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Manganese


Pronunciation

 (MAN ga nees)


Synonyms

 Manganese Chloride; Manganese Sulfate


Generic Available

 Yes


Use

 Trace element added to total parenteral nutrition (TPN) solution to prevent manganese deficiency; orally as a dietary supplement


Pregnancy Risk Factor

 C


Lactation

 Enters breast milk/compatible


Contraindications

 High manganese levels; severe liver dysfunction or cholestasis (conjugated bilirubin >2 mg/dL) due to reduced biliary excretion


Warnings/Precautions

 Manganese chloride solution for injection contains aluminum; use caution with impaired renal function and in premature infants. Use caution with hepatic impairment.


Overdosage/Toxicology

 Acute poisoning due to ingestion of manganese or manganese salts is rare (poor oral absorption). Manganese chloride solution for injection contains aluminum; aluminum doses >4-5 mcg/kg/day are associated with toxicity in patients with renal impairment and in premature neonates. The main symptoms of chronic poisoning, either from injection or usually inhalation of manganese dust or fumes, include extrapyramidal symptoms that can lead to progressive deterioration in the central nervous system.


Stability

 Solution for injection: Store at controlled room temperature of 15°C to 30°C (59°F to 86°F); compatible with electrolytes usually present in amino acid/dextrose solution used for TPN solutions.


Mechanism of Action

 Cofactor in many enzyme systems, stimulates synthesis of cholesterol and fatty acids in liver, and influences mucopolysaccharide synthesis


Pharmacodynamics/Kinetics

Absorption: Oral: Poor (3% to 4%)

Distribution: Concentrated in mitochondria of pituitary gland, pancreas, liver, kidney, and bone

Excretion: Bile (primarily); urine (negligible)


Dosage

Oral: Adequate intake:

0-6 months: 0.003 mg/day

7-12 months: 0.6 mg/day

1-3 years: 1.2 mg/day

4-8 years: 1.5 mg/day

9 years to Adults, Male: 1.9-2.3 mg/day

9 years to Adults, Female: 1.6-1.8 mg/day

Pregnancy: 2 mg/day

Lactation: 2.6 mg/day

I.V.:

Children: 2-10 mcg/kg/day usually administered in TPN solutions

Note: Use caution in premature neonates; manganese chloride solution for injection contains aluminum

Adults: 150-800 mcg/day usually administered in TPN solutions

Dosage adjustment in renal impairment: Use caution; manganese chloride solution for injection contains aluminum

Dosage adjustment in hepatic impairment: Use caution; dose may need to be decreased or withheld


Administration

 Solution for injection: Do not administer I.M. or by direct I.V. injection; acidic pH of the solution may cause tissue irritations and it is hypotonic


Monitoring Parameters

 Periodic manganese plasma level


Reference Range

 Plasma: 0.6-2 ng/mL


Dental Health: Effects on Dental Treatment

 No significant effects or complications reported


Dental Health: Vasoconstrictor/Local Anesthetic Precautions

 No information available to require special precautions


Dosage Forms

Injection, solution, as chloride [preservative free]: 0.1 mg/mL (10 mL) [contains aluminum 100 mcg/mL]

Injection, solution, as sulfate: 0.1 mg/mL (10 mL)

Tablet, elemental: 50 mg, 100 mg


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