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VERIFIED CONTENTAuthor: Karolina Porowska

Mannitol is an organic chemical, a carbohydrate. It belongs to polyhydroxy sugar alcohols. It can exist as two enantiomers (D and L). It was discovered in 1806 by the French pharmacist Joseph Louis Proust. There are several preparations available on the pharmaceutical market containing mannitol in the form of intravenous or inhaled ampoules.

Mannitol composition

Solution for infusion (Fresenius 20%) contains the active ingredient 200 mg of mannitol (Mannitolum); excipients: water for injections.

Mannitol action

The action of the drug is to increase the osmotic pressure of the extracellular fluid, which leads to the penetration of water from the inside of the cells into the interstitial fluid and plasma. As a consequence, the amount of water in the vitreous body is reduced and the intracranial pressure is lowered, the pressure inside the eyeball is lowered and puffiness is minimized.

Mannitol from the blood is transported to the renal tubules where it undergoes glomerular filtration. The site of action of the drug is the proximal tubule and the Henle loop of the nephron.

The drug is practically not reabsorbed into the blood, increases the osmotic pressure of the glomerular filtrate, enters the distal part of the nephron and is excreted as final urine.

The drug has the ability to increase the volume of circulating fluids and prevents renal failure. In addition, the drug contributes to the release of prostaglandin E2 and prostacyclin, an increase in the clearance of myoglobin, phosphates, and uric acid.

During acute renal failure, a significant proportion of mannitol is excreted through the kidneys. As it is excreted, mannitol takes water with it, increasing the patient's water excretion and helping to avoid or treat fluid overload due to oliguria in acute renal failure.

Mannitol use

Mannitol has found application in the diagnosis and prevention of acute renal failure, in glaucoma, when other methods do not bring the desired effect.

To treat increased intracranial pressure and cerebral edema, and to remove toxic substances from the body.

Indications for the use of mannitol

Recommendeduse of the drug:

  • in increasing urine output,
  • in lowering the intraocular and intracranial pressure,
  • in cerebral edema,
  • in diuresis during acute renal failure and in the prevention of oliguria.

Contraindications to the use of mannitol

Do not use the drug if you are allergic to mannitol and to any module listed in the composition of the drug. Contraindication to the use of the drug is acute renal failure or pulmonary edema. The drug is not recommended for pulmonary edema and intracranial bleeding.

Mannitol dosage

The drug should be used as described in the patient information leaflet or according to specific guidelines and recommendations of a doctor or pharmacist. Check with your doctor or pharmacist if you are not sure.


While taking the drug, monitor kidney function, blood levels of potassium and sodium. Do not exceed the recommended dose of the drug as this may cause serious kidney problems.

Cardiovascular fitness should be assessed before starting mannitol administration, as high doses and rapid administration of the drug may cause the development or worsening of congestive heart failure.

While taking the drug, respiratory function and central venous pressure should be monitored. Mannitol solution should not be administered together with blood as it may cause pseudoagglutination.

Mannitol side effects

Mannitol can cause:

  • dry mouth,
  • fluid and electrolyte imbalance,
  • blurred vision,
  • convulsions,
  • headache,
  • anuria,
  • dehydration,
  • heart failure,
  • rhinitis,
  • chills,
  • fever,
  • deterioration
  • and swelling of the brain and lungs.

Interaction with other drugs and diseases

In order to avoid undesirable ailments, inform your doctor or pharmacist about all medications that are currently or recently used, as well as about medications that the patient is going to use.

You should also inform the doctor about the current he alth condition, about any diseases or additional ailments we are struggling with. It is mainly not recommended to combine mannitol with saluretics, kanamycin, neomecin and others.

Pregnancy and breastfeeding

Before using the drug, inform your doctor if you are pregnant or breastfeeding.

Storing medicine

The drug should be stored in a suitable place that is invisible as wellnot available for children. In case of crystallization of the drug, it should be heated in a water bath to a temperature of about 70 ° C.

The solution should be cooled to body temperature before administration. The drug should not be used after the expiry date stated on the package. The expiry date refers to the last day of that month.

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