Mannitol

Mannitol Brand Names

Aridol | Osmitrol | Resectisol

What is Mannitol

Mannitol is a parenteral osmotic diuretic and also acts as a bronchoconstrictor when it is orally inhaled. It is used parenterally to reduce intracranial pressure, cerebral edema, and intraocular pressure, and to promote diuresis in the prevention and/or treatment of oliguria in patients with acute renal failure.

It is used as an additional measure in the supportive treatment of edema of various origins.

Mannitol is also used alone or in combination with other diuretic agents to promote urinary excretion of toxins such as salicylates, barbiturates, lithium, and bromides.

Orally inhaled mannitol acts as a bronchoconstrictor and is used for the assessment of bronchial hyperresponsiveness in patients 6 years and older who do not have clinically apparent asthma.

Bronchial hyperresponsiveness testing with mannitol requires an experienced clinician familiar with all aspects of the test and the management of acute bronchospasm. The mechanism for bronchoconstriction is unknown.

Indications

  1. bronchial airway hyperreactivity diagnosis
  2. cerebral edema
  3. edema
  4. glomerular filtration rate estimation without imaging
  5. increased intracranial pressure
  6. increased intraocular pressure
  7. oliguria
  8. toxin excretion enhancement
  9. urologic irrigation

For the adjunctive treatment of edema

Side Effects

  1. anaphylactoid reactions
  2. angina
  3. anuria
  4. asthenia
  5. azotemia
  6. blurred vision
  7. bronchospasm
  8. cardiac arrest
  9. chest pain (unspecified)
  10. chills
  11. coma
  12. confusion
  13. cough
  14. dehydration
  15. dizziness
  16. dyspnea
  17. edema
  18. encephalopathy
  19. erythema
  20. fever
  21. headache
  22. heart failure
  23. hematuria
  24. hyperkalemia
  25. hypernatremia
  26. hypertension
  27. hypervolemia
  28. hypokalemia
  29. hyponatremia
  30. hypotension
  31. hypovolemia
  32. injection site reaction
  33. lethargy
  34. malaise
  35. metabolic acidosis
  36. metabolic alkalosis
  37. myalgia
  38. nausea
  39. oliguria
  40. osmotic nephrosis
  41. palpitations
  42. peripheral edema
  43. phlebitis
  44. polydipsia
  45. polyuria
  46. pruritus
  47. pulmonary edema
  48. rash
  49. renal failure (unspecified)
  50. rhinitis
  51. rhinorrhea
  52. seizures
  53. sinus tachycardia
  54. skin necrosis
  55. throat irritation
  56. thrombosis
  57. urinary retention
  58. urticaria
  59. vomiting
  60. wheezing
  61. xerostomia

Monitoring Parameters

  • serum creatinine/BUN
  • serum electrolytes

Contraindications

  • acute bronchospasm
  • acute myocardial infarction
  • aneurysm
  • angina
  • anuria
  • asthma
  • breast-feeding
  • children
  • dehydration
  • electrolyte imbalance
  • gelatin hypersensitivity
  • geriatric
  • heart failure
  • hypertension
  • hypovolemia
  • infants
  • intracranial bleeding
  • labor
  • laboratory test interference
  • mannitol hypersensitivity
  • neonates
  • obstetric delivery
  • pneumothorax
  • pregnancy
  • premature neonates
  • pulmonary edema
  • renal disease
  • renal failure
  • renal impairment
  • requires an experienced clinician
  • respiratory infection
  • stroke
  • surgery

Interactions

  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetazolamide
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  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Amiloride
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Aminoglycosides
  • Aminosalicylate sodium, Aminosalicylic acid
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amphotericin B
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  • Aspirin, ASA
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
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  • Aspirin, ASA; Oxycodone
  • Aspirin, ASA; Pravastatin
  • Atenolol; Chlorthalidone
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
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  • Betamethasone
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  • Hydrochlorothiazide, HCTZ; Methyldopa
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  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Olmesartan
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Telmisartan
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Hydrocodone; Ibuprofen
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  • Ibuprofen
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