Mannitol

General

  • Type: sugar alcohol, derived from mannose, stereo-isomer of sorbitol
  • Dosage Forms: Reconstituted powder and solution[1]
    • 5% and 10% in 1000ml containers
    • 15% in 500ml containers
    • 20% in 250ml and 500ml containers
    • 25% in 50ml flip-top vials
  • Common Trade Names: Mannitol, Osmitrol

Dosing

Adult

Elevated intracranial pressure

  • 0.25-2 G/kg given every 6 to 8 hours[2]
    • Should be given as a one time bolus (may be inferior to Hypertonic Saline)[3]
    • Easy ED dosing: 1mg/kg bolus in ED (while awaiting neurosurgery eval/admission)

Pediatric Dosing

Cerebral edema

  • 0.25-1 g/kg IV initially; maintenance dose of 0.25-0.5 g/kg IV q4-6hr[4]

Special Populations

  • Pregnancy Rating: C
  • Lactation:
    • Unknown if present in breast milk
  • Renal Dosing
    • Adult
      • Contraindicated in severe renal impairment
    • Pediatric
      • Contraindicated in severe renal impairment
  • Hepatic Dosing
    • Adult
      • No adjustment necessary
    • Pediatric
      • No adjustment necessary

Indications

  • Lowering ICP with signs of impending herniation or severely deteriorating mental status in context of known trauma or intracranial lesion exerting mass effect

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life:
  • Metabolism:
  • Excretion:
  • Mechanism of Action:

See Also

References

  • Mannitol (systemic): Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.