Mannitol Side Effects
Some side effects of mannitol may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.
For the Consumer
Applies to mannitol: inhalation capsule
Along with its needed effects, mannitol may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur while taking mannitol:Less common
- Chest discomfort
- difficult or labored breathing
- dry heaves
- runny nose
- shortness of breath
- sore throat
- tightness in the chest
- troubled breathing
Some side effects of mannitol may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More common
- sore throat
For Healthcare Professionals
Applies to mannitol: compounding powder, inhalation kit, intravenous solution, irrigation solution
Cardiovascular side effects have included hypotension and tachycardia. Venous thrombosis or phlebitis extending from the injection site and hypervolemia have occurred rarely and are generally associated with the solution or technique used in administration.
Respiratory side effects have included pulmonary congestion and rhinitis. Respiratory side effects associated with mannitol inhalation have included cough, gagging, wheeze, and decreased forced expiratory volume.
Metabolic side effects have included fluid and electrolyte imbalance, acidosis, and electrolyte loss.
Nervous system side effects have included headache, convulsions, and dizziness.
Hematologic side effects have included thrombophlebitis.
Eight cases of mannitol IV overdose in patients with preexisting renal failure were reviewed. Symptoms presented in the reviewed cases were CNS involvement out of proportion to uremia, severe hyponatremia, large osmolality gap, and fluid overload. Six patients were treated with hemodialysis, one patient with peritoneal dialysis, and one patient died before initiation of treatment. All patients received large doses over 1 to 3 days with a mean dose of 310 +/- 182.8 g. CNS involvement consisted of CNS depression, confusion, lethargy, stupor, and coma. Two patients recovered cerebral function and continued on lifetime dialysis, 3 patients recovered renal and cerebral function, and 1 patient recovered renal function but had severe cerebral dysfunction.
Other side effects have included dryness of mouth, thirst, edema, arm pain, chills, dehydration, fever, mannitol intoxication, and angina-like pain.
Renal side effects have included acute renal failure.
Local side effects have included extravasation. This effect is generally attributed to the solution or technique used in administration.
Dermatologic side effects have included urticaria and skin necrosis.
Ocular side effects have included blurred vision.
Immunologic side effects have included infection at the injection site and febrile response. These effects are usually attributed to solution or technique used in administration.
Gastrointestinal side effects have included nausea and vomiting.
Genitourinary side effects have included marked diuresis and urinary retention.
A 75-year-old woman with severe major depression experienced a manic episode 30 minutes after initiation of a 20% mannitol intravenous infusion for the treatment of acute angle closure glaucoma. The patient had been started on nortriptyline 50 mg per day for the treatment of depression ten days earlier. She received oral acetazolamide, topical pilocarpine, topical timolol, and topical dexamethasone concomitantly for the treatment of glaucoma. The mania resolved within approximately 1 hour following discontinuation of the mannitol infusion, and the patient returned to a severe depressive state. An extensive lab evaluation, toxicology screening, and medical examination failed to show additional secondary causes for mania in this patient.
Psychiatric side effects have rarely included mania (1 case report).
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