Description

Simple

A medication used to test for asthma, to reduce high pressure in the brain and eye, and to measure kidney function.

Clinical

A sugar alcohol used to test for asthma, to reduce intracranial and intraocular pressure, and to measure glomerular filtration rate.

Overview

Mannitol is an osmotic diuretic that is metabolically inert in humans and occurs naturally, as a sugar or sugar alcohol, in fruits and vegetables. Mannitol elevates blood plasma osmolality, resulting in enhanced flow of water from tissues, including the brain and cerebrospinal fluid, into interstitial fluid and plasma. As a result, cerebral edema, elevated intracranial pressure, and cerebrospinal fluid volume and pressure may be reduced. Mannitol may also be used for the promotion of diuresis before irreversible renal failure becomes established; the promotion of urinary excretion of toxic substances; as an Antiglaucoma agent; and as a renal function diagnostic aid.

Pharmacology

Indication

Used for the promotion of diuresis before irreversible renal failure becomes established, the reduction of intracranial pressure, the treatment of cerebral edema, and the promotion of urinary excretion of toxic substances.

Pharmacodynamic

Chemically, mannitol is an alcohol and a sugar, or a polyol; it is similar to xylitol or sorbitol. However, mannitol has a tendency to lose a hydrogen ion in aqueous solutions, which causes the solution to become acidic. For this reason, it is not uncommon to add a substance to adjust its pH, such a... Read more

Mechanism of action

Mannitol is an osmotic diuretic that is metabolically inert in humans and occurs naturally, as a sugar or sugar alcohol, in fruits and vegetables. Mannitol elevates blood plasma osmolality, resulting in enhanced flow of water from tissues, including the brain and cerebrospinal fluid, into interstiti... Read more

Absorption

Approximately 7% of ingested mannitol is absorbed during gastrointestinal perfusion in uremic patients.

Protein binding

None

Volume of distribution

Information currently not available.

Clearance

Information currently not available.

Half life

100 minutes

Route of elimination

It is rapidly excreted in the urine.

Toxicity

LD50=1700 mg/kg (rat oral)

Adverse Effects

Contraindications

  • Regions: US
  • Patient Conditions:
      • Name: Mannitol-driven progressive oliguria
      • Drugbank Id: DBCOND0107966
  • Regions: US
  • Patient Conditions:
      • Name: Mannitol-driven progressive azotemia
      • Drugbank Id: DBCOND0107967
  • Regions: US
  • Patient Conditions:
      • Name: Mannitol-driven progressive heart failure
      • Drugbank Id: DBCOND0107968
  • Regions: US
  • Patient Conditions:
      • Name: Mannitol-driven progressive pulmonary congestion
      • Drugbank Id: DBCOND0107969
  • Route:
    • Intravenous
  • Regions: US
  • Patient Conditions:
      • Name: Severe pulmonary congestion or frank pulmonary edema
      • Drugbank Id: DBCOND0107964
  • Route:
    • Irrigation
    • Intravenous
  • Dose Form:
    • Solution
  • Regions: US
  • Patient Conditions:
      • Name: Anuria
      • Drugbank Id: DBCOND0001345
  • Regions: US
  • Patient Conditions:
      • Name: Mannitol-driven progressive renal damage
      • Drugbank Id: DBCOND0107965
  • Route:
    • Intravenous
  • Regions: US
  • Patient Conditions:
      • Name: Active intracranial bleeding except during craniotomy
      • Drugbank Id: DBCOND0107960
  • Route:
    • Intravenous
  • Regions: US
  • Patient Conditions:
      • Name: Severe Dehydration
      • Drugbank Id: DBCOND0066936
      • Modification Of:
        • Base:
          • Name: Dehydration
          • Drugbank Id: DBCOND0003946
        • Severity:
          • Includes:
            • severe

Food Interactions

    Information currently not available.

Interactions

Type in a drug name to check for interaction with Mannitol
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  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline
7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline may increase the orthostatic hypotensive activities of Mannitol.
Abacavir
Mannitol may decrease the excretion rate of Abacavir which could result in a higher serum level.
Acarbose
Mannitol may decrease the excretion rate of Acarbose which could result in a higher serum level.
Aceclofenac
The risk or severity of nephrotoxicity can be increased when Mannitol is combined with Aceclofenac.
Acemetacin
The therapeutic efficacy of Acemetacin can be decreased when used in combination with Mannitol.
Acetaminophen
Mannitol may decrease the excretion rate of Acetaminophen which could result in a higher serum level.
Acetazolamide
The risk or severity of adverse effects can be increased when Acetazolamide is combined with Mannitol.
Acetylsalicylic acid
Mannitol may decrease the excretion rate of Acetylsalicylic acid which could result in a higher serum level.
Aclidinium
Mannitol may decrease the excretion rate of Aclidinium which could result in a higher serum level.
Acrivastine
Mannitol may decrease the excretion rate of Acrivastine which could result in a higher serum level.
Acyclovir
The risk or severity of nephrotoxicity can be increased when Mannitol is combined with Acyclovir.
Adefovir
The risk or severity of nephrotoxicity can be increased when Mannitol is combined with Adefovir.
Adefovir dipivoxil
The risk or severity of nephrotoxicity can be increased when Mannitol is combined with Adefovir dipivoxil.
Afatinib
The serum concentration of Mannitol can be increased when it is combined with Afatinib.
Agmatine
The risk or severity of hyperkalemia can be increased when Mannitol is combined with Agmatine.
Albutrepenonacog alfa
Mannitol may decrease the excretion rate of Albutrepenonacog alfa which could result in a higher serum level.
Alclofenac
The risk or severity of nephrotoxicity can be increased when Mannitol is combined with Alclofenac.
Aldesleukin
Mannitol may decrease the excretion rate of Aldesleukin which could result in a higher serum level.
Alendronic acid
The risk or severity of nephrotoxicity and hypocalcemia can be increased when Mannitol is combined with Alendronic acid.
Alfentanil
The therapeutic efficacy of Mannitol can be decreased when used in combination with Alfentanil.
6 References
  1. 1 . Cruz J, Minoja G, Okuchi K: Improving clinical outcomes from acute subdural hematomas with the emergency preoperative administration of high doses of mannitol: a randomized trial. Neurosurgery. 2001 Oct;49(4):864-71.PubMed: 11564247
  2. 2 . Cruz J, Minoja G, Okuchi K: Major clinical and physiological benefits of early high doses of mannitol for intraparenchymal temporal lobe hemorrhages with abnormal pupillary widening: a randomized trial. Neurosurgery. 2002 Sep;51(3):628-37; discussion 637-8.PubMed: 12188940
  3. 3 . Cruz J, Minoja G, Okuchi K, Facco E: Successful use of the new high-dose mannitol treatment in patients with Glasgow Coma Scale scores of 3 and bilateral abnormal pupillary widening: a randomized trial. J Neurosurg. 2004 Mar;100(3):376-83.PubMed: 15035271
  4. 4 . Roberts I, Smith R, Evans S: Doubts over head injury studies. BMJ. 2007 Feb 24;334(7590):392-4.PubMed: 17322250
  5. 5 . Wakai A, Roberts I, Schierhout G: Mannitol for acute traumatic brain injury. Cochrane Database Syst Rev. 2005 Oct 19;(4):CD001049.PubMed: 16235278
  6. 6 . Wang YM, van Eys J: Nutritional significance of fructose and sugar alcohols. Annu Rev Nutr. 1981;1:437-75.PubMed: 6821187