Two medicines, side by side
Fosfomycin vs ciprofloxacin
Fosfomycin and ciprofloxacin are both labeled for urinary tract infections. Drugs@FDA records approvals of fosfomycin since 1996 and of ciprofloxacin since 1987. Pharmacies paid $26.22 per unit (Fosfomycin 3 g sachet) and $0.123 per ciprofloxacin HCl 500 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Ciprofloxacin's other strengths are brand-only: $1.25 per mL (Cipro 5% suspension). Only the ciprofloxacin label carries a boxed warning.
Check it at the source: the fosfomycin FDA label on DailyMed (effective April 9, 2026); the ciprofloxacin FDA label on DailyMed (effective March 2, 2026).
Highlights of the fosfomycin record
Fosfomycin (Monurol) · label of April 9, 2026
Used for
From the label: indicationsFosfomycin tromethamine granules for oral solution is indicated only for the treatment of uncomplicated urinary tract infections (acute cystitis) in women due to susceptible strains of Escherichia coli and Enterococcus faecalis. Fosfomycin tromethamine granules for oral solution is not indicated for the treatment of pyelonephritis or perinephric abscess. […]
On the market
- Earliest approval on file
- December 19, 1996
- Generic labelers
- 10 labelers
- Pharmacy cost
- $26.22 per unit
Supply and safety
- Shortage
- No current entry
- Recalls
- 2
Highlights of the ciprofloxacin record
Ciprofloxacin (Cipro) · label of March 2, 2026
SERIOUS ADVERSE REACTIONS INCLUDING TENDINITIS, TENDON RUPTURE, PERIPHERAL NEUROPATHY, CENTRAL NERVOUS SYSTEM EFFECTS AND EXACERBATION OF MYASTHENIA GRAVIS
Fluoroquinolones, including CIPRO ® , have been associated with disabling and potentially irreversible serious adverse reactions that have occurred together [see Warnings and Precautions ( 5.1 )], including:
Tendinitis and tendon rupture [see Warnings and Precautions ( 5.2 )].
Peripheral neuropathy [see Warnings and Precautions ( 5.3 )].
Used for
From the label: indicationsCIPRO is a fluoroquinolone antibacterial indicated in adults (18 years of age and older) with the following infections caused by designated, susceptible bacteria and in pediatric patients where indicated: • Skin and Skin Structure Infections ( 1.1 ) • Bone and Joint Infections ( 1.2 ) • Complicated Intra-Abdominal Infections ( 1.3 ) • Infectious Diarrhea ( 1.4 ) • Typhoid Fever (Enteric Fever) ( 1.5 ) • […]
On the market
- Earliest approval on file
- October 22, 1987
- Generic labelers
- 54 labelers
- Pharmacy cost
- $0.123 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 14
Source: FDA drug labels via openFDA (Fosfomycin label of April 9, 2026, Ciprofloxacin label of March 2, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do fosfomycin and ciprofloxacin differ on the record?
Only the ciprofloxacin label carries a boxed warning.
Generics: fosfomycin since 2020; ciprofloxacin since 2004 (Drugs@FDA).
| Fosfomycin | Ciprofloxacin | |
|---|---|---|
| Labeled for | Urinary tract infections | Diarrhea, Urinary tract infections, Bacterial infections |
| Pharmacologic class | n/a | Fluoroquinolone Antibacterial, Quinolone Antimicrobial |
| How it works (label) | n/a | Ciprofloxacin is a member of the fluoroquinolone class of antibacterial agents [see Microbiology ( 12.4 )]. |
| Half-life (label) | n/a | The serum elimination half-life in subjects with normal renal function is approximately 4 hours. |
| Earliest approval on file (Drugs@FDA) | December 19, 1996 | October 22, 1987 |
| First generic approved | October 6, 2020 | March 16, 2004 |
| Generic labelers (NDC) | 10 labelers | 54 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $26.22 per unit (Fosfomycin 3 g sachet) | $0.123 per tablet (Ciprofloxacin HCl 500 mg tablet) |
| 12-month price change | -29% | -9% |
| Boxed warning | No | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 2 | 14 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 598 | 96,726 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to fosfomycin
- every medicine labeled for the same conditions