Mannisol B Teva (Mannitol)

Mannisol B is an osmotic diuretic used in several acute medical conditions where fluid shifting is required.

• Reduction of intracranial pressure: lowers pressure within the skull to protect brain tissue.
• Acute renal failure: promotes diuresis to assist renal clearance of waste products.
• Intraocular pressure: decreases pressure inside the eye, aiding in ocular emergencies.

• Mannitol increases extracellular osmolarity when administered intravenously, drawing water from intracellular and cerebral compartments into the vascular space. This osmotic shift expands plasma volume, induces diuresis, and reduces pressure in the intracranial and intraocular compartments, facilitating fluid removal and pressure normalization.

Mannitol may cause a range of adverse reactions that vary in frequency and severity.

Common Side Effects

• Headache: mild to moderate discomfort.
• Nausea: feeling of unease or urge to vomit.
• Vomiting: expulsion of stomach contents.
• Electrolyte imbalance: changes such as hyponatremia or hypokalemia.
• Transient hypotension: temporary drop in blood pressure.

Serious or Rare Side Effects

• Anaphylaxis: severe allergic reaction requiring immediate medical attention.
• Pulmonary edema: fluid accumulation in the lungs.
• Exacerbation of renal failure: worsening kidney function.
• Seizures: convulsive episodes in susceptible patients.

When using Mannisol B, clinicians should observe several safety measures.

• Assess renal function: evaluate baseline kidney status before initiation.
• Monitor electrolytes: check serum sodium and potassium regularly during therapy.
• Avoid rapid infusion: administer over the recommended period to reduce hypotension risk.
• Use with caution in heart failure: may worsen fluid overload.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Mannitol can interact with other medications, altering efficacy or safety.

Major Interactions (Avoid)

• Loop diuretics: may cause excessive fluid loss and electrolyte disturbances.
• Insulin: can potentiate hypoglycaemia when combined.
• Lithium: increased risk of lithium toxicity due to altered renal clearance.

Moderate Interactions (Monitor Closely)

• ACE inhibitors: additive hypotensive effect, monitor blood pressure.
• Antihypertensives: may enhance blood pressure lowering, require observation.
• Nephrotoxic antibiotics: monitor renal function closely when co‑administered.