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Osmitrol Side Effects

Generic Name: mannitol

Note: This page contains side effects data for the generic drug mannitol. It is possible that some of the dosage forms included below may not apply to the brand name Osmitrol.

For the Consumer

Applies to mannitol: inhalation capsule

As well as its needed effects, mannitol (the active ingredient contained in Osmitrol) may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking mannitol, check with your doctor or nurse immediately:

Less common:
  • Chest discomfort
  • cough
  • difficult or labored breathing
  • dry heaves
  • runny nose
  • shortness of breath
  • sore throat
  • tightness in the chest
  • troubled breathing
  • vomiting
  • wheezing
Incidence not known:
  • Gagging

Minor Side Effects

Some mannitol side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common:
  • Headache
Less common:
  • Dizziness
  • nausea
  • sore throat

For Healthcare Professionals

Applies to mannitol: compounding powder, inhalation kit, intravenous solution, irrigation solution

Cardiovascular

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.[Ref]

Respiratory

Respiratory side effects have included pulmonary congestion and rhinitis. Respiratory side effects associated with mannitol (the active ingredient contained in Osmitrol) inhalation have included cough, gagging, wheeze, and decreased forced expiratory volume.[Ref]

Metabolic

Metabolic side effects have included fluid and electrolyte imbalance, acidosis, and electrolyte loss.[Ref]

Nervous system

Nervous system side effects have included headache, convulsions, and dizziness.[Ref]

Hematologic

Hematologic side effects have included thrombophlebitis.[Ref]

Other

Eight cases of mannitol (the active ingredient contained in Osmitrol) 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.[Ref]

Other side effects have included dryness of mouth, thirst, edema, arm pain, chills, dehydration, fever, mannitol intoxication, and angina-like pain.[Ref]

Renal

Renal side effects have included acute renal failure.[Ref]

Local

Local side effects have included extravasation. This effect is generally attributed to the solution or technique used in administration.[Ref]

Dermatologic

Dermatologic side effects have included urticaria and skin necrosis.[Ref]

Ocular

Ocular side effects have included blurred vision.[Ref]

Immunologic

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.[Ref]

Gastrointestinal

Gastrointestinal side effects have included nausea and vomiting.[Ref]

Genitourinary

Genitourinary side effects have included marked diuresis and urinary retention.[Ref]

Psychiatric

Psychiatric side effects have rarely included mania (1 case report).[Ref]

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.[Ref]

References

1. "Product Information. Osmitrol (mannitol)." Baxter I.V. Systems Division, Round Lake, IL.

2. "Product Information. Aridol (mannitol)." Pharmaxis Inc, Exton, PA.

3. Better OS, Rubinstein I, Winaver JM, Knochel JP "Mannitol therapy revisited (1940-1997)." Kidney Int 52 (1997): 886-94

4. Sakemi T, Ikeda Y, Ohtsuka N, Ohtsuka Y, Tomiyoshi Y, Baba N "Acute renal failure associated with mannitol infusion and reversal with ultrafiltration and hemodialysis." Nephron 73 (1996): 733-4

5. Doi K, Ogawa N, Suzuki E, Noiri E, Fujita T "Mannitol-induced acute renal failure." Am J Med 115 (2003): 593-4

6. Edwards JJ, Samuels D, Fu ES "Forearm compartment syndrome from intravenous mannitol extravasation during general anesthesia." Anesth Analg 96 (2003): 245-6, table of contents

7. Navarro V, Vieta E, Gasto C "Mannitol-induced acute manic state." J Clin Psychiatry 62 (2001): 126

It is possible that some side effects of Osmitrol may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.

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