Manganese

Pronunciation: MAN-ga-nees
Class: Trace metal

Trade Names

Manganese chloride
- Injection, solution manganese 0.1 mg/mL (as manganese chloride 0.36 mg/mL)

Manganese sulfate
- Injection, solution manganese 0.1 mg/mL (as manganese sulfate 0.308 mg/mL)

Pharmacology

Activator for enzymes such as polysaccharide polymerase, liver arginase, cholinesterase, and pyruvate carboxylase.

Pharmacokinetics

Distribution

Bound to transmanganin, a beta-1 globulin. Widely distributed but concentrates in the mitochondria-rich tissues such as brain, kidney, pancreas, and liver.

Elimination

Eliminated via the bile.

Indications and Usage

As a supplement to TPN to help maintain manganese plasma levels and to prevent depletion of endogenous stores and subsequent deficiency syndromes.

Contraindications

Do not give undiluted by direct injection into a peripheral vein; do not give manganese chloride by direct IM or IV injection.

Dosage and Administration

IV 0.15 to 0.8 mg/day of manganese added to the TPN.

IV 2 to 10 mcg/kg/day of manganese added to the TPN.

Omit or reduce dose as needed in patients with liver dysfunction and/or biliary tract dysfunction.

General Advice

• Do not give undiluted by direct injection into a peripheral vein.
• Do not give manganese chloride by direct IM or IV injection.
• Add to TPN solution.

Storage/Stability

Store between 59° and 86°F.

Drug Interactions

None well documented.

Adverse Reactions

Adverse reactions are unlikely to occur at the recommended dosage levels.

Precautions

Pregnancy

Category C.

Lactation

Undetermined.

Elderly

Use with caution.

Hepatic Function

Excreted in the bile; adjust or omit dose as needed in patients with hepatic dysfunction and/or biliary tract dysfunction (eg, bile duct obstruction).

Aluminum toxicity

Parenteral products may contain aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk.

Overdosage

Symptoms

None well documented.

Patient Information

• Advise patient that medication will be prepared and administered by a health care provider in a hospital setting.

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