineZambon USA, LtdNDA AUTHORIZED GENERICCurrent

Documents#

Document, Submission type, Date table
DocumentSubmission typeDate
56481SUPPL2018-11-23
56465SUPPL2018-11-15
54408SUPPL2018-06-01
54397SUPPL2018-05-31
8091SUPPL2011-04-13
18102SUPPL2011-04-11
30349SUPPL2008-03-13
18101SUPPL2008-03-13
39170SUPPL2003-04-07
30348SUPPL2002-12-18
57460ORIG1996-12-17