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MANNITOL

 * Brand Name: Mannitol IV, Osmitrol in Viaflex, Osmitrol in Aviva
 * Drug Class: Diuretics, Osmotic Agents

 * Medical and Pharmacy Editor: John P. Cunha, DO, FACOEP

Reviewed on 11/1/2023

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 * Uses
   * What Is Mannitol and How Does It Work?
 * Dosage
   * What Are Dosages of Mannitol?
 * Side Effects
   * What Are Side Effects Associated with Using Mannitol?
 * Drug Interactions
   * What Other Drugs Interact with Mannitol?
 * Warnings and Precautions
   * What Are Warnings and Precautions for Mannitol?


WHAT IS MANNITOL AND HOW DOES IT WORK?



Mannitol is a diuretic used to force urine production in people with acute
(sudden) kidney failure. Mannitol injection is also used to reduce swelling and
pressure inside the eye or around the brain.

 * Mannitol is available under the following different brand names: Osmitrol.


WHAT ARE DOSAGES OF MANNITOL?



Dosages of Mannitol:

Adult and Pediatric Dosage Forms and Strengths

Capsule

 * 5%
 * 10%
 * 15%
 * 20%
 * 25%

Dosage Considerations – Should be Given as Follows:

Cerebral Edema

Reduction of intracranial pressure and treatment of cerebral edema

1.5-2 g/kg intravenously (IV) infused over 30-60 minutes

Edema, Pediatric

 * 0.25-1 g/kg intravenously (IV) initially; maintenance dose of 0.25-0.5 g/kg
   IV every 4-6 hours

Intraocular Pressure

 * 1.5-2 g/kg intravenously (IV) infused over 30-60 minutes

Anuria/Oliguria

 * Test dose: 200 mg/kg intravenously (IV) infused over 3-5 minutes
 * Load: 500-1000 mg/kg IV for 1 dose
 * Maintenance: 250-500 mg/kg IV every 4-6 hours
 * Pediatric: Test dose: 0.2 g/kg IV over 3-5 minutes; not to exceed 12.5 g
 * Discontinue if no diuresis within 2 hours

Other Information

 * Do NOT give simultaneously with blood
 * Use 15-25% solution
 * Pediatric: Treatment of intoxications: Give the therapeutic dose like 5 or
   10% solution intravenously (IV) as needed

Other Indications and Uses

 * Brain mass


WHAT ARE SIDE EFFECTS ASSOCIATED WITH USING MANNITOL?



Common side effects of Mannitol include:

 * Angina-like chest pains
 * Congestive heart failure
 * Low blood pressure (hypotension)
 * Phlebitis
 * Convulsions
 * Chills
 * Dizziness
 * Headache
 * Acidosis
 * Fluid/electrolyte imbalances
 * Thirst
 * Nausea
 * Vomiting
 * Blurred vision
 * Urinary retention
 * Runny nose
 * Skin rash
 * Hives
 * High blood pressure (hypertension)
 * Fever

This document does not contain all possible side effects and others may occur.
Check with your physician for additional information about side effects.


WHAT OTHER DRUGS INTERACT WITH MANNITOL?



If your doctor has directed you to use this medication, your doctor or
pharmacist may already be aware of any possible drug interactions and may be
monitoring you for them. Do not start, stop, or change the dosage of any
medicine before checking with your doctor, health care provider, or pharmacist
first.

Mannitol has no known severe interactions with other drugs.

Serious interactions of mannitol include:

 * tobramycin

Moderate interactions of mannitol include:

 * dichlorphenamide
 * lurasidone
 * nitroglycerin rectal
 * tobramycin inhaled

Mild interactions of mannitol include:

 * magnesium chloride
 * magnesium citrate
 * magnesium hydroxide
 * magnesium oxide
 * magnesium sulfate

This information does not contain all possible interactions or adverse effects.
Therefore, before using this product, tell your doctor or pharmacist of all the
products you use. Keep a list of all your medications with you, and share this
information with your doctor and pharmacist. Check with your health care
professional or doctor for additional medical advice, or if you have health
questions, concerns, or for more information about this medicine.


WHAT ARE WARNINGS AND PRECAUTIONS FOR MANNITOL?



WARNINGS

This medication contains mannitol. Do not take Osmitrol if you are allergic to
mannitol or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact
a Poison Control Center immediately.

CONTRAINDICATIONS

 * Hypersensitivity, anuria, severe pulmonary edema or heart failure, severe
   dehydration, metabolic edema, progressive renal dz, active intracranial
   bleeding (except during craniotomy)

Effects of Drug Abuse

 * No information available

Short-Term Effects

 * See "What Are Side Effects Associated with Using Mannitol?"

Long-Term Effects

 * See "What Are Side Effects Associated with Using Mannitol?"

Cautions

 * Do not mix with blood.
 * May cause low blood volume (hypovolemia), headache, excessive thirst
   (polydipsia).
 * It might be more effective than pentobarbital, but less effective than
   hypertonic saline in patients with acute traumatic brain injury.

Pregnancy and Lactation

 * Use mannitol with caution during pregnancy if the benefits outweigh the
   risks. Animal studies show risk and human studies are not available or
   neither animal nor human studies were done.
 * Use caution if breastfeeding.




FROM

HEALTHY RESOURCES

 * Living With ADPKD
 * Manage Your Mental & Kidney Health

FEATURED CENTERS

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References
Medscape. Mannitol.
https://reference.medscape.com/drug/osmitrol-mannitol-343061
RxList. Osmitrol Side Effects Drug Center.
https://www.rxlist.com/osmitrol-in-viaflex-side-effects-drug-center.htm

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