Mannitol/sorbitol topical Disease Interactions

The use of laxatives is contraindicated in patients with inflammatory bowel disease. Patients with inflammatory bowel disease may experience colonic perforation with use of stimulant laxatives.

The use of laxatives is contraindicated in patients with intestinal obstruction disorders. Patients with intestinal obstruction disorders may need their underlying condition treated to correct the constipation. Some laxatives require reduction in the colon to their active form to be effective which may be a problem in patients with intestinal obstruction.

The use of osmotic diuretics is contraindicated in patients with anuria, severe dehydration, pulmonary edema, or severe cardiac decompensation. An increase in the tonicity of the blood may occur in these patients that could exacerbate these conditions.

The use of sorbitol solution for urologic irrigation is contraindicated in patients with anuria. In addition, sorbitol irrigation should be administered cautiously in patients with cardiopulmonary or renal dysfunction. Irrigating fluids may enter the systemic circulation, and absorption of large quantities of fluids containing sorbitol may significantly alter cardiopulmonary and renal dynamics. Before and during the urologic procedure, cardiovascular and renal status should be monitored, particularly if the volume absorbed is expected to produce a substantial expansion of the intravascular fluid (e.g., via opened prostatic veins in transurethral prostatectomies).

The use of osmotic diuretics is associated with an increase in blood tonicity. Osmotic diuretics should be administered cautiously in patients with confused mental states, diabetes, congestive heart failure, severe dehydration, and cardiac, renal, or hepatic disease.

Sorbitol is converted to glucose in the body. The use of sorbitol is not recommended as an alternative sweetener in patients with diabetes. Sorbitol is one of the end products of glucose metabolism that results in some of the late complications of diabetes.

Shift of sodium-free intracellular fluid into the extracellular compartment following systemic absorption of sorbitol irrigation may lower serum sodium concentration and aggravate preexisting-existing hyponatremia. Excessive loss of water and electrolytes may may also cause hypernatremia. Sustained diuresis from transurethral irrigation with sorbitol irrigation may obscure and intensify inadequate hydration or hypovolemia. Patients with sodium imbalances or dehydration should be closely monitored.