Mannitol: Difference between revisions
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==General==
==General==
*Type: Sugar Alcohol, derived from mannose, stereo-isomer of sorbitol
*Type: sugar alcohol, derived from mannose, stereo-isomer of sorbitol
*Dosage Forms: Reconstituted powder and solution, [http://www.medicinenet.com/mannitol-injectable/article.htm 5% and 10% in 1000 ml containers; 15% in 500 ml containers, 20% in 250 ml and 500 ml containers; and 25% in 50 ml flip-top vials]. IV
*Dosage Forms: Reconstituted powder and solution<ref>[http://www.medicinenet.com/mannitol-injectable/article.htm</ref>
*Common Trade Names: Mannitol, [http://www.medicinenet.com/mannitol-injectable/article.htm Osmitrol]
**5% and 10% in 1000ml containers
**15% in 500ml containers
**20% in 250ml and 500ml containers
**25% in 50ml flip-top vials  
*Common Trade Names: Mannitol, Osmitrol


==Adult Dosing==
==Dosing==
===[[Elevated intracranial pressure]]===
===Adult===
*0.25-2 G/kg given every 6 to 8 hours<ref>http://www.medicinenet.com/mannitol-injectable/article.htm</ref>
====[[Elevated intracranial pressure]]====
*0.25-2 g/kg given every 6 to 8 hours<ref>http://www.medicinenet.com/mannitol-injectable/article.htm</ref>
**Should be given as a one time bolus (may be inferior to Hypertonic Saline)<ref>http://www.cochrane.org/CD001049/INJ_mannitol-for-acute-traumatic-brain-injury</ref>
**Should be given as a one time bolus (may be inferior to Hypertonic Saline)<ref>http://www.cochrane.org/CD001049/INJ_mannitol-for-acute-traumatic-brain-injury</ref>
**Easy ED dosing: 1g/kg bolus in ED (while awaiting neurosurgery eval/admission)


==Pediatric Dosing==
===Pediatric Dosing===
For Cerebral Edema: [http://reference.medscape.com/drug/osmitrol-mannitol-343061 0.25-1 g/kg IV initially; maintenance dose of 0.25-0.5 g/kg IV q4-6hr]
====Cerebral edema====
*0.25-1 g/kg IV initially; maintenance dose of 0.25-0.5 g/kg IV q4-6hr<ref>http://reference.medscape.com/drug/osmitrol-mannitol-343061</ref>


==Special Populations==
==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C
*Lactation:
*Lactation:
** Unknown if present in breast milk
*Renal Dosing
*Renal Dosing
**Adult
**Adult
*** Contraindicated in severe renal impairment
**Pediatric
**Pediatric
*** Contraindicated in severe renal impairment
*Hepatic Dosing
*Hepatic Dosing
**Adult
**Adult
*** No adjustment necessary
**Pediatric
**Pediatric
*** No adjustment necessary


==Indications==
==Indications==
Line 30: Line 42:
==Adverse Reactions==
==Adverse Reactions==
===Serious===
===Serious===
*Heart failure
*Worsening dehydration
*Hyponatremia
*Hypokalemia
*Hypocalcemia


===Common===
===Common===
*Cough
*Sore throat
*Dry mouth
*Headache
*Nausea


==Pharmacology==
==Pharmacology==
*Half-life:  
*Onset of action: 5-10 minutes
*Half-life: 6 hours
*Metabolism:  
*Metabolism:  
*Excretion:  
*Excretion: Urine
*Mechanism of Action:
*Mechanism of Action: Increased tonicity of mannitol draws water out of the brain parenchyma and into the intravascular space<ref>https://www.ncbi.nlm.nih.gov/books/NBK470392/#:~:text=Tenny%20S%2C%20Patel%20R%2C%20Thorell%20W.%20Mannitol.%20%5BUpdated%202022%20Feb%2021%5D.%20In%3A%20StatPearls%20%5BInternet%5D.%20Treasure%20Island%20(FL)%3A%20StatPearls%20Publishing%3B%202022%20Jan%2D.%20Available%20from%3A%20https%3A//www.ncbi.nlm.nih.gov/books/NBK470392/</ref>
 
 
==Indications by Condition==
''The following table is automatically generated from disease/condition pages across WikEM.''
 
{{#ask:[[Has DrugName::Mannitol]]
|?Has Indication=Indication
|?Has Dose=Dose
|?Has Context=Context
|?Has Route=Route
|?Has Population=Population
|format=table
|headers=plain
|mainlabel=-
|sort=Has Indication
|limit=50
}}


==See Also==
==See Also==


==Sources==


==References==
<references/>
<references/>
[[Category:Drugs]]
* Mannitol (systemic): Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.
[[Category:Pharmacology]]

Latest revision as of 21:57, 20 March 2026

General

  • Type: sugar alcohol, derived from mannose, stereo-isomer of sorbitol
  • Dosage Forms: Reconstituted powder and solution[1]
    • 5% and 10% in 1000ml containers
    • 15% in 500ml containers
    • 20% in 250ml and 500ml containers
    • 25% in 50ml flip-top vials
  • Common Trade Names: Mannitol, Osmitrol

Dosing

Adult

Elevated intracranial pressure

  • 0.25-2 g/kg given every 6 to 8 hours[2]
    • Should be given as a one time bolus (may be inferior to Hypertonic Saline)[3]
    • Easy ED dosing: 1g/kg bolus in ED (while awaiting neurosurgery eval/admission)

Pediatric Dosing

Cerebral edema

  • 0.25-1 g/kg IV initially; maintenance dose of 0.25-0.5 g/kg IV q4-6hr[4]

Special Populations

  • Pregnancy Rating: C
  • Lactation:
    • Unknown if present in breast milk
  • Renal Dosing
    • Adult
      • Contraindicated in severe renal impairment
    • Pediatric
      • Contraindicated in severe renal impairment
  • Hepatic Dosing
    • Adult
      • No adjustment necessary
    • Pediatric
      • No adjustment necessary

Indications

  • Lowering ICP with signs of impending herniation or severely deteriorating mental status in context of known trauma or intracranial lesion exerting mass effect

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

  • Heart failure
  • Worsening dehydration
  • Hyponatremia
  • Hypokalemia
  • Hypocalcemia

Common

  • Cough
  • Sore throat
  • Dry mouth
  • Headache
  • Nausea

Pharmacology

  • Onset of action: 5-10 minutes
  • Half-life: 6 hours
  • Metabolism:
  • Excretion: Urine
  • Mechanism of Action: Increased tonicity of mannitol draws water out of the brain parenchyma and into the intravascular space[5]


Indications by Condition

The following table is automatically generated from disease/condition pages across WikEM.

IndicationDoseContextRoutePopulation
Elevated intracranial pressure1-1.5 g/kgOsmotic diuretic for ICP reductionIV bolusAdult
Elevated intracranial pressure0.25-1 g/kg IV over 15-20 minOsmotherapy for elevated ICPIVAdult
Moderate-to-severe traumatic brain injury0.25-1 g/kg IV over 15-20 minOsmotherapy for elevated ICPIVAdult
Orbital compartment syndrome2g/kg IV (20% solution)Adjunctive to lateral canthotomyIVAdult
Retrobulbar hemorrhage2g/kg IV (20% solution)Adjunctive to cantholysisIVAdult
Traumatic intracerebral hemorrhage0.25-1 g/kg IV over 15-20 minOsmotherapy for elevated ICPIVAdult

See Also

References

  1. ↑ [http://www.medicinenet.com/mannitol-injectable/article.htm
  2. ↑ http://www.medicinenet.com/mannitol-injectable/article.htm
  3. ↑ http://www.cochrane.org/CD001049/INJ_mannitol-for-acute-traumatic-brain-injury
  4. ↑ http://reference.medscape.com/drug/osmitrol-mannitol-343061
  5. ↑ https://www.ncbi.nlm.nih.gov/books/NBK470392/#:~:text=Tenny%20S%2C%20Patel%20R%2C%20Thorell%20W.%20Mannitol.%20%5BUpdated%202022%20Feb%2021%5D.%20In%3A%20StatPearls%20%5BInternet%5D.%20Treasure%20Island%20(FL)%3A%20StatPearls%20Publishing%3B%202022%20Jan%2D.%20Available%20from%3A%20https%3A//www.ncbi.nlm.nih.gov/books/NBK470392/
  • Mannitol (systemic): Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.
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