MANNITOL

Osmotic diuretic

Dosage Forms

Intravenous infusion

20%

Uses

  • Cerebral oedema
  • Raised intraocular pressure

Dose and Duration

Test dose (in oliguria or patient with poor renal function)

Adult and child: IV infusion of 200 mg/kg of 20% solution over 3–5 minutes. Repeat test dose if urine output is less than 30–50 ml/hour. Re-evaluate the patient if response is inadequate after 2ⁿᵈ test dose

Cerebral oedema

Adult and child: infuse rapidly 1 g/kg of 20% solution IV repeated 1–2 times if necessary after 4–8 hours

Raised intracranial or intraocular pressure

Adult: infuse 0.25–2 g/kg of 20% solution IV over 30–60 minutes repeated 1–2 times if necessary after 4–8 hours

Contraindications

  • Pulmonary oedema
  • Intracranial bleeding
  • Anuria
  • Severe congestive heart failure
  • Metabolic oedema with abnormal capillary fragility
  • Severe dehydration
  • Renal failure unless test dose produces diuresis

Side Effects

  • Fluid and electrolyte imbalances, circulatory overload
  • Acidosis
  • Pulmonary oedema

Pregnancy

  • Can be used

Breast-feeding

  • Can be used

⚠️ Caution

  • Monitor fluid and electrolyte balance, renal function, pulmonary function and serum osmolality. Assess cardiac function before and during treatment
  • The solution may crystallize during storage, thereby need re-dissolution by warming prior to administration. Do not use solution if crystals remain after warming
  • IV administration sets must have a filter. Do not administer mannitol with whole blood or pass it through the same transfusion set as blood
  • Only use in pregnancy and breast-feeding if it is essential