Mannitol-Infusionslösung 10 (Mannitol)

Mannitol is employed in clinical situations where osmotic diuresis or reduction of fluid pressure is required.

• Cerebral edema: lowers intracranial pressure and helps control brain swelling.
• Acute renal failure (oliguria): enhances urine output to support renal clearance.
• Acute glaucoma: rapidly decreases intra‑ocular pressure during an attack.

• Mannitol acts as an osmotically active agent that does not readily cross cell membranes. When administered intravenously, it raises the osmolarity of plasma and renal tubular fluid, drawing water from intracellular and interstitial spaces into the vascular compartment and subsequently into the urine, thereby producing diuresis and reducing tissue edema, including intracranial and intra‑ocular pressure.

Mannitol may cause a range of adverse reactions, from mild to severe.

Common Side Effects

• Headache: mild to moderate discomfort.
• Nausea: feeling of unease or urge to vomit.
• Vomiting: expulsion of stomach contents.
• Thirst: increased desire for fluids.
• Dizziness: sensation of light‑headedness.
• Electrolyte imbalance: changes in sodium or potassium levels.

Serious or Rare Side Effects

• Acute renal failure: sudden loss of kidney function.
• Pulmonary edema: fluid accumulation in the lungs.
• Severe hyponatremia: dangerously low blood sodium.
• Anaphylactic reaction: severe allergic response.
• Hemolysis: destruction of red blood cells.
• Metabolic acidosis: excess acidity in the body.

Mannitol administration requires careful monitoring and adherence to safety guidelines.

• Renal function: assess baseline kidney status and monitor creatinine.
• Electrolyte balance: check serum sodium and potassium regularly.
• Fluid status: avoid overload; monitor input and output.
• Pregnancy: use only if potential benefit justifies potential risk.
• Contraindications: do not administer to patients with severe renal impairment or anuria.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Mannitol can interact with other medications, affecting safety and efficacy.

Major Interactions (Avoid)

• Loop diuretics: may exacerbate electrolyte disturbances.
• Nephrotoxic agents (e.g., aminoglycosides): increase risk of renal injury.
• Insulin: enhanced hypoglycaemic effect due to altered fluid shifts.

Moderate Interactions (Monitor Closely)

• NSAIDs: may blunt diuretic response.
• Antihypertensives: additive blood pressure lowering.
• Corticosteroids: potential for increased fluid retention.