Dosing and uses of Osmitrol (mannitol)
Adult dosage forms and strengths
injectable solution
- 5%
- 10%
- 15%
- 20%
- 25%
Cerebral Edema
Reduction of intracranial pressure and treatment of cerebral edema
1.5-2 g/kg IV infused over 30-60 minutes
Intraocular Pressure
1.5-2 g/kg IV infused over 30-60 minutes
Anuria/Oliguria
Test dose: 200 mg/kg IV infused over 3-5 minutes
Load: 500-1000 mg/kg IV x1 dose
Maintenance: 250-500 mg/kg IV q4-6hr
Bronchiectasis (Orphan)
Bronchitol: Facilitates clearance of mucus with bronchiectasis, and in patients with cystic fibrosis at risk for bronchiectasis
Orphan indication sponsor
- Pharmaxis Ltd; 10 Rodborough Rd, NSW 2086, Australia
Other Information
Do NOT give simultaneously with blood
Use 15-25% solution
Other Indications & Uses
Brain mass
Pediatric dosage forms and strengths
injectable solution
- 5%
- 10%
- 15%
- 20%
- 25%
Edema
0.25-1 g/kg IV initially; maintenance dose of 0.25-0.5 g/kg IV q4-6hr
Anuria/Oliguria
Test dose: 0.2 g/kg IV over 3-5 minutes; not to exceed 12.5 g
Discontinue if no diuresis within 2 hr
Other Information
Treatment of intoxications: Give therapeutic dose as 5 or 10% solution IV PRn
Osmitrol (mannitol) adverse (side) effects
Frequency not defined
Angina-like chest pains
CHF
Hypotension
Phlebitis
Convulsions
Chills
Dizziness
Headache
Acidosis
Fluid/electrolyte imbalances
Thirst
Nausea
Vomiting
Blurred vision
Urinary retention
Warnings
Contraindications
Hypersensitivity, anuria, severe pulmonary edema or heart failure, severe dehydration, metabolic edema, progressive renal dz, active intracranial bleeding (except during craniotomy)
Cautions
Do not mix w/ blood
May cause hypovolemia, headache, polydipsia
It might be more effective than pentobarbital, but less effective than hypertonic saline in pt w/acute traumatic brain injury
Pregnancy and lactation
Pregnancy category: C
Lactation: use caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Osmitrol (mannitol)
Half life: 100 min
Onset
Diuresis: 1-3 hr after IV administration of mannitol. Lowering of
IOP reduction: 30-60 min
ICP reduction: 15 min
Duration
IOP reduction: 4-6 hr
ICP reduction: 3-8 hr
Other Information
Metabolism: liver (very slight)
Metabolites: glycogen
Excretion: urine (80%)
Mechanism of action
Osmotic diuretic
Administration
IV Incompatibilities:
Additive: etoposide w/ cisplatin & KCl(?), imipenem-cilastatin (may be used for shorter periods), meropenem (may be used for shorter periods)
Y-site: cefepime, doxorubicin liposomal, filgrastim
IV Compatibilities
Additive (partial list): cefoxitin, cimetidine, furosemide. metoclopramide, ondansetron
Y-site: allopurinol, cisatracurium, etoposide phosphate, linezolid, ondansetron, propofol, vinorelbine
IV Preparation
Infusion only
Use administration set with filter for infusion of injections containing 20% or more, since crystals may be present
For transurethral prostatic resection, mannitol irrigation solns are instilled into bladder via indwelling urethral catheter
