Mannitol, solution for infusion 150mg/ml 200ml vials 1pc

Composition

Active ingredient:

mannitol – 150 g.

Auxiliary substances:

sodium chloride – 9 g,

water for injection-up to 1 l

Pharmacological action

Mannitol is an osmotic diuretic that, by increasing the osmotic pressure of blood plasma and filtration in the renal glomeruli, without subsequent tubular reabsorption (mannitol is little reabsorbed), leads to water retention in the renal tubules and an increase in urine volume.

Mannitol acts mainly in the proximal tubules, although the effect is slightly preserved in the descending loop of the nephron and in the collecting tubules. It does not penetrate cellular and tissue barriers (for example, the blood-brain barrier), and does not increase the content of residual nitrogen in the blood.

By increasing the osmolarity of blood plasma, it causes fluid to move from the tissues (in particular, the eyeball, brain) to the vascular bed. Diuresis is accompanied by a moderate increase in natriuresis without significantly affecting the excretion of potassium. The diuretic effect is higher, the higher the concentration (dose).

It is ineffective in violation of the filtration function of the kidneys, as well as in azotemia in patients with cirrhosis of the liver and ascites: Causes an increase in the volume of circulating blood.

Indications

Brain edema, intracranial hypertension (with renal or renal-hepatic insufficiency); oliguria in acute renal or renal-hepatic insufficiency with preserved filtration capacity of the kidneys (as part of combination therapy), post-transfusion complications after use of incompatible blood, forced diuresis in case of poisoning with barbiturates, salicylates; prevention of hemolysis during surgical interventions using extracorporeal circulation in order to prevent kidney ischemia and associated acute renal failure.

Contraindications

Hypersensitivity to the drug, anuria on the background of acute renal tubular necrosis, left ventricular failure (especially accompanied by pulmonary edema), hemorrhagic stroke, subarachnoid hemorrhage (except for bleeding during cranial trepanation), severe dehydration, hyponatremia, hypochloremia, hypokalemia.

With caution Pregnancy, lactation, old age.

Side effects

Dehydration (dry skin, dry mouth, thirst, dyspepsia, muscle weakness, convulsions, hallucinations, decreased blood pressure), impaired water and electrolyte metabolism (increased circulating blood volume, hyponatremia, rarely hypokalemia).

Rarely-tachycardia, pain behind the sternum, thrombophlebitis, skin rash.

Interaction

It is possible to increase the toxic effect of cardiac glycosides (against the background of hypokalemia).

How to take, course of use and dosage

Intravenous (slow jet or drip).

The prophylactic dose is 0.5 g / kg of body weight, the therapeutic dose is 1.0-1.5 g/kg; the daily dose should not exceed 140-180 g.

Before use, the drug should be heated to a temperature of 37 °C (you can use a water bath). In operations with artificial blood circulation, the drug is injected into the device in a dose of 20-40 g immediately before the start of perfusion.

Patients with oliguria should first be given an intravenous drip of a test dose (200 mg/kg) for 3-5 minutes.

If there is no increase in the rate of diuresis to 30-50 ml/h within 2-3 hours, further use of the drug should be abandoned.

Special instructions

With left ventricular failure (due to the risk of developing pulmonary edema), it is necessary to combine mannitol with fast-acting “loop” diuretics. It is necessary to monitor blood pressure, diuresis, and the concentration of Electrolytes in the blood serum (potassium, sodium).

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

If signs of dehydration appear, it is necessary to introduce fluids into the body. It can be used in heart failure (only in combination with” loop ” diuretics) and in hypertensive crisis with encephalopathy.

Repeated use of mannitol should be carried out under the control of blood water-electrolyte balance indicators. The introduction of mannitol in anuria caused by organic kidney diseases can lead to the development of pulmonary edema.

Form of production

Solution for infusions

Active ingredient

Mannitol

Conditions of release from pharmacies

By prescription

Dosage form

infusion solution