Precautions
Mannitol has a half-life of approximately 36 hours during the intervals without treatment. The ideal treatment is hemodialysis that rapidly removes mannitol (half-life, six hours) and replaces it with sodium; peritoneal dialysis removed mannitol slowly (half-life, 21 hours) 3).
How long does it take for mannitol to go away?
Mannitol solution should be used with care in patients with hypervolemia, renal insufficiency, urinary tract obstruction, or impending or frank cardiac decompensation.
When should mannitol solution be used in the treatment of hypervolemia?
If output declines, consideration should be given to possible discontinuation of mannitol therapy. Mannitol inhalation is used in patients 6 years of age and older to help diagnose asthma.
When should mannitol be discontinued in the treatment of asthma?
A test dose should be administered in patients with severe renal impairment. Urine output should be monitored during mannitol infusion. If output declines, consideration should be given to possible discontinuation of mannitol therapy. Mannitol inhalation is used in patients 6 years of age and older to help diagnose asthma.
When should a test dose of mannitol be administered?
When should mannitol be stopped?
To prevent renal dysfunction, mannitol administration should be avoided when serum osmolality is >320 mOsm/L, but more specifically when the osmolar gap is >20. Mannitol frequently causes hypotension due to its diuretic effect, making administration in hemodynamically unstable patients less appealing.
Why do we taper mannitol?
Mannitol opens the blood-brain barrier, and mannitol that has crossed the blood-brain barrier may draw fluid into the brain, which can aggravate edema. Mannitol should be tapered to prevent rebound in cerebral edema.
What should you monitor when giving mannitol?
Serum sodium and potassium should be carefully monitored during mannitol (mannitol (mannitol injection) injection) administration.
What happens if you give mannitol too fast?
Too rapid infusion of large amounts of mannitol will cause a shift of intracellular water into the extracellular compartment resulting in cellular dehydration and overexpansion of the intravascular space with hyponatremia, congestive heart failure and pulmonary edema.
Can mannitol cause hypotension?
Our conclusions are that mannitol generally results in hypotension if given excessively rapidly. The blood pressure usually returns to normal in two minutes if the infusion rate is slowed.
Why does mannitol cause pulmonary edema?
Mannitol may cause excessive expansion of the intravascular space when administered in high concentrations at a rapid rate. This may result in congestive heart failure and pulmonary edema.
How does mannitol cause renal failure?
The increase in renal blood flow after mannitol administration is accompanied by a redistribution of renal blood flow, which leads to reduced oxygen delivery to the medulla and predisposes patients to ischemic renal injury.
Does mannitol cause hyponatremia?
Impaired kidney function and overdosing may lead to a longer mannitol half-life and therefore increase serum osmolality with transfer of water and potassium to the extracellular area. These changes may lead to hyponatremia, hyperkalemia, metabolic acidosis, and pulmonary edema.
Does mannitol cause hypokalemia?
The most notable finding was the high rates of hypokalemia observed during mannitol administration. Hypokalemia was observed in 22% of subjects on the first day and continuously increased to 52.3%, and this increase was significant.
Why is furosemide given after mannitol?
[3] Mannitol and furosemide combination exerts synergistic action, as furosemide enhances the effect of mannitol on plasma osmolality, resulting in a greater reduction of brain water content, relaxing the brain, lowering intracranial pressure (ICP) effectively, and hence lowering mannitol dose and side effects.
How fast can you give mannitol IV?
The recommended dosage is 1.5 to 2 g/kg as a single dose administered as an intravenous infusion over at least 30 minutes. When used preoperatively, administer Mannitol Injection 60 to 90 minutes before surgery to achieve maximal reduction of intraocular pressure before operation.
How long does it take to infuse mannitol?
The usual dose is 1.5 to 2 g/kg bw (10 to 13 ml/kg bw), infused over 30 to 60 minutes. When used preoperatively, the dose should be administered 1 to 1.5 hours before surgery to obtain the maximum effect. In forced diuresis the dose of mannitol should be adjusted to maintain urinary output of at least 100 ml/hour.
How to report mannitol IV side effects?
For more information, ask your doctor or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What is mannitol IV?
Mannitol IV is a prescription medicine used to treat the symptoms of Elevated Intracranial or Intraocular Pressure. Mannitol IV may be used alone or with other medications. Mannitol IV belongs to a class of drugs called Diuretics, Osmotic Agents.
What is mannitol injection?
Mannitol I.V. (Mannitol Injection, USP) is a sterile, nonpyrogenic solution of man nitol (mannitol (mannitol injection) injection) in water for injection available in concentrations of 5%, 10%, 15%, 20% in flexible plastic containers and 25% in a Fliptop vial for administration by intravenous infusion only.
What happens if you infuse too much mannitol?
Too rapid infusion of large amounts of mannitol (mannitol (mannitol injection) injection) will cause a shift of intracellular water into the extracellular compar tment resulting in cellular dehydration and overexpansion of the intravascular space with hyponatremia, congestive heart failure and pulmonary edema. Repeated doses should not be given to patients with persistent oliguria as this can produce a hyperosmolar state and precipitate congestive heart failure and pulmonary edema due to volume overload. Dosage must be carefully monitored and adjusted in accordance with the clinical situation to avoid the consequences of overdosage. See CONTRAINDICATIONS, WARNINGS, PRECAUTIONS and DOSAGE AND ADMINISTRATION.
What are the side effects of mannitol?
The most common side effects of Mannitol IV include: headache, nausea, diarrhea, vomiting, dry mouth,
Can you give mannitol in whole blood?
Never add mannitol in whole blood for transfusion. Mannitol (mannitol (mannitol injection) injection) may increase the cerebral blood flow and worsen intracranial hypertension in children who develop a generalized cerebral hyperemia during the first 24 to 48 hours post injury.
Can mannitol be administered intravenously?
Mannitol I.V. (Mannitol (mannitol (mannitol injection) injection) Injection, USP) should be administered only by intravenous infusion. The total dosage, concentration and rate of administration should be governed by the nature and severity of the condition being treated, fluid requirement and urinary output.
How old do you have to be to take mannitol?
How to use mannitol inhalation capsule. Mannitol inhalation is used in patients 6 years of age and older to help diagnose asthma. It is used in a procedure called bronchial challenge test to help your doctor measure the effect of this medicine on your lungs and check if you have difficulty with breathing.
What is the mechanism of action of mannitol?
The mechanism of action of mannitol is as an osmotic agent 4) . The physiologic effect of mannitol is by means of increased diuresis. Mannitol, when administered intravenously, exerts its osmotic effect as a solute of relatively small molecular size being largely confined to the extracellular space.
What is mannitol used for?
Mannitol can be used to treat oliguria associated with kidney failure or other manifestations of inadequate renal function and has been used for determination of glomerular filtration rate (GFR). Mannitol is also commonly used as a research tool in cell biological studies, usually to control osmolarity.
How many capsules of mannitol are in a blister pack?
Aridol is a test kit containing one single patient use inhaler and 3 blister packs containing 19 capsules of mannitol for inhalation in marked doses to perform one bronchial challenge test. It is given by a doctor or other trained health professional who will be with you during the test.
What is 20% mannitol injection?
20% Mannitol Injection USP (United States Pharmacopeia) treats early kidney failure by increasing urination. This helps your body get rid of extra fluids. 20% Mannitol Injection USP treats brain swelling and increased pressure in the eye. Also treats poisoning by increasing urination to remove toxins from the body.
How long does it take for mannitol to appear in urine?
In this fashion, approximately 80% of a 100 gram dose of mannitol will appear in the urine in three hours with lesser amounts thereafter.
Can 20% mannitol be given to pregnant women?
Pregnancy Category C. Animal reproduction studies have not been conducted with 20% Mannitol Injection USP. It is also not known whether 20% Mannitol Injection USP can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. 20% Mannitol Injection USP should be given to a pregnant woman only if clearly needed.
Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Pediatric
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of mannitol injection in children. However, children younger than 2 years of age, especially preterm and term neonates, are more likely to have fluid and electrolyte abnormalities. Safety and efficacy have been established.
Geriatric
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of prochlorperazine in the elderly.
Breastfeeding
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Drug Interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary.
Other Interactions
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
Why is mannitol used in kidney failure?
Mannitol is also used to help your body produce more urine. This medicine is used in people with kidney failure, to remove excess water and toxins from the body. Mannitol is sometimes given so that your body will produce enough urine to be collected and tested. This helps your doctor determine if your kidneys are working properly.
Can mannitol cause false results?
You will need frequent medical tests to be sure this medicine is not causing harmful effects. This will also help your doctor determine how long to treat you with mannitol. This medicine may affect certain medical tests and you may have false results. Tell any doctor who treats you that you are using mannitol.
Can you take mannitol if you are allergic to it?
You should not receive mannitol if you are allergic to it, or if you have: severe or long-term kidney disease; swelling or congestion in your lungs; severe heart failure; bleeding in your brain that is not related to surgery; severe dehydration; or. if your kidneys have already shut down and you are unable to urinate.
Does Multum cover all medical issues?
Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.
Can you take mannitol if you have kidney disease?
You should not receive mannitol if you have severe kidney disease, lung swelling or congestion, severe heart failure, severe dehydration, bleeding in your brain not caused by surgery, or if your kidneys have already shut down and you are unable to urinate.
Can you take mannitol injections at the clock?
A healthcare provider will give you this injection. Mannitol must be given slowly, and you may receive the medication around the clock. Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when mannitol is injected.
Does mannitol affect kidneys?
Mannitol can harm your kidneys, especially if you also use certain medicines for infections, cancer, osteoporosis, organ transplant rejection, bowel disorders, or pain or arthritis (including aspirin, Tylenol, Advil, and Aleve ). Tell your doctor about all your other medicines, especially a diuretic or "water pill.".
How long before bronchitol can you take mannitol?
Your doctor will prescribe another inhaled medicine that you should use 5 to 15 minutes before each dose of Bronchitol. Do not use any other medicines not recommended by your doctor. Do not swallow a mannitol inhalation capsule. It is for use only in the inhaler device provided with this medicine.
What are the side effects of mannitol?
cough, throat pain or irritation; runny nose; headache, dizziness; or. nausea, vomiting. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. Mannitol side effects (more detail)
How much IV fluid is used for cardiovascular surgery?
Prevention (for use during cardiovascular and other types of surgery): 50 to 100 g IV. usually a 5 , 10, or 20% solution is used depending on the fluid requirements of the patient.
Can you take mannitol with chest tightness?
Before taking this medicine. You should not use mannitol inhalation if you've ever had an allergic reaction or bronchospasm (wheezing, chest tightness, trouble breathing) after using mannitol. You also should not use this medicine if you are allergic to anything used to make the capsules (such as gelatin, shellac, isopropyl alcohol, ...
Can mannitol cause breathing problems?
wheezing, choking, or other breathing problems after using mannitol inhalation; or. if you cough up large amounts of blood. Common side effects of Bronchitol may include: pain or irritation in your mouth or throat; trouble swallowing; fever; or. vomiting. Common side effects of Aridol may include: wheezing, trouble breathing, chest discomfort;
Can you take mannitol with bronchitol?
Bronchitol is used together with other medicines to improve breathing in adults with cystic fibrosis. Bronchitol is given only after you have passed a tolerance test to make sure you can safely use mannitol inhalation. Aridol is used as a part of medical testing for asthma in children at least 6 years old.
Can mannitol cause hives?
Mannitol inhalation side effects. Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have: wheezing, choking, or other breathing problems after using mannitol inhalation; or. if you cough up large amounts of blood.
What happens if you take too much mannitol?
Too rapid infusion of large amounts of mannitol will cause a shift of intracellular water into the extra cellular compartment resulting in cellular dehydration and overexpansion of the intravascular space with hyponatremia, congestive heart failure and pulmonary edema. Repeated doses should not be given to patients with persistent oliguria as this can produce a hyperosmolar state and precipitate congestive heart failure and pulmonary edema due to volume overload. Dosage must be carefully monitored and adjusted in accordance with the clinical situation to avoid the consequences of overdosage (see
How long does it take to reduce intracranial pressure?
Reduction of Intracranial Pressure and Brain Mass: In adults a dose of 0.25 to 2 g/kg body weight as a 15% to 25% solution administered over a period of 30 to 60 minutes; pediatric patients 1 to 2 g/kg body weight or 30 to 60 g/m2 body surface area over a period of 30 to 60 minutes. In small or debilitated patients, a dose of 500 mg/kg may be sufficient. Careful evaluation must be made of the circulatory and renal reserve prior to and during administration of mannitol at the higher doses and rapid infusion rates. Careful attention must be paid to fluid and electrolyte balance, body weight, and total input and output before and after infusion of mannitol. Evidence of reduced cerebral spinal fluid pressure must be observed within 15 minutes after starting infusion.
Can mannitol cause congestive heart failure?
The cardiovascular status of the patient should be carefully evaluated before rapidly administering mannitol since sudden expansion of the extracellular fluid may lead to fulminating congestive heart failure.
Can mannitol cause fetal harm?
Animal reproduction studies have not been conducted with mannitol injection. It is also not known whether mannitol injection can cause fetal harm when given to a pregnant woman or can affect reproduction. Mannitol injection should be given to a pregnant woman only if clearly needed.
Allergies
This medication is used to treat cystic fibrosis.
May Treat: Diagnostic test for asthma · Respiratory cystic fibrosis
Brand Names: Bronchitol · Aridol Bronchial Challenge
Drug Class: Cystic Fibrosis - Inhaled Osmotic Agents · Diagnostic Drugs - Pulmonary
Availability: Prescription Required
Pregnancy: Consult a doctor before using
Lactation: Consult a doctor before using
- If available, read the patient package insert
- Use capsules in inhaler. Do not swallow capsules.
- Know how to use before taking.
- If available, read the patient package insert
- Use capsules in inhaler. Do not swallow capsules.
- Know how to use before taking.
- Dry hands before using.
- Do not use more often than recommended by Dr.
- Tell doctor your complete medical history
- Store in a cool and dry place at room temperature
- Important to try not to skip doses
Pediatric
Geriatric
Breastfeeding
Drug Interactions
- Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of mannitol injection in children. However, children younger than 2 years of age, especially preterm and term neonates, are more likely to have fluid and electrolyte abnormalities. Safety and efficacy have been established.
Other Interactions
- Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of prochlorperazine in the elderly. However, elderly patients are more likely to have fluid and electrolyte imbalances and age-related kidney, heart, or lung problems, which may require caution in the dose for patients receiving this medicine.
Other Medical Problems
- There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.