Mannitol, 150 mg/ml 150 ml

Mannitol is an osmotic diuretic.

By increasing plasma osmotic pressure and filtration without subsequent reabsorption leads to water retention in the tubules and increased urine volume.

Elevating blood plasma osmolarity causes movement of fluid from the tissues (in particular the eyeball, brain) into the vascular bed. It does not affect glomerular filtration.

Diuresis is accompanied by a moderate increase in natriuresis without significant effect on excretion of potassium ions.

The diuretic effect is the greater the concentration (dose).

It is ineffective in impaired renal filtration function, as well as in azotemia in patients with cirrhosis and ascites.

Causes an increase in the BOD.

Indications

• cerebral edema;
• intracranial hypertension (in renal or renal-hepatic failure);
• .Oliguria in acute renal or renal-hepatic failure with preserved renal filtration capacity (as part of combined therapy);
• Post-transfusion complications after administration of incompatible blood;
• Forced diuresis in poisonings with barbiturates and salicylates;
• for prevention of hemolysis during operations with extracorporeal circulation in order to prevent renal ischemia and associated acute renal failure.

Active ingredient

Mannitol

Composition

Active substance:

Mannitol 150 g;

Auxiliary substances:

Sodium chloride – 9 g;

Injection water – up to 1 liter

How to take, the dosage

Intravenously, slowly by trickle or drip.

The prophylactic dose is 0.5 g/kg, therapeutic dose is 1-1.5 g/kg; the daily dose should not exceed 140-180 g.

The drug should be heated to a temperature of 37 ° C (can be in a water bath) before administration.

In operations with artificial circulation the drug is administered in a dose of 20-40 g immediately before perfusion.

Patients with oliguria should be given a test dose (200 mg/kg) by IV drip beforehand for 3-5 minutes. If no increase in diuresis rate to 30-50 ml/h is noted within 2-3 h thereafter, the drug should be refrained from further administration.

Interaction

The toxic effects of cardiac glycosides may be increased (associated with hypokalemia).

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Special Instructions

In case of left ventricular insufficiency (due to the risk of pulmonary edema), Mannitol should be combined with fast-acting loop diuretics. It is necessary to control BP, diuresis, and concentration of electrolytes in blood serum (sodium and potassium ions).

If headache, vomiting, dizziness, visual disturbances occur during drug administration, the administration should be discontinued and the development of such complications as subdural and subarachnoid bleeding should be excluded.

Possible use in heart failure (only in combination with loop diuretics) and hypertensive crisis with encephalopathy. Repeated administration of Mannitol should be carried out under control of parameters of water-electrolyte balance of blood.

Possible cases of crystallization of the drug during storage (at temperatures below 20 ° C). In case of crystallization the bottle is heated to 50-70 ° C until the precipitate dissolves. Use after cooling to body temperature if crystals do not precipitate again.

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Contraindications

• high sensitivity to the ingredients of the drug;
• anuria against a background of acute tubular necrosis with severe renal damage;
• dehydration of severe severity;
• left ventricular failure (especially accompanied by pulmonary edema);
• chronic heart failure;
• hemorrhagic stroke;
• hyponatremia;
• hypochloremia;
• hypokalemia.

With caution: pregnancy, lactation, advanced age.

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Side effects

Dehydration (dry skin, dyspepsia, myasthenia gravis, convulsions, dry mouth, thirst, hallucinations, BP decrease), disorders of water-electrolyte metabolism (increase of the BCC, hyponatremia; rarely – hyperkalemia).

Rarely – tachycardia, chest pain, thrombophlebitis, skin rash.

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