MANNITOL(15% infusion solution)

Solutio Manniti 15% pro infusia

International nonproprietary name (INN)

Mannitol.

Pharmacotherapeutic group

Diuretics.

Composition

1 ml solution contains 150 mg of mannitol and 9 mg of sodium chloride.

Pharmacological effect

Pharmacodynamics

Hypertonic solutions of mannitol are of high diuretic action. The effect is conditioned by increase of plasma osmotic pressure and decrease of reabsorption of water. Diuretic effect: elimination of large quantity of osmotic free water. Itdoesn’teffectglomerularfiltration. Diuresisisaccompaniedbysignificantsodiumeliminationwithoutsignificantinfluenceonpotassiumelimination. Thehigherthedrugconcentration, thehighertheeffect. Diureticeffectmaylackinrenalfiltrationimpair.

The drug enhances fluid elimination after perfusion, inhibits the resistance of renal vessels and enhances bloodstream in them and nephrotoxine elimination.

Pharmacokinetics

Distribution volume corresponds to extracellular fluid volume. Mannitol is liver metabolized with the formation of glycogene. Half-excretion is about 100 min. it is renal excreted. In renal failure half-excretion may be 36 h.

Indicationsforusage

Mannitol is administered as 15% solution for decreasing intracranial pressure and brain edema, in acute hepatic and renal failure with maintenance of renal filtration, in other conditions requiring increased diuresis. In acute persistent glaucoma mannitol is administered for dehydration.

Due to dehydration activity and decrease of intracranial pressure it is also administered in intensive therapy of convulsion state.

Mannitol is recommended in operations with artificial blood circulation to prevent renal ischemia and related acute renal failure.

The drug is effective also in barbiturate poisoning.

Administrationanddosage

i.v.injection (stream, slowly or by drops). For prevention single dose is 0.5 g/kg, for therapy 1-1.5 g/kg. Daily dose is NMT 140—180 g.

Adverse reaction

Excessiveintroductionof 15% mannitolsolutionmayrevealdehydrationsigns (dyspepsia, hallucinationsandothers). Toavoiddehydrationintroducefluid. Mannitol is repeated under the control of water-salt balance.

Possible tachycardia, posterior chest bone pain, thrombophlebitis, skin eruption.

Contraindications

Disorder of renal excretion function and severe blood circulation failure. Hypersensitivitytomannitol. Intracranialhemorrhage. Pulmonaryedemaх.

Safetymeasures

In pregnancy and lactation administer the drug only if the supposed advantage for mother prevails on the risk for fetus and infant.

Administer with care in patients with severe chronic cardiac failure, hypovolemia, hyponatremia, hyperkalemia. In case of such symptoms as headache, vertigo, vomit, visual impairment cancel the drug.

5% mannitol solution dosing is accompanied with arterial pressure/diuresis/electrolit serum concentration control (potassium, sodium).

Interaction with other drugs

Concurrent administration of cardiac glycosides increases their toxicity related to hypokalemia.

Dosageform

15% injection solution (infusion solution). 400 ml in a glass bottle for blood.