Mannitol: Difference between revisions

Latest revision as of 21:57, 20 March 2026

Type: sugar alcohol, derived from mannose, stereo-isomer of sorbitol
Dosage Forms: Reconstituted powder and solution^[1]
- 5% and 10% in 1000ml containers
- 15% in 500ml containers
- 20% in 250ml and 500ml containers
- 25% in 50ml flip-top vials
Common Trade Names: Mannitol, Osmitrol

0.25-2 g/kg given every 6 to 8 hours^[2]
- Should be given as a one time bolus (may be inferior to Hypertonic Saline)^[3]
- Easy ED dosing: 1g/kg bolus in ED (while awaiting neurosurgery eval/admission)

Pregnancy Rating: C
Lactation:
- Unknown if present in breast milk
Renal Dosing
- Adult
  - Contraindicated in severe renal impairment
- Pediatric
  - Contraindicated in severe renal impairment
Hepatic Dosing
- Adult
  - No adjustment necessary
- Pediatric
  - No adjustment necessary

Lowering ICP with signs of impending herniation or severely deteriorating mental status in context of known trauma or intracranial lesion exerting mass effect

Onset of action: 5-10 minutes
Half-life: 6 hours
Metabolism:
Excretion: Urine
Mechanism of Action: Increased tonicity of mannitol draws water out of the brain parenchyma and into the intravascular space^[5]

The following table is automatically generated from disease/condition pages across WikEM.

Indication	Dose	Context	Route	Population
Elevated intracranial pressure	1-1.5 g/kg	Osmotic diuretic for ICP reduction	IV bolus	Adult
Elevated intracranial pressure	0.25-1 g/kg IV over 15-20 min	Osmotherapy for elevated ICP	IV	Adult
Moderate-to-severe traumatic brain injury	0.25-1 g/kg IV over 15-20 min	Osmotherapy for elevated ICP	IV	Adult
Orbital compartment syndrome	2g/kg IV (20% solution)	Adjunctive to lateral canthotomy	IV	Adult
Retrobulbar hemorrhage	2g/kg IV (20% solution)	Adjunctive to cantholysis	IV	Adult
Traumatic intracerebral hemorrhage	0.25-1 g/kg IV over 15-20 min	Osmotherapy for elevated ICP	IV	Adult

Mannitol (systemic): Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.

Authors:

@@ Line 61: / Line 61: @@
 *Excretion: Urine
 *Mechanism of Action: Increased tonicity of mannitol draws water out of the brain parenchyma and into the intravascular space<ref>https://www.ncbi.nlm.nih.gov/books/NBK470392/#:~:text=Tenny%20S%2C%20Patel%20R%2C%20Thorell%20W.%20Mannitol.%20%5BUpdated%202022%20Feb%2021%5D.%20In%3A%20StatPearls%20%5BInternet%5D.%20Treasure%20Island%20(FL)%3A%20StatPearls%20Publishing%3B%202022%20Jan%2D.%20Available%20from%3A%20https%3A//www.ncbi.nlm.nih.gov/books/NBK470392/</ref>
+==Indications by Condition==
+''The following table is automatically generated from disease/condition pages across WikEM.''
+{{#ask:[[Has DrugName::Mannitol]]
+ |?Has Indication=Indication
+ |?Has Dose=Dose
+ |?Has Context=Context
+ |?Has Route=Route
+ |?Has Population=Population
+ |format=table
+ |headers=plain
+ |mainlabel=-
+ |sort=Has Indication
+ |limit=50
+}}
 ==See Also==