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Manganese

Pronunciation

(MAN ga nees)

Index Terms

  • Manganese Chloride
  • Manganese Sulfate

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule, Oral, as chelated:

MN-50: Elemental manganese 16.67 mg

Solution, Intravenous, as chloride:

Generic: Elemental manganese 0.1 mg/mL (10 mL)

Solution, Intravenous, as sulfate [preservative free]:

Generic: Elemental manganese 0.1 mg/mL (10 mL)

Tablet, Oral, as aspartate:

Generic: 93 mg [elemental manganese 25 mg]

Tablet, Oral, as chelated:

Mangimin: Elemental manganese 10 mg [corn free, rye free, wheat free]

Generic: Elemental manganese 15 mg [DSC], Elemental manganese 50 mg

Tablet, Oral, as gluconate:

Generic: 50 mg [elemental manganese 5.7 mg]

Brand Names: U.S.

  • Mangimin [OTC]
  • MN-50 [OTC]

Pharmacologic Category

  • Dietary Supplement
  • Trace Element, Parenteral

Pharmacology

Cofactor in many enzyme systems, stimulates synthesis of cholesterol and fatty acids in liver, and influences mucopolysaccharide synthesis

Absorption

Poor

Distribution

Concentrated in mitochondria of pituitary gland, pancreas, liver, kidney, and bone

Excretion

Bile (primarily); urine (negligible)

Use: Labeled Indications

Trace element added to parenteral nutrition (PN) to prevent manganese deficiency; orally as a dietary supplement

Contraindications

There are no contraindications listed within the manufacturer's US labeling.

Dosing: Adult

Parenteral nutrition, maintenance requirement: IV: 150 to 800 mcg/day

Expert recommendations favor the use of lower doses in the range of 60 to 100 mcg/day to avoid neurotoxicity with routine use and those with cholestatic jaundice. However, these recommendations are difficult to follow with the current sources of parenteral manganese (ASPEN [Vanek 2012]).

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Parenteral nutrition, maintenance requirement: IV: 2 to 10 mcg/kg/day

Expert recommendations suggest decreasing the daily dose for infants and children to 1 mcg/kg/day (up to a maximum of 50 mcg/day). However, these recommendations are difficult to follow with the current sources of parenteral manganese (ASPEN [Vanek 2012]).

Note: Use caution in premature neonates; manganese chloride solution for injection contains aluminum.

Administration

Capsule, tablet: May be administered with a meal.

Solution for injection: Do not administer IM or by direct IV injection; acidic pH of the solution may cause tissue irritations and it is hypotonic; administer after dilution in volume of fluid ≥100 mL

Dietary Considerations

Dietary adequate intake (IOM 2001):

0 to 6 months: 0.003 mg/day

7 to 12 months: 0.6 mg/day

1 to 3 years: 1.2 mg/day

4 to 8 years: 1.5 mg/day

9 to 13 years: Males: 1.9 mg/day; Females: 1.6 mg/day

14 to 18 years: Males: 2.2 mg/day; Females: 1.6 mg/day

>18 years: Males: 2.3 mg/day; Females: 1.8 mg/day

Pregnancy: 2 mg/day

Lactation: 2.6 mg/day

Storage

Capsule/tablet (dietary supplement): Store in a cool, dry place.

Solution for injection: Store at controlled room temperature of 20°C to 25°C (68°F to 77°F). Compatible with electrolytes usually present in amino acid/dextrose solution used for TPN solutions; after admixture, discard unused portion immediately.

Drug Interactions

There are no known significant interactions.

Warnings/Precautions

Disease-related concerns:

• Biliary tract impairment: Use with caution in patients with biliary tract impairment; dose may need to be decreased or withheld.

• Hepatic impairment: Use with caution in patients with hepatic impairment; dose may need to be decreased or withheld.

Dosage form specific issues:

• Aluminum: The parenteral product may contain aluminum; toxic aluminum concentrations may be seen with high doses, prolonged use, or renal dysfunction. Premature neonates are at higher risk due to immature renal function and aluminum intake from other parenteral sources. Parenteral aluminum exposure of >4 to 5 mcg/kg/day is associated with CNS and bone toxicity; tissue loading may occur at lower doses (Federal Register, 2002). See manufacturer's labeling.

Other warnings/precautions:

• Appropriate use: Due to its highly acidic pH (pH 2.0), direct IV or IM injection is contraindicated; may result in severe tissue damage.

Monitoring Parameters

Periodic manganese plasma level

Pregnancy Risk Factor

C

Pregnancy Considerations

Animal reproduction studies have not been conducted. Manganese crosses the placenta and can be detected in placental tissue and cord blood (Osada, 2002).

Patient Education

What is this drug used for?

• It is used to help growth and good health.

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.