- Mannilyte (Osmotol)

MANNILYTE

(20% mannitol Intravenous Infusion B.P.)
 
Therapeutic Class
 
Osmotic diuretic
 
Description and Composition
 
A clear, colorless fluid, each 1000 ml. of which contains:
 
Mannitol B.P.                        200.0 grams Water for Injections B.P.         q.s.
 
Pharmacological Effects
 

• Large molecular size of this medication prevents its movement out of the vascular space. As such, an osmotic gradient is created which moves fluid from the tissues into the intravascular system.
• In the kidney, it moves into the glomerular filtrate which raises the osmotic pressure and induces diuresis.
• The pH range is 4.5 - 7.5.

 
Indications
 

• Treatment and                 of cerebral edema.
• Reduction of intracranial pressure in neurosurgery.
• To reduce raised intraocular pressure prior to ophthalmic procedures.
• To increase urine flow in patients with acute renal failure.
• Promotion of excretion of toxic materials.
• Prophylaxis of acute renal failure.

 
Dosage and Administration
 

• The dosage and the rate of administration depends on the fluid requirements, urinary output and the condition being treated. The usual adult dose ranges from 50-200 grams/24 hours.
• Reduction of intracranial pressure:

In adults usually 250-300 ml. of the solution infused rapidly over 15-30 minutes.

• Diuresis:

50-200 grams over 24 hours in adults, preceded by a test dose of
200  mg/kg  (about  60  ml.  in  a  50  kg.  person)  given  over  3-5 minutes produces a diuresis of 30-50 ml/hour.

• Reduction of intraocular pressure:

1.5-2.0 grams/kg. (about 10-13ml/kg) over a period of 30 minutes to obtain a prompt and maximal result. The dose should be given 1-1½ hours prior to surgery to achieve maximal effect.

• Excretion of toxic materials:

While  using

as  an  adjunctive  therapy  for  excretion  of  toxic

materials the dosage depends on the fluid requirements and the urine output of the patient.

• The recommended dose for children is 200-500 mg/kg. I.V. over 30- 60 minutes.

Adverse Effects
 

• Chest pain, chills, thrombophlebitis and visual disturbances.
• Hypertension.
• Congestive heart failure and pulmonary edema.
• Hypotension due to rapid volume depletion from large diuresis
• Blurred vision and convulsions may occur.
• Nausea and vomiting may occur.
• Electrolyte depletion, especially sodium.
• Irritation, pain and/or swelling at the injection site.

 
Contraindications
 

• Hypersensitivity to any component of the preparation
• Dehydration.
• Electrolyte depletion and hypovolemia.
• Suspected intracranial hemorrhage.
• Congestive heart failure.
• Acute pulmonary edema.
• Renal failure, unless a test dose has produced a diuretic response.

 
Precautions
 

• Avoid use in pregnant women. Safe use of mannitol has not been established with respect to             effects upon fetal development. It should not be used unless the potential benefits outweigh the possible hazards.
• Monitor ECG continuously.
• Monitor vital signs, level of consciousness, breath sounds and urine output closely during administration.
• The patient should have Foley’s catheter in place.

 
Osmolarity and Tonicity
 
Hypotonic solution as it does not contain any cations. Hyper-osmolar solution (1098 mOsm/L)
 
Caloric Value
 
Nil.
 
Pharmaceutical precautions
 

• The  solution  is  incompatible  with  any  medication  in  syringe  or solution, and whole blood .
• Crystallizes at any temperature but room temperature.

• If crystals are observed, the preparation should be warmed to room temperature before administration.
• Administration through a filter is preferable.

Packaging
 
500ml.in plabottle.