Mannitol (Osmitrol, Resectisol)


  • Diuretic


  • Osmolar diuretic


  • Reduction of intracranial pressure associated with cerebral edema

  • Reduction of intraocular pressure

  • Improve renal function in oliguric phase of acute renal failure

  • Promote urinary excretion of toxic substances


  • Active intracranial bleeding

  • Anuria; severe pulmonary congestion or edema; severe dehydration  


  • Pregnancy category C

  • Monitor serum electrolytes, urine output  

Adverse Reactions (Side Effects):

  • CNS: confusion, dizziness, seizures, headache, rebound increased intracranial pressure

  • CV: angina-like chest pain, CHF, edema, hypertension, hypotension, tachycardia, thrombophlebitis

  • EENT: blurred vision, loss of hearing, nasal congestion

  • GU: osmotic necrosis, urinary retention

  • METAB: acidosis, dehydration, electrolyte loss, fluid and electrolyte imbalances

  • SKIN: skin necrosis, urticaria

  • MISC: chills, fever  


Administered intravenously

  • Adult: Oliguria prevention: 

    • IV 50-100 grams of 5%-25% solution

    • Oliguria treatment: 

      • IV 50-100 grams of 15%-20% solution

    • Intraocular pressure, intracranial pressure: 

      • IV 1.5-2 g/kg of 15%-25% solution over 30-60 minutes

    • Diuresis in drug intoxication: 

      • IV 5%-10% solution continuously up to 200 grams while maintaining urine output of 100-500 ml/hr

    • Urologic irrigation: 

      • Add contents of two 50ml vials of 25% mannitol to 900ml sterile water for injection and use as irrigation

  • Child: 

    • IV 0.5-1 g/kg initially,k then 0.25-0.5 g/kg every 4-6 hours for maintenance

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