Mannitol Bradex (Mannitol)

• Mannitol is an osmotic agent used in conditions where reduction of fluid pressure is required.
• Intracranial hypertension: lowers intracranial pressure to prevent cerebral edema.
• Intraocular pressure elevation: reduces intraocular pressure in acute glaucoma attacks.
• Renal failure with oliguria: promotes diuresis to manage fluid overload.
• Peri‑operative kidney transplantation: supports urine output during surgical management.

• Mannitol acts as an osmotic diuretic by increasing extracellular osmolarity when administered intravenously. The elevated osmolarity draws water from intracellular and interstitial spaces into the vascular compartment, expanding plasma volume and enhancing renal filtration. This osmotic gradient promotes urine formation and reduces fluid pressure in the brain and eye, facilitating the therapeutic effects in the indicated conditions.

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

Common Side Effects

• Headache: transient headache occurring during or after infusion.
• Nausea or vomiting: gastrointestinal upset related to osmotic load.
• Electrolyte imbalance: especially hypokalemia or hyponatremia.
• Dehydration or hypotension: due to rapid fluid shifts.

Serious or Rare Side Effects

• Pulmonary edema: fluid accumulation in lungs, requiring immediate attention.
• Severe electrolyte disturbances: hypernatremia or severe hypokalemia.
• Anaphylactoid reaction: rare hypersensitivity with rash or bronchospasm.
• Worsening renal failure: in patients with pre‑existing severe kidney dysfunction.

• Mannitol requires careful monitoring and specific safety measures.
• Renal function: monitor urine output and serum electrolytes closely.
• Cardiovascular status: watch for hypotension, especially in hypovolemic patients.
• Pregnancy: category C; use only if potential benefit justifies the risk.
• Electrolyte balance: correct pre‑existing abnormalities before infusion.
• Concurrent nephrotoxic drugs: avoid or monitor closely for additive renal risk.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Mannitol can interact with several drug classes, influencing safety and efficacy.

Major Interactions (Avoid)

• Loop diuretics: may cause excessive fluid loss and electrolyte depletion.
• Insulin: hyperosmolar state can impair glucose control, requiring dose adjustment.
• ACE inhibitors: increased risk of profound hypotension.

Moderate Interactions (Monitor Closely)

• Antihypertensive agents: may potentiate blood pressure reduction.
• Nephrotoxic antibiotics (e.g., aminoglycosides): heightened risk of renal injury.