DaeHan D-Mannitol Injection (15%)

Key information summary

Efficacy & effects

This medication is used to prevent and treat acute renal failure that may occur during or after surgery, as well as after trauma. It also helps to expel toxic substances from the body more quickly in cases of drug overdose. It is effective in lowering elevated intracranial pressure and reducing brain volume. Additionally, it is used to lower intraocular pressure when it is increased. Overall, this medication is effective in preventing acute renal failure, promoting drug excretion, and reducing intracranial and intraocular pressure.

Dosage

As D-mannitol, typically administered as an intravenous drip at a rate of 1-3 g per kg of body weight using a 15% or 20% solution. The maximum daily dose is up to 200 g. The administration rate is 100 mL over 3-10 minutes. Adjustments may be made according to age and symptoms.

Precautions

This medication should not be administered to patients with acute intracranial hematoma or cerebral hemorrhage due to the risk of rebleeding during the process of lowering intracranial pressure. It is also not used in patients with severe heart failure, dehydration, or fluid and electrolyte imbalances, as well as those with pulmonary edema or pulmonary congestion. Additionally, it should not be given to patients with metabolic edema, those with anuria due to complete renal failure, patients with known allergic reactions to this medication, or those with tension-type headaches. Patients with impaired renal function, heart disease, liver disease, head trauma, children under 12 years of age, pregnant women, elderly individuals, and those with high blood volume should use this medication with caution. Rarely, cardiovascular abnormalities such as chest tightness, angina, increased heart rate, or changes in blood pressure may occur when using this medication. Symptoms of increased intracranial pressure such as headache, nausea, vomiting, and dizziness may also occur. In case of massive administration, renal injury such as acute renal failure can be observed, so treatment should be initiated immediately if these symptoms appear. Fluid and electrolyte imbalances may occur, and metabolic acidosis can present with overdose. Severe allergic reactions may occur in those with a history of allergies, so caution is needed. If electrolyte abnormalities, heart failure, pulmonary edema, etc., appear after administration, treatment should be stopped immediately. CNS toxicity may occur with high-dose administration, and inflammatory, painful, or swollen reactions may occur at the injection site. Before administration, it is advisable to perform a load test to check urine output for assessing renal function. If renal function is insufficient, treatment with this medication should be discontinued. This medication can place a burden on the kidneys, so frequent monitoring of kidney function is necessary. This medication can increase cerebral blood flow, raising the risk of postoperative bleeding, so caution is necessary in neurosurgical patients. Also, it should be administered only after thoroughly assessing cardiovascular status, and if a severe allergic reaction is suspected, administration should be discontinued immediately, and appropriate treatment should be received. Patients receiving this medication chronically may report CNS toxicity, such as confusion, drowsiness, and coma, so caution is required. Fluid overload may occur during administration, which can exacerbate heart failure. The risk of fluid overload is increased due to mannitol accumulation, so careful monitoring of fluid and electrolyte status is needed. During administration, serum osmolality, electrolyte concentrations, acid-base balance, urine output, blood pressure, renal and cardiopulmonary function, and intracranial pressure should be regularly monitored. This medication, when administered as a hypertonic solution of over 10% into peripheral veins, may cause venous irritation or leakage of the solution outside the blood vessels, so it is safer to administer through a central venous catheter. When administering this medication with blood, a solution containing sodium chloride must be used, and when combined with drugs such as lithium, regular checks of blood concentration and signs of toxicity should be conducted. Its safety during pregnancy has not been established, so it should be administered cautiously, and it is advisable not to give it to breastfeeding women. For elderly patients or those with impaired renal function, the risk of side effects is high; therefore, prior evaluation of kidney, heart, and lung status is necessary. Overdose may lead to dehydration, acute renal failure, heart failure, acidosis, and other symptoms, thus appropriate treatment should be provided based on the symptoms. This medication is intended for intravenous drip administration only. If the solution has precipitated crystals, it should be heated to dissolve and then cooled to body temperature before use. Before use, the solution should be checked for clarity, and if it is opaque or contains particulates, it should not be used.

Side effects

Urticaria, severe swelling (edema), chest tightness, difficulty breathing, cold sweats, pallor, severe allergic reactions, severe skin adverse reactions, dyspnea or difficulty breathing, asthma attacks, respiratory abnormalities associated with cough and fever, yellowing of skin or eyes (jaundice), marked lethargy, liver abnormalities (jaundice), sudden and severe headache, lightning-like headache, seizures, altered consciousness, visual disturbances, paralysis, severe kidney

Alternatives / Same-ingredient medications

• Chungwoo 15% Mannitol Injection

  Same ingredient
• Jungwoo 20% Mannitol Injection

  Same ingredient

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