Indication |uses contraindication,side effect of mannitol drug

Mannitol

Generic Name: mannitol (MAN-ih-tole)
Brand Name: Osmitrol

Mannitol is used for:

Preventing or treating excess body water in certain kidney conditions, reducing swelling of the brain, or reducing pressure in the eye. It may also be used for other conditions as determined by your doctor.

Mannitol is an osmotic diuretic. It works by increasing the amount of fluid excreted by the kidneys and helps the body to decrease pressure in the brain and eyes.

Do NOT use mannitol if:

you are allergic to any ingredient in mannitolyou have a history of heart failureyou have decreased or absent production of urine due to severe kidney disease, certain severe lung problems (eg, pulmonary congestion or pulmonary edema), bleeding in the brain, or severe dehydration

Contact your doctor or health care provider right away if any of these apply to you.

Before using mannitol:

Some medical conditions may interact with mannitol. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feedingif you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplementif you have allergies to medicines, foods, or other substancesif you have swelling, kidney problems, or heart problems (eg, congestive heart failure)

Some MEDICINES MAY INTERACT with mannitol. However, no specific interactions with mannitol are known at this time.

Ask your health care provider if mannitol may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use mannitol:

Use mannitol as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Mannitol is usually administered as an injection at your doctor's office, hospital, or clinic.If mannitol contains particles or is discolored, or if the vial is cracked or damaged in any way, do not use it.Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.If you miss a dose of mannitol, contact your doctor right away.

Ask your health care provider any questions you may have about how to use mannitol.

Important safety information:

Mannitol may cause dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use mannitol with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.Tell your doctor immediately if you have difficulty urinating or experience extreme dizziness.Lab tests, including blood electrolytes, kidney function, lung function, heart function, and blood counts, may be performed to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments.Use mannitol with caution in the ELDERLY; they may be more sensitive to its effects.Mannitol should be used with extreme caution in CHILDREN younger than 12 years old; safety and effectiveness in these children have not been confirmed.PREGNANCY and BREAST-FEEDING: It is not known if mannitol can cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using mannitol while you are pregnant. It is not known if this medicine is found in breast milk. If you are or will be breast-feeding while you use mannitol, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of mannitol:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Increased urination; nausea; runny nose; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision; chest pain; chills or fever; confusion; decreased alertness; difficulty urinating; extreme dizziness; extreme thirst or dry mouth; fast or irregular heartbeat; headache; muscle cramps; pain, redness, or swelling at the injection site; weakness.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of mannitol:

Mannitol is usually handled and stored by a health care provider. If you are using mannitol at home, store mannitol as directed by your pharmacist or health care provider. Keep mannitol out of the reach of children and away from pets.

General information:

If you have any questions about mannitol, please talk with your doctor, pharmacist, or other health care provider.Mannitol is to be used only by the patient for whom it is prescribed. Do not share it with other people.If your symptoms do not improve or if they become worse, check with your doctor.Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take mannitol or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about mannitol. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to mannitol. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using mannitol.

Review Date: May 2, 2017

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

Mannitol Side Effects

Applies to mannitol: inhalation capsule

In addition to its needed effects, some unwanted effects may be caused by mannitol. In the event that any of these side effects do occur, they may require medical attention.

If any of the following side effects occur while taking mannitol, check with your doctor or nurse immediately:

Less common:

• Chest discomfort
• cough
• difficult or labored breathing
• dry heaves
• runny nose
• shortness of breath
• sore throat
• tightness in the chest
• troubled breathing
• vomiting
• wheezing

Incidence not known:

• Gagging

Minor Side Effects

Some of the side effects that can occur with mannitol may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:

• Headache

Less common:

• Dizziness
• nausea
• sore throat

For Healthcare Professionals

Applies to mannitol: compounding powder, inhalation kit, intravenous solution, irrigation solution

Cardiovascular

Cardiovascular side effects have included hypotension and tachycardia. Venous thrombosis or phlebitis extending from the injection site and hypervolemia have occurred rarely and are generally associated with the solution or technique used in administration.[Ref]

Respiratory

Respiratory side effects have included pulmonary congestion and rhinitis. Respiratory side effects associated with mannitol inhalation have included cough, gagging, wheeze, and decreased forced expiratory volume.[Ref]

Metabolic

Metabolic side effects have included fluid and electrolyte imbalance, acidosis, and electrolyte loss.[Ref]

Nervous system

Nervous system side effects have included headache, convulsions, and dizziness.[Ref]

Hematologic

Hematologic side effects have included thrombophlebitis.[Ref]

Other

Eight cases of mannitol IV overdose in patients with preexisting renal failure were reviewed. Symptoms presented in the reviewed cases were CNS involvement out of proportion to uremia, severe hyponatremia, large osmolality gap, and fluid overload. Six patients were treated with hemodialysis, one patient with peritoneal dialysis, and one patient died before initiation of treatment. All patients received large doses over 1 to 3 days with a mean dose of 310 +/- 182.8 g. CNS involvement consisted of CNS depression, confusion, lethargy, stupor, and coma. Two patients recovered cerebral function and continued on lifetime dialysis, 3 patients recovered renal and cerebral function, and 1 patient recovered renal function but had severe cerebral dysfunction.[Ref]

Other side effects have included dryness of mouth, thirst, edema, arm pain, chills, dehydration, fever, mannitol intoxication, and angina-like pain.[Ref]

Renal

Renal side effects have included acute renal failure.[Ref]

Local

Local side effects have included extravasation. This effect is generally attributed to the solution or technique used in administration.[Ref]

Dermatologic

Dermatologic side effects have included urticaria and skin necrosis.[Ref]

Ocular

Ocular side effects have included blurred vision.[Ref]

Immunologic

Immunologic side effects have included infection at the injection site and febrile response. These effects are usually attributed to solution or technique used in administration.[Ref]

Gastrointestinal

Gastrointestinal side effects have included nausea and vomiting.[Ref]

Genitourinary

Genitourinary side effects have included marked diuresis and urinary retention.[Ref]

Psychiatric

Psychiatric side effects have rarely included mania (1 case report).[Ref]

A 75-year-old woman with severe major depression experienced a manic episode 30 minutes after initiation of a 20% mannitol intravenous infusion for the treatment of acute angle closure glaucoma. The patient had been started on nortriptyline 50 mg per day for the treatment of depression ten days earlier. She received oral acetazolamide, topical pilocarpine, topical timolol, and topical dexamethasone concomitantly for the treatment of glaucoma. The mania resolved within approximately 1 hour following discontinuation of the mannitol infusion, and the patient returned to a severe depressive state. An extensive lab evaluation, toxicology screening, and medical examination failed to show additional secondary causes for mania in this patient.[Ref]

References

1. "Product Information. Osmitrol (mannitol)." Baxter I.V. Systems Division, Round Lake, IL.

2. "Product Information. Aridol (mannitol)." Pharmaxis Inc, Exton, PA.

3. Better OS, Rubinstein I, Winaver JM, Knochel JP "Mannitol therapy revisited (1940-1997)." Kidney Int 52 (1997): 886-94

4. Sakemi T, Ikeda Y, Ohtsuka N, Ohtsuka Y, Tomiyoshi Y, Baba N "Acute renal failure associated with mannitol infusion and reversal with ultrafiltration and hemodialysis." Nephron 73 (1996): 733-4

5. Doi K, Ogawa N, Suzuki E, Noiri E, Fujita T "Mannitol-induced acute renal failure." Am J Med 115 (2003): 593-4

6. Edwards JJ, Samuels D, Fu ES "Forearm compartment syndrome from intravenous mannitol extravasation during general anesthesia." Anesth Analg 96 (2003): 245-6, table of contents

7. Navarro V, Vieta E, Gasto C "Mannitol-induced acute manic state." J Clin Psychiatry 62 (2001): 126

Not all side effects for mannitol may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA