Two medicines, side by side
Fosfomycin vs nitrofurantoin
Fosfomycin and nitrofurantoin are both labeled for urinary tract infections. Drugs@FDA records approvals of fosfomycin since 1996 and of nitrofurantoin since 1953. Pharmacies paid $26.22 per unit (Fosfomycin 3 g sachet) and $0.165 per nitrofurantoin mcr 50 mg capsule (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like.
Check it at the source: the fosfomycin FDA label on DailyMed (effective April 9, 2026); the nitrofurantoin FDA label on DailyMed (effective June 24, 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 nitrofurantoin record
Nitrofurantoin (Macrobid) · label of June 24, 2026
Used for
From the label: indicationsNitrofurantoin capsules (monohydrate/macrocrystals) are indicated only for the treatment of acute uncomplicated urinary tract infections (acute cystitis) caused by susceptible strains of Escherichia coli or Staphylococcus saprophyticus. Nitrofurantoin is not indicated for the treatment of pyelonephritis or perinephric abscesses. […]
On the market
- Earliest approval on file
- February 6, 1953
- Generic labelers
- 47 labelers
- Pharmacy cost
- $0.165 per capsule
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 13
Source: FDA drug labels via openFDA (Fosfomycin label of April 9, 2026, Nitrofurantoin label of June 24, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do fosfomycin and nitrofurantoin differ on the record?
Generics: fosfomycin since 2020; nitrofurantoin since 1970 (Drugs@FDA).
| Fosfomycin | Nitrofurantoin | |
|---|---|---|
| Labeled for | Urinary tract infections | Urinary tract infections, Bacterial infections |
| Pharmacologic class | n/a | Nitrofuran Antibacterial |
| How it works (label) | n/a | Mechanism of Action The mechanism of the antimicrobial action of nitrofurantoin is unusual among antibacterials. |
| Half-life (label) | n/a | n/a |
| Earliest approval on file (Drugs@FDA) | December 19, 1996 | February 6, 1953 |
| First generic approved | October 6, 2020 | September 30, 1970 |
| Generic labelers (NDC) | 10 labelers | 47 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $26.22 per unit (Fosfomycin 3 g sachet) | $0.165 per capsule (Nitrofurantoin mcr 50 mg capsule) |
| 12-month price change | -29% | -12% |
| Boxed warning | No | No |
| Shortage now | No current entry | A presentation being discontinued |
| Recalls recorded | 2 | 13 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 598 | 22,755 |
| 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