Mannitol

Indications
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.
Contraindications
Pulmonary congestion or oedema; intracranial bleeding; CHF; metabolic oedema with abnormal capillary fragility; anuria due to severe renal disease; severe dehydration.
Warnings / Precautions
Hypervolaemia; urinary tract obstruction; check for signs of fluid and electrolyte imbalance. Should not be administered with whole blood. Pregnancy, lactation.
Adverse Reactions
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.
Drug Interactions
Increased nephrotoxicity with ciclosporin.
See Below for More mannitol Drug Interactions
Mechanism of Actions
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).
Storage Conditions
Intravenous: Store at 20-25°C Irrigation: Store at 20-25°C
ATC Classification
A06AD16 - mannitol ; Belongs to the class of osmotically acting laxatives.
B05BC01 - mannitol ; Belongs to the class of solutions producing osmotic diuresis used in I.V. solutions.
B05CX04 - mannitol ; Belongs to the class of other solutions used as irrigating solutions.
Storage
Intravenous: Store at 20-25°C Irrigation: Store at 20-25°C
Available As
  • Mannitol 10 gm
  • Mannitol 10%
  • Mannitol 10% w/v
  • Mannitol 12 mg
  • Mannitol 18 mg
  • Mannitol 20 mg
  • Mannitol 20%
  • Mannitol 20% w/v
  • Mannitol 200 mg
  • Mannitol 26.65 mg
  • Mannitol 36 mg
  • Mannitol 5% w/w
  • Mannitol 500 mg
  • Mannitol 6.65 mg
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