Formulary
Mannitol: Indications, Dosing, Side Effects and Interactions
Mannitol clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Mannitol: Indications, Dosing, Side Effects and Interactions
Mannitol clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Cerebral oedema**
- **Adult** (By Intravenous Infusion): 0.25-2 g/kg, repeated if necessary, to be administered over 30-60 minutes, dose may be repeated 1-2 times after 4-8 hours.
**Raised intra-ocular pressure**
- **Adult** (By Intravenous Infusion): 0.25-2 g/kg, repeated if necessary, to be administered over 30-60 minutes, dose may be repeated 1-2 times after 4-8 hours.
**Treatment of cystic fibrosis as an add-on therapy to standard care**
- **Adult** (By Inhalation Of Powder): Maintenance 400 mg twice daily, an initiation dose assessment must be carried out under medical supervision, for details of the initiation dose regimen, consult product literature.
**Cerebral oedema for mannitol**
- **Child 1 month-11 years** (By intravenous infusion): 0.25-1.5 g/kg, repeated if necessary, to be administered over 30-60 minutes, dose may be repeated 1-2 times after 4-8 hours.
- **Child 12-17 years** (By intravenous infusion): 0.25-2 g/kg, repeated if necessary, to be administered over 30-60 minutes, dose may be repeated 1-2 times after 4-8 hours.
**Peripheral oedema and ascites for mannitol**
- **Child** (By intravenous infusion): 1-2 g/kg, to be given over 2-6 hours.
Cautions
When used by inhalation Asthma; haemoptysis With intravenous use Extravasation causes inflammation and thrombophlebitis
Contraindications
When used by inhalation Bronchial hyperresponsiveness to inhaled mannitol; impaired lung function (forced expiratory volume in 1 second < 30% of predicted); non-CF bronchiectasis With intravenous use Anuria; intracranial bleeding (except during craniotomy); severe cardiac failure; severe dehydration; severe pulmonary oedema
Side effects
General side-effects: Common or very common Cough; headache; vomiting Uncommon Dizziness; fever; malaise; nausea; pain; skin reactions Specific side-effects: Common or very common When used by inhalation Chest discomfort; condition aggravated; haemoptysis; respiratory disorders; throat complaints Uncommon When used by inhalation Abdominal pain upper; appetite decreased; asthma; burping; cold sweat; cystic fibrosis related diabetes; dehydration; diarrhoea; dysphonia; dyspnoea; ear pain; fatigue; gastrointestinal disorders; hypoxia; increased risk of infection; influenza like illness; insomnia; joint disorders; morbid thoughts; odynophagia; oral disorders; rhinorrhoea; sputum discolouration; urinary incontinence Frequency not known With intravenous use Arrhythmia; asthenia; azotaemia; chest pain; chills; coma; compartment syndrome; confusion; congestive heart failure; dry mouth; electrolyte imbalance; fluid imbalance; hyperhidrosis; hypersensitivity; hypertension; lethargy; metabolic acidosis; muscle complaints; musculoskeletal stiffness; nephrotic syndrome; neurotoxicity; peripheral oedema; pulmonary oedema; rebound intracranial pressure increase; renal impairment; rhinitis; seizure; thirst; urinary disorders; vision blurred
Interactions
**Other interactions (7):**
- Effect Potentialisation Concurrent use of other diuretics may potentiate the effects of mannitol and dose adjustments may be required.
- Effect Inhibition Mannitol promotes urine flow, which will mainly affect drugs that are renally reabsorbed to a large extent - thereby increasing their clearance and reducing their exposure .
- Mannitol increases urinary excretion of lithium and therefore concomitant use of mannitol may impair the response to lithium.
- Nephrotoxicity of drugs due to fluid imbalance related to mannitol Patients receiving concomitant ciclosporin and aminoglycoside should be closely monitored for signs of nephrotoxicity.
- Neurotoxic agents Concomitant use of neurotoxic agents (e.g.
- Agents affected by electrolyte imbalances The development of electrolyte imbalances (e.g., hyperkalaemia, hypokalaemia) associated with mannitol administration may alter the effects of agents that...
Pregnancy
With intravenous use: Manufacturer advises avoid unless essential- no information available. When used by inhalation: Manufacturer advises avoid.
Breast feeding
With intravenous use: Manufacturer advises avoid unless essential-no information available. When used by inhalation: Manufacturer advises avoid.
Renal impairment
With intravenous use: Caution in severe impairment (consult product literature). M
Medicinal forms
Solution,Powder
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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