Mannitol (Intravenous)

Mannitol injection is used to reduce pressure in the head (intracranial pressure) and high pressure in the eye (intraocular pressure). It is also used to treat swelling in the brain (cerebral edema).

This medicine should be given only by your doctor or under their direct supervision.

It is very important that your doctor closely monitors you or your child's progress while receiving this medicine to ensure it is working properly. Blood and urine tests will be necessary to check for unwanted effects.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Inform your doctor right away if you experience a rash, itching, hoarseness, trouble breathing or swallowing, or any swelling of your hands, face, or mouth after receiving this medicine.

Mannitol may increase your risk of having kidney problems, including kidney failure. Contact your doctor right away if you notice blood in the urine, decreased urine output, muscle twitching, nausea, rapid weight gain, seizures, decreased awareness or responsiveness, severe sleepiness, swelling of the face, ankles, or hands, or unusual tiredness or weakness.

This medicine may cause fluid or electrolyte imbalances (e.g., hypernatremia, hyponatremia, hyperkalemia, hypokalemia, metabolic acidosis or alkalosis). These imbalances may lead to or worsen other conditions, including existing heart failure or dehydration. Discuss any concerns with your doctor.

This medicine may cause infusion-related reactions, which can be life-threatening and require immediate medical attention. Notify your doctor right away if you start to experience a fever, chills or shaking, dizziness, trouble breathing, itching or rash, lightheadedness, or fainting after receiving this medicine.

Before undergoing any medical tests, inform the medical doctor in charge that you are taking this medicine. The results of some tests may be influenced by this medicine.

Do not take other medicines unless your doctor has discussed them with you. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

In deciding to use a medicine, you and your doctor need to consider the risks of taking the medicine against the benefits it can provide. For this medicine, keep the following points in mind:

Allergies

Inform your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also, let your healthcare professional know if you have any other allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, carefully read the label or package ingredients.

Pediatric

Current studies have not shown any specific problems that would limit the usefulness of mannitol injection in children. However, children younger than 2 years old, especially preterm and term newborns, are more likely to experience fluid and electrolyte issues. Safety and effectiveness have been established.

Geriatric

Current studies have not shown any specific problems that would limit the usefulness of prochlorperazine in older adults. However, older patients are more likely to experience fluid and electrolyte imbalances and age-related issues with kidneys, heart, or lungs, which may require careful dosing for patients taking this medicine.

Breast Feeding

There are no sufficient studies in women to determine the risk to infants when using this medication during breastfeeding. Consider the potential benefits and risks before taking this medicine while breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines may be used together even if there could be an interaction. In these situations, your doctor may adjust the dose or take other precautions. It is particularly important that your healthcare professional knows if you are taking any of the medicines listed below. The following interactions have been chosen based on their possible significance and are not necessarily a complete list.

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some situations. If both medicines are prescribed together, your doctor may adjust the dose or how often you take one or both of the medicines.

• Amikacin
• Amikacin Liposome
• Arsenic Trioxide
• Droperidol
• Levomethadyl
• Sotalol
• Tobramycin

Using this medicine with any of the following medicines may increase the risk of certain side effects, but taking both drugs may be the best option for you. If both medicines are prescribed together, your doctor may change the dose or how often you take one or both of the medicines.

• Licorice

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken with food or certain types of food because interactions may happen. Using alcohol or tobacco with certain medicines may also cause interactions. Talk to your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical problems can affect the use of this medicine. Be sure to inform your doctor if you have any other medical issues, especially:

• Anuria (cannot pass urine) or
• Hypovolemia (low blood volume), severe or
• Active intracranial bleeding (except during craniotomy or head surgery) or
• Severe lung or breathing problems (e.g., congestion, fluid or swelling in the lungs)—Should not be used in patients with these conditions.

• Brain issues (e.g., compromised blood-brain barrier) or
• Congestive heart failure or
• Kidney disease—Use with caution. May worsen this condition.

• Fluid or electrolyte imbalance—Use with caution. Must be corrected first before receiving this medicine.

Along with its necessary effects, this medicine may cause some unwanted effects. Not all of these side effects may happen, but if they do, you may need medical help.

Check with your doctor or nurse right away if you notice any of the following side effects:

Incidence not known

• Agitation
• bloating or swelling of the face, arms, hands, lower legs, or feet
• bloody or cloudy urine
• blue lips and fingernails
• blurred vision
• bulging soft spot on an infant's head
• change in the ability to see colors, especially blue or yellow
• change in the amount or frequency of urine
• changes in skin color
• chest pain
• chills
• cloudy urine
• confusion
• cough
• coughing that sometimes produces pink frothy sputum
• decreased awareness or responsiveness
• decreased urination
• depression
• difficult or labored breathing
• difficult, fast, or noisy breathing
• difficulty swallowing
• dilated neck veins
• dizziness, faintness, or lightheadedness when standing up suddenly from a lying or sitting position
• drowsiness
• dry mouth
• extreme tiredness or weakness
• fainting
• fast, irregular, pounding, or racing heartbeat or pulse
• fever
• headache
• high blood pressure
• hives, itching, skin rash
• hostility
• increase in heart rate
• increased sweating
• increased thirst
• irregular breathing
• irritability
• lightheadedness
• loss of appetite
• loss of consciousness
• mood changes
• muscle pain, cramps, tremors, or twitching
• nausea
• nervousness
• unable to pass urine
• numbness or tingling in the hands, feet, or lips
• pain in the lower back or side
• pain, redness, or pale skin at the injection site
• pale skin
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• rapid weight gain
• rapid, deep breathing
• restlessness
• seizures
• severe sleepiness
• stomach cramps or pain
• sunken eyes
• tightness in the chest
• trouble sleeping
• unusual drowsiness, dullness, tiredness, weakness, or feeling sluggish
• unusual weight gain or loss
• vomiting
• weakness or heaviness of the legs
• wrinkled skin

Some side effects may happen that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Your healthcare professional may also have ways to prevent or reduce some of these side effects. Check with your healthcare professional if any of the following side effects continue, are bothersome, or if you have any questions about them:

Incidence not known

• Bone or muscle stiffness
• difficulty in moving
• general feeling of discomfort or illness
• joint pain or swelling
• lack or loss of strength
• swelling or itching at the injection site

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Osmitrol

Available Dosage Forms:

• Solution

Therapeutic Class: Cardiovascular Agent

Pharmacologic Class: Diuretic, Osmotic

A nurse or other trained health professional will give you this medicine in a medical facility. It is given through a needle placed into one of your veins. The medicine must be given slowly, so it will have to stay in place for at least 30 minutes.