Mannitol

Products

Mannitol is commercially available as a powder and as an infusion preparation. The pure substance is available in pharmacies and drugstores.

Structure and properties

D-mannitol (C6H14O6, Mr = 182.2 g/mol) exists as white crystals or white powder that dissolves readily in water. Mannitol is a hexavalent sugar alcohol and occurs naturally in plants, algae, and lichens, among others. It has a sweet taste and is odorless. Mannitiol is also characterized by its low hygroscopicity. Industrially, it is produced from fructose, but can also be isolated from organic material.

Effects

Mannitol (ATC A06AD16, ATC B05BC01, ATC B05CX04) has diuretic (diuretic) properties on the one hand. Administered intravenously, it is filtered in the kidneys and poorly reabsorbed in the nephron, leading to osmotic diuresis. On the other hand, mannitol also has a laxative effect when taken dissolved in water, for example. It is little absorbed and increases the water content in the colon for osmotic reasons. As a result, it stimulates intestinal movements and makes the stool softer and more slippery. Finally, mannitol is also used as a sweetener. It is less sweet and has a lower caloric value than table sugar (sucrose).

Fields of application (selection)

Oral administration:

Parenteral administration:

  • Promote diuresis in oliguria and acute renal failure before irreversible renal failure occurs.
  • Decrease intraocular pressure and treat cerebral edema, with intact bloodbrain barrier.
  • Determination of glomerular clearance.
  • Promote elimination of urinary toxic substances in poisoning.

Inhalation administration:

  • Cystic fibrosis, to liquefy the mucus.
  • Mannitol provocation test for bronchial hyperresponsiveness.

As a pharmaceutical excipient:

  • As an excipient, mannitol is used, among other things, as a filler for the production of capsules (eg magistral formulations) and for the production of tablets and melting tablets.
  • As a sweetener (sugar substitute).

Other uses:

  • As a food additive (E 421).
  • For bacterial culture media.

Dosage

According to the SmPC. The drugs are administered perorally, parenterally (intravenously) and by inhalation. As a laxative, the literature recommends about 10 to 30 g for adults.

Abuse

As an extender to dilute intoxicants.

Contraindications

Precautions depend on the area of application.

Adverse effects

Gastrointestinal symptoms such as bloating, flatulence, nausea, and diarrhea may occur with oral administration, excessive consumption, or in sensitive individuals (food intolerance). In the case of infusion, possible adverse effects include, for example, water and electrolyte disturbances, confusion, and irritation and inflammation of the vein wall.