Pronunciation:

(MAN i tole)

U.S. Brand Names:

Synonyms:

Generic Available:

Canadian Brand Names:

Use:

Pregnancy Risk Factor:

Lactation:

Contraindications:

Warnings/Precautions:

Adverse Reactions:

Cardiovascular: Circulatory overload, CHF

Central nervous system: Headache, convulsions, headache, chills, dizziness

Dermatologic: Rash

Endocrine & metabolic: Fluid and electrolyte imbalance, water intoxication, dehydration and hypovolemia secondary to rapid diuresis, hyponatremia

Gastrointestinal: Nausea, vomiting, xerostomia

Genitourinary: Polyuria, dysuria

Local: Tissue necrosis

Ocular: Blurred vision

Respiratory: Pulmonary edema

Miscellaneous: Allergic reactions

Overdosage/Toxicology:

Drug Interactions:

Stability:

Compatibility:

Y-site administration: Compatible: Allopurinol, amifostine, amphotericin B cholesteryl sulfate complex, aztreonam, cisatracurium, cladribine, docetaxel, etoposide, fludarabine, fluorouracil, gatifloxacin, gemcitabine, idarubicin, linezolid, melphalan, ondansetron, paclitaxel, piperacillin/tazobactam, propofol, remifentanil, sargramostim, teniposide, thiotepa, vinorelbine. Incompatible: Cefepime, doxorubicin liposome, filgrastim

Compatibility when admixed: Compatible: Amikacin, bretylium, cefamandole, cefoxitin, cimetidine, cisplatin, dopamine, fosphenytoin, furosemide, gentamicin, metoclopramide, nizatidine, ofloxacin, ondansetron, sodium bicarbonate, tobramycin, verapamil. Incompatible: Imipenem/cilastatin, meropenem. Variable (consult detailed reference): Etoposide with cisplatin and potassium chloride, potassium chloride

Mechanism of Action:

Pharmacodynamics/Kinetics:

Onset of action: Diuresis: Injection: 1-3 hours; Reduction in intracerebral pressure: ~15 minutes

Duration: Reduction in intracerebral pressure: 3-6 hours

Distribution: Remains confined to extracellular space (except in extreme concentrations); does not penetrate the blood-brain barrier

Metabolism: Minimally hepatic to glycogen

Half-life elimination: 1.1-1.6 hours

Excretion: Primarily urine (as unchanged drug)

Dosage:

Children:

Test dose (to assess adequate renal function): 200 mg/kg over 3-5 minutes to produce a urine flow of at least 1 mL/kg for 1-3 hours

Initial: 0.5-1 g/kg

Maintenance: 0.25-0.5 g/kg given every 4-6 hours

Adults:

Test dose (to assess adequate renal function): 12.5 g (200 mg/kg) over 3-5 minutes to produce a urine flow of at least 30-50 mL of urine per hour over the next 2-3 hours

Initial: 0.5-1 g/kg

Maintenance: 0.25-0.5 g/kg every 4-6 hours; usual adult dose: 20-200 g/24 hours

Intracranial pressure: Cerebral edema: 1.5-2 g/kg/dose I.V. as a 15% to 20% solution over 30 minutes; maintain serum osmolality 310-320 mOsm/kg

Preoperative for neurosurgery: 1.5-2 g/kg administered 1-1.5 hours prior to surgery

Transurethral irrigation: Use urogenital solution as required for irrigation

Administration:

Monitoring Parameters:

Patient Education:

Additional Information:

Anesthesia and Critical Care Concerns/Other Considerations:

Mannitol 20% has an approximate osmolarity of 1100 mOsm/L.

Mannitol 25% has an approximate osmolarity of 1375 mOsm/L.

Dental Health: Effects on Dental Treatment:

Dental Health: Vasoconstrictor/Local Anesthetic Precautions:

Mental Health: Effects on Mental Status:

Mental Health: Effects on Psychiatric Treatment:

Dosage Forms:

Injection, solution: 5% [50 mg/mL] (1000 mL); 10% [100 mg/mL] (500 mL, 1000 mL); 15% [150 mg/mL] (500 mL); 20% [200 mg/mL] (150 mL, 250 mL, 500 mL); 25% [250 mg/mL] (50 mL)

Osmitrol®: 5% [50 mg/mL] (1000 mL); 10% [100 mg/mL] (500 mL, 1000 mL); 15% [150 mg/mL] (500 mL); 20% [200 mg/mL] (250 mL, 500 mL)

Solution, urogenital (Resectisol®): 5% [50 mg/mL] (2000 mL, 4000 mL)

International Brand Names: