Mannitol

182.17200

182.17

201-770-2

3OWL53L36A

DTXSID1023235

C625

Orthorhombic needles from alc|WHITE, CRYSTALLINE POWDER OR FREE FLOWING GRANULES

R05CB16|B05BC01|A - Alimentary tract and metabolism|B - Blood and blood forming organs|R - Respiratory system|V - Various

2905430000

121.38000

-3.1

White crystalline powder

1.52 g/cm³ @ Temp: 20 °C

166-168 °C

290-295 °C @ Press: 3.5 Torr

100ºC

1.333 (20ºC)

soluble

Mannitol solutions should be stored at room temperature and protected from freezing.

LD50 orally in Rabbit: 13500 mg/kg

Specific optical rotation: -0.49 deg @ 25 °C/D (water)

Odorless

Sweetish taste

13.5(at 25 °C)

13.5 (at 25 °C)|pKa = 13.50 @ 18 °C

141 Ų [M+Na]+ [CCS Type: DT, Method: single field calibrated with Agilent tune mix (Agilent)]|137 Ų [M+Na]+ [CCS Type: TW, Method: calibrated with polyalanine]|141.1 Ų [M+Na]+ [CCS Type: DT, Method: single field calibrated with ESI Low Concentration Tuning Mix (Agilent)]|131.6 Ų [M-H]- [CCS Type: DT, Method: single field calibrated with ESI Low Concentration Tuning Mix (Agilent)]|144.5 Ų [M+Li]+ [CCS Type: DT, Method: stepped-field]|140.6 Ų [M+Na]+ [CCS Type: DT, Method: stepped-field]|139.6 Ų [M+Na]+ [CCS Type: TW, Method: calibrated with polyalanine and drug standards]|131.9 Ų [M-H]-

Water soluble.

Alcohols and Polyols

A sugar alcohol. More closely related to carbohydrates than to other polyhydric alcohols [Noller]. Flammable and/or toxic gases are generated by the combination with alkali metals, nitrides, strong reducing agents and strong oxidizing agents.

NONH for all modes of transport

2

R36/37/38

S24/25

OP2060000

Xi

Stable. Combustible. Incompatible with strong oxidizing agents.

SRP: At the time of review, criteria for land treatment or burial (sanitary landfill) disposal practices are subject to significant revision. Prior to implementing land disposal of waste residue (including waste sludge), consult with environmental regulatory agencies for guidance on acceptable disposal practices.

It has been stated that mannitol is incompatible in strongly acidic and alkaline solutions.

Mannitol used as a nutrient and/or dietary supplement in animal drugs, feeds, and related products is generally recognized as safe when used in accordance with good manufacturing or feeding practice.

This chemical is probably combustible. (NTP, 1992)

Fires involving this material can be controlled with a dry chemical, carbon dioxide or Halon extinguisher. A water spray may also be used. (NTP, 1992)

SMALL SPILLS AND LEAKAGE: If you spill this chemical, you should dampen the solid spill material with water, then transfer the dampened material to a suitable container. Use absorbent paper dampened with water to pick up any remaining material. Seal your contaminated clothing and the absorbent paper in a vapor-tight plastic bag for eventual disposal. Wash all contaminated surfaces with a soap and water solution. Do not reenter the contaminated area until the Safety Officer (or other responsible person) has verified that the area has been properly cleaned. STORAGE PRECAUTIONS: You should store this material under ambient temperatures, and keep it away from oxidizing materials. (NTP, 1992)

RECOMMENDED RESPIRATOR: Where the neat test chemical is weighed and diluted, wear a NIOSH-approved half face respirator equipped with an organic vapor/acid gas cartridge (specific for organic vapors, HCl, acid gas and SO2) with a dust/mist filter. (NTP, 1992)

Mannitol overdose may result in bronchoconstriction and should be counteracted using a short-acting bronchodilator and other symptomatic and supportive care, as necessary.

Hydroxyurea (HU) is a potent mammalian teratogen. Within 2-4 hours after maternal injection, HU causes 1) a rapid episode of embryonic cell death and 2) profound inhibition of embryonic DNA synthesis. A variety of antioxidants delays the onset of embryonic cell death and reduces the incidence of birth defects. Antioxidants do not block the inhibition of DNA synthesis, indicating that early embryonic cell death is not caused by inhibited DNA synthesis. We have suggested that some HU molecules may react within the embryo to produce H2O2 and subsequent free radicals, including the very reactive hydroxyl free radical. The free radicals could cause the early cell death; antioxidants are believed to terminate the aberrant free radical reactions resulting in lessened developmental toxicity. To investigate whether hydroxyl free radicals cause the early episode of cell death, pregnant New Zealand white rabbits were injected subcutaneously on gestational day 12 with a teratogenic dose of HU (650 mg/kg) in the presence or absence of 550 mg/kg of D-mannitol (Man), a specific scavenger of hydroxyl free radicals. Osmotic control rabbits received HU plus 550 mg/kg of xylose (Xyl, a nonactive aldose). At term, the teratologic effects of HU were ameliorated by Man as evidenced by decreased incidences of the expected limb malformations. Xyl exerted no demonstrable effect on HU teratogenesis. Histological examination of limb buds at 3-8 hours after maternal injection, showed that Man delayed the onset of HU-induced cell death by as much as 4 hours. Xyl had no effect. That Man acts within the embryo was shown by performing intracoelomic injections on alternate implantation sites with Man, Xyl, or saline followed by subcutaneous injection of the pregnant doe with HU. Embryos were harvested 3-8 hours later. Limb buds from saline- and Xyl-injected embryos exhibited the typical pattern of widespread HU-induced cell death at 3-4 hours, whereas Man-injected embryos did not exhibit cell death until 5-8 hours. These results are consistent with those reported for antioxidant-mediated amelioration of HU-induced developmental toxicity and with the hypothesis that hydroxyl free radicals are the proximate reactive species in HU-induced early embryonic cell death.|... Pentobarbital attenuated the blood-brain barrier disruption induced by hyperosmolar mannitol. This may be attributed, at least in part, to the blood pressure effect of pentobarbital. Implications: When the blood-brain barrier (BBB) was disrupted by a hyperosmolar solution, pentobarbital attenuated the degree of leakage of the blood-brain barrier. Systemic hypotension caused by pentobarbital played a significant role in decreasing the leakage. Our study suggests that when the blood-brain barrier is disrupted, pentobarbital may be effective in protecting the blood-brain barrier. Furthermore, systemic blood pressure plays an important role in determining the degree of disruption.

LD50 Rat oral 13,500 mg/kg|LD50 Rat iv 9690 mg/kg|LD50 Mouse oral 22 g/kg|LD50 Mouse ip 14 g/kg|LD50 Mouse iv 7470 mg/kg

A carcinogenesis bioassay of D-mannitol (98%-100% pure) ... was conducted by feeding diets containing 25,000 or 50,000 ppm D-mannitol to groups of 50 F344/N rats and 50 B6C3F1 mice of each sex for 103 wk. Groups of 50 rats and 50 mice of each sex served as controls. Survival and mean body weights of dosed and control male rats and of dosed and control mice of each sex were comparable. ... Under the conditions of this bioassay, D-mannitol was not carcinogenic for F344/N rats or B6C3F1 mice of either sex. Levels of Evidence of Carcinogenicity: Male Rats: Negative; Female Rats: Negative; Male Mice: Negative; Female Mice: Negative.

D-Mannitol is widespread in nature(SRC). It is found to a significant extent in the exudates of trees and shrubs such as the plane tree, manna ash and olive tree(1). D-Mannitol occurs in pumpkin, hedge parsley, onions, celery, strawberries, the genus Euonymus, the genus Hebe, cocoa bean, grasses, lilac, Digitalis purpurea, mistletoe and lichens(1).

D-Mannitol's production and use as a flavorant and non-nutritive sweetener(1) may result in its release to the environment through various waste streams(SRC).

TERRESTRIAL FATE: Based on a classification scheme(1), an estimated Koc value of 5(SRC), determined from a water solubility of 2.16X10+5 mg/l(2) and a regression-derived equation(3), indicates that D-mannitol is expected to have very high mobility in soil(SRC). Volatilization of D-mannitol from moist soil surfaces is not expected to be an important fate process(SRC) given an estimated Henry's Law constant of 7.3X10-13 atm-cu m/mole(SRC), using a fragment constant estimation method(4). D-Mannitol is not expected to volatilize from dry soil surfaces(SRC) based upon an estimated vapor pressure of 4.9X10-9 mm Hg(SRC), determined from a fragment constant method(5). D-Mannitol is a simple sugar alcohol and should be readily biodegraded in the environment(SRC).|AQUATIC FATE: Based on a classification scheme(1), an estimated Koc value of 5(SRC), determined from a water solubility of 2.16X10+5 mg/l(2) and a regression-derived equation(3), indicates that D-mannitol is not expected to adsorb to suspended solids and sediment in water(SRC). Volatilization from water surfaces is not expected(3) based upon an estimated Henry's Law constant of 7.3X10-13 atm-cu m/mole(SRC), developed using a fragment constant estimation method(4). According to a classification scheme(5), an estimated BCF of 1(3,SRC), from its water solubility(2) suggests the potential for bioconcentration in aquatic organisms is low(SRC). D-Mannitol is a simple sugar alcohol and should be readily biodegraded in the environment(SRC).|ATMOSPHERIC FATE: According to a model of gas/particle partitioning of semivolatile organic compounds in the atmosphere(1), D-mannitol, which has an estimated vapor pressure of 4.3X10-9 mm Hg at 25 °C(2), is expected to exist in the particulate phase in the ambient atmosphere. Particulate-phase D-mannitol may be removed from the air by wet and dry deposition(SRC).

D-Mannitol is not expected to undergo hydrolysis in the environment due to the lack of hydrolyzable functional groups(1) nor to directly photolyze due to the lack of absorption in the environmental UV spectrum.

An estimated BCF of 1 was calculated for D-mannitol(SRC), using a water solubility of 2.16X10+5 mg/l(1) and a regression-derived equation(2). According to a classification scheme(3), this BCF suggests the potential for bioconcentration in aquatic organisms is low(SRC).

The Koc of D-mannitol is estimated as approximately 5(SRC), using a water solubility of 2.16X10+5 mg/l(1) and a regression-derived equation(2). According to a classification scheme(3), this estimated Koc value suggests that D-mannitol is expected to have very high mobility in soil(SRC).

The Henry's Law constant for D-mannitol is estimated as 7.3X10-13 atm-cu m/mole(SRC) using a fragment constant estimation method(1). This Henry's Law constant indicates that D-mannitol is expected to be essentially nonvolatile from water surfaces(2). D-Mannitol's Henry's Law constant(1,SRC) indicates that volatilization from moist soil surfaces is not expected(SRC). D-Mannitol is not expected to volatilize from dry soil surfaces(SRC) based upon an estimated vapor pressure of 4.9X10-9 mm Hg(SRC), determined from a fragment constant method(3).

NIOSH (NOES Survey 1981-1983) has statistically estimated that 11,641 workers (9,148 of these are female) are potentially exposed to D-mannitol in the US(1). Occupational exposure to D-mannitol may occur through inhalation of dust particles and dermal contact with this compound at workplaces where D-mannitol is produced or used(SRC). The general population may be exposed to D-mannitol through the ingestion of fruits and foods that contain this compound(SRC).

Used for the promotion of diuresis before irreversible renal failure becomes established, the reduction of intracranial pressure, the treatment of cerebral edema, and the promotion of urinary excretion of toxic substances. Mannitol is also indicated as add-on maintenance therapy for improving pulmonary function in cystic fibrosis patients aged 18 and over who have passed the BRONCHITOL tolerance test (BTT). It is recommended that patients take an orally inhaled short-acting bronchodilator 5-15 minutes prior to every inhaled mannitol dose.|FDA Label|Bronchitol is indicated for the treatment of cystic fibrosis (CF) in adults aged 18 years and above as an add-on therapy to best standard of care.|Cystic fibrosis with pulmonary disease

Diuretics, Osmotic|MEDICATION (VET): INTRAAORTIC PRETREATMENT WITH 10% MANNITOL SOLN PRIOR TO INTRAAORTIC CONTRAST ANGIOGRAPHY PROCEDURES GIVES RENAL PROTECTION & REDUCES INCIDENCE OF PARAPLEGIA & AZOTEMIA IN DOGS.|MEDICATION (VET): IN DOGS AS OSMOTIC DIURETIC CAUSING CELLULAR DEHYDRATION, TO REDUCE INTRAOCULAR PRESSURE IN GLAUCOMA, & TO REDUCE CEREBRAL EDEMA FOLLOWING SURGERY OR INJURY.|DOSE FOR REDUCTION OF INTRACRANIAL PRESSURE & BRAIN MASS PRIOR TO NEUROSURGERY, OR FOR REDUCTION OF INTRAOCULAR TENSION...OF CONGESTIVE GLAUCOMA OR FOR OPHTHALMIC SURGERY, IS 1.5 TO 2 G/KG, GIVEN AS 15 OR 20% SOLN OVER PERIOD OF 30 TO 60 MIN.|For more Therapeutic Uses (Complete) data for D-MANNITOL (15 total), please visit the HSDB record page.

IN EDEMATOUS STATES ASSOC WITH DIMINISHED CARDIAC RESERVE, ADMIN OF MANNITOL INTRODUCES A RISK THAT MAY FAR OUTWEIGH ANY THERAPEUTIC BENEFIT.|CONTRAINDICATIONS TO ADMIN OF MANNITOL INCL RENAL DISEASE...ANURIA, MARKED PULMONARY CONGESTION OR EDEMA, MARKED DEHYDRATION, & INTRACRANIAL HEMORRHAGE... MANNITOL SHOULD BE TERMINATED IF PATIENTS DEVELOPS...PROGRESSIVE RENAL DYSFUNCTION, HEART FAILURE, OR PULMONARY CONGESTION.|ITS SAFE USE DURING PREGNANCY & IN CHILDREN UNDER 12 YR OF AGE HAS NOT BEEN ESTABLISHED.|FACTITIOUS HYPOPHOSPHATEMIA WAS OBSERVED IN A PATIENT RECEIVING LARGE AMT OF IV MANNITOL. CONCN AS LOW AS 25 MMOL/L INHIBITED PHOSPHORUS MEASUREMENT BY DUPONT ACA ENDPOINT METHOD; A KINETIC METHOD WAS UNAFFECTED. MECHANISM OF MANNITOL INTERFERENCE WAS BINDING TO MOLYBDATE IN REACTION, DECR RATE OF COLOR DEVELOPMENT & ENDPOINT MEASUREMENT.|For more Drug Warnings (Complete) data for D-MANNITOL (9 total), please visit the HSDB record page.

Chemically, mannitol is an alcohol and a sugar, or a polyol; it is similar to xylitol or sorbitol. However, mannitol has a tendency to lose a hydrogen ion in aqueous solutions, which causes the solution to become acidic. For this reason, it is not uncommon to add a substance to adjust its pH, such as sodium bicarbonate. Mannitol is commonly used to increase urine production (diuretic). It is also used to treat or prevent medical conditions that are caused by an increase in body fluids/water (e.g., cerebral edema, glaucoma, kidney failure). Mannitol is frequently given along with other diuretics (e.g., furosemide, chlorothiazide) and/or IV fluid replacement. Inhaled mannitol has the possibility to cause bronchospasm and hemoptysis; the occurrence of either should lead to discontinuation of inhaled mannitol.

Compounds that increase urine volume by increasing the amount of osmotically active solute in the urine. Osmotic diuretics also increase the osmolarity of plasma. (See all compounds classified as Diuretics, Osmotic.)|Substances that sweeten food, beverages, medications, etc., such as sugar, saccharine or other low-calorie synthetic products. (From Random House Unabridged Dictionary, 2d ed) (See all compounds classified as Sweetening Agents.)

Approximately 7% of ingested mannitol is absorbed during gastrointestinal perfusion in uremic patients. Inhalation of 635 mg of mannitol powder yields a plasma C_max of 13.71 μg/mL in 1.5 hours (T_max) and a mean systemic AUC of 73.15 μg\*h/mL.|Mannitol is primarily excreted unchanged in the urine. Following oral inhalation of 635 mg of mannitol in healthy volunteers, 55% of the total dose was recovered unchanged in the urine; following oral or intravenous administration of 500 mg, the corresponding values were 54 and 87%, respectively.|Mannitol administered intravenously has a volume of distribution of 34.3 L.|Intravenous administration of mannitol yields a total clearance of 5.1 L/hr and renal clearance of 4.4 L/hr.|MANNITOL IS GENERALLY REGARDED AS BEING UNABSORBED FROM GI TRACT. HOWEVER, RECENT WORK CONTRADICTS THIS BELIEF, FOR 18% OF ORAL DOSE OF D-(14)C MANNITOL WAS RECOVERED UNCHANGED IN 48-HR URINE OF HUMAN SUBJECTS & UP TO 19% AS CO2 IN EXPIRED AIR IN 12 HR. 32% PRESENT IN FECES IN 48 HR...UNABSORBED MATERIAL.|SUBSTANCES /MANNITOL/ HAVING APPARENT VOL OF DISTRIBUTION CORRESPONDING TO TOTAL EXTRACELLUR WATER, WHICH IS ABOUT 20% BODY WT...PENETRATE CAPILLARY MEMBRANES BUT DO NOT PENETRATE CELLULAR MEMBRANES.|MANNITOL UNDERGOES VERY LITTLE REABSORPTION, & FOR MANY PRACTICAL PURPOSES TUBULE MAY BE CONSIDERED TO BE IMPERMEABLE TO IT. ...OSMOTIC DIURETICS, WHICH, BY DEFINITION, ARE POORLY REABSORBED BY RENAL TUBULES, ARE ALSO NOT ABSORBED FROM GI TRACT. ...THESE AGENTS MUST BE ADMIN PARENTERALLY...TO ACHIEVE EFFECTIVE PLASMA CONCN.

Mannitol is metabolized only slightly, if at all, to glycogen in the liver.|...POLYHYDRIC SUGAR ALC...MANNITOL (C6H14O6)...LARGELY EXCRETED UNCHANGED IN URINE.|MANNITOL OCCURS IN LARGE AMT IN SPORES OF ASPERGILLUS ORYZAE, WHERE IT IS RAPIDLY METABOLIZED IN EARLY STAGES OF GERMINATION. IT IS CONVERTED TO FRUCTOSE BY D-MANNITOL DEHYDROGENASE...|...FATE OF MANNITOL IN ANIMAL BODY (MONKEYS, RABBITS, RATS, DOGS, ETC) AFTER ABSORPTION FROM DIGESTIVE TRACT INCL LIMITED CONVERSION TO GLYCOGEN IN LIVER & ELIMINATION OF BALANCE UNCHANGED IN URINE.

Mannitol has an elimination half-life of 4.7 hours following oral administration; the mean terminal elimination half-life is similar regardless of administration route (oral, inhalation, and intravenous.

Mannitol is an osmotic diuretic that is metabolically inert in humans and occurs naturally, as a sugar or sugar alcohol, in fruits and vegetables. Mannitol elevates blood plasma osmolality, resulting in enhanced flow of water from tissues, including the brain and cerebrospinal fluid, into interstitial fluid and plasma. As a result, cerebral edema, elevated intracranial pressure, and cerebrospinal fluid volume and pressure may be reduced. As a diurectic mannitol induces diuresis because it is not reabsorbed in the renal tubule, thereby increasing the osmolality of the glomerular filtrate, facilitating excretion of water, and inhibiting the renal tubular reabsorption of sodium, chloride, and other solutes. Mannitol promotes the urinary excretion of toxic materials and protects against nephrotoxicity by preventing the concentration of toxic substances in the tubular fluid. As an Antiglaucoma agent mannitol levates blood plasma osmolarity, resulting in enhanced flow of water from the eye into plasma and a consequent reduction in intraocular pressure. As a renal function diagnostic aid mannitol is freely filtered by the glomeruli with less than 10% tubular reabsorption. Therefore, its urinary excretion rate may serve as a measurement of glomerular filtration rate (GFR). The exact mechanism of action of inhaled mannitol in the symptomatic maintenance treatment of cystic fibrosis remains unclear. It is hypothesized that mannitol produces an osmotic gradient across the airway epithelium that draws fluid into the extracellular space and alters the properties of the airway surface mucus layer, allowing easier mucociliary clearance.|MANNITOL IS.../USED/ IN PROPHYLAXIS OF ACUTE RENAL FAILURE. IT IS USED FOR THIS PURPOSE IN CONDITIONS AS DIVERSE AS CARDIOVASCULAR OPERATIONS, SEVERE TRAUMATIC INJURY, OPERATIONS IN THE PRESENCE OF SEVERE JAUNDICE, AND MGMNT OF HEMOLYTIC TRANSFUSION REACTIONS. IN EACH OF THESE CONDITIONS, A PRECIPITOUS FALL IN THE FLOW OF URINE MAY BE ANTICIPATED EITHER AS THE RESULT OF AN ACUTELY REDUCED FILTRATION RATE OR FROM ACUTE CHANGES IN TUBULAR PERMEABILITY. THE LATTER MAY BE CONSEQUENCE OF THE PRESENCE OF NOXIOUS AGENT WITHIN THE TUBULAR FLUID IN EXCESSIVELY HIGH CONCN, IN SOME INSTANCES SUFFICIENT TO RESULT IN ACTUAL PRECIPITATION. IN THESE SITUATIONS, MANNITOL EXERTS OSMOTIC EFFECT WITHIN THE TUBULAR FLUID, INHIBITS WATER REABSORPTION, & MAINTAINS THE RATE OF URINE FLOW. ...CONCN OF TOXIC AGENT WITHIN TUBULAR FLUID DOES NOT REACH EXCESSIVELY HIGH LEVELS THAT OTHERWISE WOULD HAVE BEEN ACHIEVED BY MORE COMPLETE REABSORPTION OF WATER.|...EVEN THOUGH /GLOMERULAR/ FILTRATION RATE IS REDUCED, MANNITOL IS STILL FILTERED @ GLOMERULUS. THE TUBULAR IMPERMEABILITY TO MANNITOL IS NOT ALTERED BY ACUTE RENAL ISCHEMIA OF SHORT DURATION. HENCE, THE MANNITOL THAT IS FILTERED IS ALSO EXCRETED IN THE VOIDED URINE. UNREABSORBED SOLUTE LIMITS BACK DIFFUSION OF WATER. ...URINE VOL CAN BE MAINTAINED EVEN IN PRESENCE OF DECR GLOMERULAR FILTRATION.

SYMPTOMS: Symptoms of exposure to this compound include nausea, vomiting, headache, chills, chest pain and pulmonary edema. It may cause irritation of the skin, eyes and respiratory tract. Other symptoms may include lethargy, confusion, heart failure and death. Exposure has caused an electrolyte and fluid imbalance, hypersensitivity reactions, diarrhea, thirst, fever, tachycardia, hyponatremia, urinary retention, dehydration, blurred vision, convulsions, urticaria, hypotension and hypertension. It has also caused hyperglycemia and glycosuria. Coughing may result from inhalation. Ingestion may cause gastric irritation. Skin contact may cause discoloration of sensitive skin. Eye contact may cause redness and pain. Intravenous use has led to blood pressure elevation and bladder tubule changes. ACUTE/CHRONIC HAZARDS: This compound may cause irritation of the skin, eyes and respiratory tract. When heated to decomposition it emits acrid smoke and toxic fumes of carbon monoxide and carbon dioxide. (NTP, 1992)

EYES: First check the victim for contact lenses and remove if present. Flush victim's eyes with water or normal saline solution for 20 to 30 minutes while simultaneously calling a hospital or poison control center. Do not put any ointments, oils, or medication in the victim's eyes without specific instructions from a physician. IMMEDIATELY transport the victim after flushing eyes to a hospital even if no symptoms (such as redness or irritation) develop. SKIN: IMMEDIATELY flood affected skin with water while removing and isolating all contaminated clothing. Gently wash all affected skin areas thoroughly with soap and water. If symptoms such as redness or irritation develop, IMMEDIATELY call a physician and be prepared to transport the victim to a hospital for treatment. INHALATION: IMMEDIATELY leave the contaminated area; take deep breaths of fresh air. If symptoms (such as wheezing, coughing, shortness of breath, or burning in the mouth, throat, or chest) develop, call a physician and be prepared to transport the victim to a hospital. Provide proper respiratory protection to rescuers entering an unknown atmosphere. Whenever possible, Self-Contained Breathing Apparatus (SCBA) should be used; if not available, use a level of protection greater than or equal to that advised under Protective Clothing. INGESTION: DO NOT INDUCE VOMITING. If the victim is conscious and not convulsing, give 1 or 2 glasses of water to dilute the chemical and IMMEDIATELY call a hospital or poison control center. Be prepared to transport the victim to a hospital if advised by a physician. If the victim is convulsing or unconscious, do not give anything by mouth, ensure that the victim's airway is open and lay the victim on his/her side with the head lower than the body. DO NOT INDUCE VOMITING. IMMEDIATELY transport the victim to a hospital. (NTP, 1992)

SIX PATIENTS WITH SEVERE MANNITOL INTOXICATION WERE TREATED WITH HEMODIALYSIS & ONE WITH PERITONEAL DIALYSIS. MANNITOL HAD HALF-LIFE OF APPROX 36 HR DURING INTERVALS WITHOUT TREATMENT. IDEAL TREATMENT IS HEMODIALYSIS WHICH RAPIDLY REMOVES MANNITOL (HALF-LIFE, 6 HR) & REPLACES IT WITH SODIUM; PERITONEAL DIALYSIS REMOVED MANNITOL SLOWLY (HALF-LIFE, 21 HR).

...DEHYDRATION, & MASSIVE DIURESIS ARE COMMON UNTOWARD EFFECTS OF MANNITOL. ... OCCASIONALLY CAUSED AGITATION, DISORIENTATION, & CONVULSIONS. LARGE DOSES MAY CAUSE ACUTE INCR IN INTRAVASCULAR VOL, RESULTING IN CONGESTIVE HEART FAILURE OR INTRACRANIAL HEMORRHAGE.|HEADACHE, NAUSEA, VOMITING, CHILLS, DIZZINESS, POLYDIPSIA, LETHARGY, CONFUSION, & SENSATION OF CONSTRICTION OR PAIN IN CHEST HAVE BEEN OBSERVED FOLLOWING INFUSION OF MANNITOL. FATALITIES HAVE OCCURRED AFTER LARGE DOSES.|TOO RAPID ADMIN OF LARGE AMT WILL DRAW INTRACELLULAR WATER INTO EXTRACELLULAR SPACE, CAUSING CELLULAR DEHYDRATION & OVEREXPANSION OF INTRAVASCULAR SPACE WITH CONGESTIVE HEART FAILURE & PULMONARY EDEMA. HYPONATREMIA IS A COMMON PROBLEM. ...MAY INCR CEREBRAL BLOOD FLOW & THUS THE RISK OF POSTOPERATIVE BLEEDING IN NEUROSURGICAL PATIENTS.|A VARIETY OF SIGNS & SYMPTOMS SUGGESTIVE OF HYPERSENSITIVITY REACTIONS HAS OCCURRED IN OCCASIONAL PATIENTS.|For more Human Toxicity Excerpts (Complete) data for D-MANNITOL (7 total), please visit the HSDB record page.

(L)-Mannitol

MANNITOL, USP (OSMITROL), IS AVAIL FOR IV ADMIN AS MANNITOL INJECTION, USP, & MANNITOL & SODIUM CHLORIDE INJECTION, USP, IN CONCN OF 5, 10, 15, 20, OR 25% MANNITOL IN VOL RANGING FROM 50 TO 1000 ML OF WATER OR 0.3 TO 0.45% SODIUM CHLORIDE SOLN.|Grades: Reagent; Commercial; NF; FCC|Resectisol (Amer. McGaw)

Pharmaceutical and medicine manufacturing|D-Mannitol: ACTIVE|Mannitol: ACTIVE|LEVEL OF USE RECOMMENDED: UP TO 1.0% IN CHEWING GUM, UP TO 5.0% IN CANDY.

COLUMN CHROMATOGRAPHY DEVELOPED BY 85% ISOPROPYL ALC & 15% WATER. CUT MANNITOL FROM COLUMN. ELUTE WITH WARM WATER. ADD SODIUM PERIODATE SOLN & HEAT. COOL & ADD NAHCO3 & POTASSIUM IODIDE. TITRATE WITH 0.05 N SODIUM ARSENITE.|MANNITOL DETERMINED BY CONVERSION TO ACETATE & GAS CHROMATOGRAPHY.

A GC/MS METHOD FOR QUANTITATIVE SIMULTANEOUS DETERMINATION OF MANNITOL & SORBITOL IN PLASMA USING N-BUTYLDIBORONATE DERIVATIVES & GALACTITOL INTERNAL STD WAS DEVELOPED. DETECTION LIMITED TO 20 NG/0.1 ML.

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