Mannitolo Diaco (Mannitol)

Mannitol is used as an intravenous osmotic diuretic to manage conditions associated with elevated fluid pressure.

• Elevated intracranial pressure: rapid reduction of intracranial pressure in neurosurgical and traumatic brain injury patients.
• Acute kidney injury: assists renal protection by increasing urine output and flushing nephrotoxic substances.
• Intra‑ocular pressure spikes: lowers intra‑ocular pressure during ocular surgery or acute glaucoma attacks.

• Mannitol acts as an osmotically active agent that remains largely extracellular after intravenous infusion. By increasing plasma osmolality, it creates an osmotic gradient that draws water from intracellular and interstitial spaces into the vascular compartment, expanding plasma volume and promoting renal filtration. The resulting diuresis helps to lower intracranial and intra‑ocular pressure and facilitates removal of metabolic waste.

Mannitol may be associated with several adverse reactions, ranging from mild to severe.

Common Side Effects

• Headache: mild to moderate headache occurring during or after infusion.
• Nausea and vomiting: gastrointestinal discomfort commonly reported.
• Electrolyte imbalance: transient changes in sodium or potassium levels.

Serious or Rare Side Effects

• Pulmonary edema: fluid accumulation in lungs, especially with rapid infusion.
• Severe hypotension: marked drop in blood pressure requiring intervention.
• Anaphylactoid reaction: rare allergic response with rash, bronchospasm, or shock.

When using Mannitol, clinicians should observe specific safety measures to minimize risks.

• Fluid balance monitoring: assess input and output to avoid overload.
• Serum electrolytes: check sodium, potassium and osmolality before and during therapy.
• Renal function evaluation: ensure adequate glomerular filtration before administration.
• Cardiac status: use cautiously in patients with heart failure or pulmonary congestion.
• Infusion rate control: avoid rapid bolus in susceptible individuals.
• Store at below 25°C: keep in original packaging, protect from moisture and direct sunlight.

Mannitol can interact with other medicines, altering its efficacy or safety profile.

Major Interactions (Avoid)

• Loop diuretics: additive diuretic effect may cause excessive fluid loss.
• Nephrotoxic agents (e.g., aminoglycosides, amphotericin B): increased risk of renal injury.
• Insulin: enhanced hypoglycaemic effect due to increased renal clearance of glucose.

Moderate Interactions (Monitor Closely)

• Antihypertensives: possible additive blood pressure lowering.
• Corticosteroids: may affect electrolyte balance.
• Lithium: altered lithium clearance requiring level monitoring.