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Mannitol information from DrugsUpdate  

See Available Brands of Mannitol in India

P - Caution when used during pregnancy
L - Caution when used during lactation

Mannitol is an organic compound with the formula (C6H8(OH)6). This polyol is used as an osmotic diuretic agent and a weak renal vasodilator. It was originally isolated from the secretions of the flowering ash, called manna after their resemblance to the Biblical food, and is also be referred to as mannite and manna sugar.

Pharmacodynamics

Pharmacokinetics

Mannitol increases urinary output by inhibiting tubular reabsorption of water and electrolytes. It raises the osmotic pressure of the plasma allowing water to be drawn out of body tissues.


 


Onset


 


Diuresis: 1-3 hr. Reduction in intracerebral pressure: around 15 min.


 


Duration


 


Reduction in intracerebral pressure: 1.5-6 hr.


 


Absorption


 


Small amounts are absorbed from the GI tract.


 


Distribution


 


Concentrated in extracellular compartments. It does not penetrate the blood-brain barrier nor the eye.


 


Metabolism


 


Minimal hepatic metabolism, converted to glycogen.


 


Excretion


 


Urine via the kidneys (unchanged drug).

Mannitol Indications / Mannitol Uses

Information Not Available

Mannitol Adverse Reactions / Mannitol Side Effects

Fluid and electrolyte imbalance; acidosis (with high doses). Nausea, vomiting, thirst; headache, dizziness, convulsions, chills, fever; tachycardia, chest pain; blurred vision; urticaria and hypotension or hypertension; acute renal failure; skin necrosis; thrombophloebitis.

Precautions

The cardiovascular status of the patient should be carefully evaluated before rapidly administering Mannitol since sudden expansion of the extracellular fluid may lead to fulminating congestive heart failure. Shift of sodium-free intracellular fluid into the extracellular compartment following Mannitol infusion may lower serum sodium concentration and aggravate pre-existing hyponatremia.


 


By sustaining diuresis, Mannitol administration may obscure and intensify inadequate hydration or hypovolemia.Electrolyte-free Mannitol solutions should not be given conjointly with blood. If it is essential that blood be given simultaneously, at least 20 mEq of sodium chloride should be added to each liter of Mannitol solution to avoid pseudoagglutination.When exposed to low temperatures, solutions of Mannitol may crystalize. If crystals are observed, the container should be warmed to redissolve, then cooled to body temperature before administering.When infusing 20% or 25% Mannitol concentrations, the administration set should include a filter. Do not infuse Mannitol solution if crystals are present. Do not administer unless solution is clear and container is undamaged. Discard unused portion. Do not administer Mannitol 25% if the Fliptop vial seal is not intact.

Special Precautions

Hypervolaemia; urinary tract obstruction; check for signs of fluid and electrolyte imbalance. Should not be administered with whole blood. Pregnancy, lactation.

Other Drug Interactions

Increased nephrotoxicity with ciclosporin

Other Interactions

Information Not Available

Dosage

Intravenous


Oliguric phase of renal failure Adult: 50-100 g in a 24-hr period by IV infusion of a 5-25% solution. Adjust rate of administration to maintain a urine flow of at least 30-50 mL/hr. Child: 0.25-2 g/kg.


 


Intravenous


 


Cerebral oedema Adult: 0.25-2 g/kg by IV infusion of a 15-25% solution given over 30-60 minutes.


 


Intravenous


 


Reduction of raised intracranial pressure Adult: 0.25-2 g/kg by IV infusion of a 15-25% solution given over 30-60 minutes.


 


Intravenous


 


Reduction of raised intraocular pressure Adult: 0.25-2 g/kg by IV infusion of a 15-25% solution given over 30-60 minutes.


 


Intravenous Renal function testing Adult: 0.2 g/kg infused over 3-5 min. Irrigation Transurethral prostatic resection Adult: Use 2.5-5% solution for bladder irrigation.

Food(before/after)

Information Not Available

List of Contraindications

Mannitol and Pregnancy

Caution when used during pregnancy


Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Mannitol and Lactation

Caution when used during lactation

Mannitol and Children

Safety and effectiveness of solutions from flexible plastic containers in pediatric patients have not been well established.

Mannitol and Geriatic

Information Not Available

Mannitol and Other Contraindications

Pulmonary congestion or oedema; intracranial bleeding; CHF; metabolic oedema with abnormal capillary fragility; anuria due to severe renal disease; severe dehydration.

Storage

Intravenous


Store at 20-25 ℃


Irrigation


Store at 20-25 ℃

Lab interference

Intravenous


Store at 20-25 ℃


Irrigation


Store at 20-25 ℃

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