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甘露醇

Mannitol

滲透性利尿劑IV狗貓馬牛豬羊山羊

別名: Osmitrol · Resectisol · Am-Vet Mannitol · Isotol · Manniject · Osmofundin · Mannitol IV · cordycepic acid · E421 · manita · manitol · manna sugar · mannite · mannitolum · D-Mannitol

由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本

0.25-0.5 gram/kg IV over 5-10 minutesIV· May repeat q4-6 hours or as CRI for first 12-24 hours· 12-24 hours
— 🐕

劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。

各物種劑量

🌎 NA — North America🌍 EU — Europe

狗

適應症劑量途徑頻次療程地區
Oliguric renal failure (not anuric)0.25-0.5 gram/kg IV over 5-10 minutesIVMay repeat q4-6 hours or as CRI for first 12-24 hours12-24 hours🌎 NA
Oliguric renal failure (rehydrated, not fluid overloaded)0.25-0.5 gram/kg IV slowly over 5-10 minutes; repeat dose at 30-40 minute intervals up to 1.5 gram/kg totalIVq30-40minUp to 1.5 g/kg total🌎 NA
Oliguric renal failure (fluid replete)0.5 gram/kg IV over 20-30 minutes; if significant diuresis is accomplished within 30 minutes, may administer as a CRI of 60-120 mg/kg/hr IV or as intermittent boluses repeated every 4-6 hoursIVCRI or q4-6h—🌎 NA
Acute glaucoma0.5-1 gram/kg IV given over 15-20 minutesIVSingle dose—🌎 NA
Acute glaucoma (if latanoprost fails)1-2 grams/kg IV over a period of 20 minutesIVSingle dose—🌎 NA
Acute primary angle-closure glaucoma1 gram/kg of mannitol 20% for injection IV over 20 minIVMay repeat in 4 hours if needed—🌎 NA
Increased CSF pressure/cerebral edema0.5-1.5 grams/kg IV over 10-20 minutesIVq6-8h—🌎 NA
Increased CSF pressure (critical/deteriorating patient)0.25 gram/kg IV bolus over 15 minutesIVAs needed based on ICP—🌎 NA
Cerebral edema secondary to trauma0.5-1 gram/kg IV followed 20 minutes later by furosemide (1 mg/kg IV)IVSingle dose—🌎 NA
  • Oliguric renal failure (not anuric): After correcting fluid, electrolyte, acid/base balance. CRI dose is 8-10% solution.
  • Oliguric renal failure (fluid replete): Contraindicated in patients who are dehydrated, hypervolemic, or anuric.
  • Acute glaucoma: Withhold water for 3-4 hours. IOP reduction begins in 20-30 mins.
  • Acute glaucoma (if latanoprost fails): Withhold water for 1-2 hours.
  • Acute primary angle-closure glaucoma: Chronic use not advised. Withhold water for several hours post-dose.
  • Increased CSF pressure/cerebral edema: Limit to three boluses in a 24-hr period if possible. Monitor osmolality.
  • Increased CSF pressure (critical/deteriorating patient): Equally effective as 1 g/kg but may last a shorter time.
  • Cerebral edema secondary to trauma: Aggressive therapy for dying patients; potential risk for worsening hemorrhage.

貓

適應症劑量途徑頻次療程地區
Oliguric renal failure (not anuric)0.25-0.5 gram/kg IV over 5-10 minutesIVMay repeat q4-6 hours or as CRI for first 12-24 hours12-24 hours🌎 NA
Oliguric renal failure (rehydrated, not fluid overloaded)0.25-0.5 gram/kg IV slowly over 5-10 minutes; repeat dose at 30-40 minute intervals up to 1.5 gram/kg totalIVq30-40minUp to 1.5 g/kg total🌎 NA
Oliguric renal failure (fluid replete)0.5 gram/kg IV over 20-30 minutes; if significant diuresis is accomplished within 30 minutes, may administer as a CRI of 60-120 mg/kg/hr IV or as intermittent boluses repeated every 4-6 hoursIVCRI or q4-6h—🌎 NA
Acute glaucoma0.5-1 gram/kg IV given over 15-20 minutesIVSingle dose—🌎 NA
Acute glaucoma (if latanoprost fails)1-2 grams/kg IV over a period of 20 minutesIVSingle dose—🌎 NA
Acute primary angle-closure glaucoma1 gram/kg of mannitol 20% for injection IV over 20 minIVMay repeat in 4 hours if needed—🌎 NA
Increased CSF pressure/cerebral edema0.5-1.5 grams/kg IV over 10-20 minutesIVq6-8h—🌎 NA
Increased CSF pressure (critical/deteriorating patient)0.25 gram/kg IV bolus over 15 minutesIVAs needed based on ICP—🌎 NA
Cerebral edema secondary to trauma0.5-1 gram/kg IV followed 20 minutes later by furosemide (1 mg/kg IV)IVSingle dose—🌎 NA
  • Oliguric renal failure (not anuric): After correcting fluid, electrolyte, acid/base balance. CRI dose is 8-10% solution.
  • Oliguric renal failure (fluid replete): Contraindicated in patients who are dehydrated, hypervolemic, or anuric.
  • Acute glaucoma: Withhold water for 3-4 hours. IOP reduction begins in 20-30 mins.
  • Acute glaucoma (if latanoprost fails): Withhold water for 1-2 hours.
  • Acute primary angle-closure glaucoma: Chronic use not advised. Withhold water for several hours post-dose.
  • Increased CSF pressure/cerebral edema: Limit to three boluses in a 24-hr period if possible. Monitor osmolality.
  • Increased CSF pressure (critical/deteriorating patient): Equally effective as 1 g/kg but may last a shorter time.
  • Cerebral edema secondary to trauma: Aggressive therapy for dying patients; potential risk for worsening hemorrhage.

馬

適應症劑量途徑頻次療程地區
General diuresis/edema0.25-2 gram/kg as a 20% solution by slow IV infusionIVSingle dose—🌎 NA
Increased intracranial pressure from traumatic brain injury (TBI)Intermittent IV bolus doses of 0.25-1 gram/kgIVIntermittent—🌎 NA
  • Increased intracranial pressure from traumatic brain injury (TBI): Rapid bolus administration preferred over continuous. Monitor to avoid hypovolemia.

牛

適應症劑量途徑頻次療程地區
Cerebral edema1-3 gram/kg IVIVSingle dose—🌎 NA
Oliguric renal failure1-2 gram/kg (5-10mL of 20% solution) IVIVSingle dose—🌎 NA
  • Cerebral edema: Usually given with steroids and/or DMSO.
  • Oliguric renal failure: Give after rehydration; monitor urine flow and fluid balance.

豬

適應症劑量途徑頻次療程地區
Cerebral edema1-3 gram/kg IVIVSingle dose—🌎 NA
Oliguric renal failure1-2 gram/kg (5-10mL of 20% solution) IVIVSingle dose—🌎 NA
  • Cerebral edema: Usually given with steroids and/or DMSO.
  • Oliguric renal failure: Give after rehydration; monitor urine flow and fluid balance.

羊

適應症劑量途徑頻次療程地區
Cerebral edema1-3 gram/kg IVIVSingle dose—🌎 NA
Oliguric renal failure1-2 gram/kg (5-10mL of 20% solution) IVIVSingle dose—🌎 NA
  • Cerebral edema: Usually given with steroids and/or DMSO.
  • Oliguric renal failure: Give after rehydration; monitor urine flow and fluid balance.

山羊

適應症劑量途徑頻次療程地區
Cerebral edema1-3 gram/kg IVIVSingle dose—🌎 NA
Oliguric renal failure1-2 gram/kg (5-10mL of 20% solution) IVIVSingle dose—🌎 NA
  • Cerebral edema: Usually given with steroids and/or DMSO.
  • Oliguric renal failure: Give after rehydration; monitor urine flow and fluid balance.

劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。

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概覽

甘露醇是一種強效的​滲透性利尿劑​，主要用於急診和重症監護獸醫學。它是一種糖醇，能將水分從細胞內抽吸至細胞外間隙。

​主要適應症：​

  • 處理​急性少尿性腎衰竭​（促進利尿）
  • 降低​顱內壓 (ICP)​ 和腦水腫（例如創傷性腦損傷）
  • 降低急性青光眼中的​眼內壓 (IOP)​
  • 促進特定毒素（如阿斯匹靈、巴比妥類藥物、溴化物、乙二醇）的尿液排泄

​臨床提示：​ 由於甘露醇會引起快速的體液轉移，其療效顯著但需要嚴格監測病患的體液和水合狀態。由於其在室溫下容易結晶，給藥時必須使用輸液過濾器。

作用機轉

Mannitol is freely filtered at the glomerulus and poorly reabsorbed in the renal tubules.

  • ​Osmotic Diuresis:​ The presence of mannitol in the tubular fluid increases osmotic pressure → prevents water reabsorption → proportionately increases water excretion along with sodium, uric acid, and urea.
  • ​Neuroprotection & ICP Reduction:​ Increases intravascular osmolarity → draws water from brain parenchyma across an intact blood-brain barrier (BBB) into the intravascular space → decreases cerebral edema and CSF pressure.
  • ​Renal Protection:​ Dilates renal arterioles → decreases vascular resistance and blood viscosity → increases renal blood flow and glomerular filtration rate (GFR). It also minimizes renal tubular swelling and prevents the concentration of nephrotoxins in tubular fluid.

安全性與警告

禁忌症

  • Anuria secondary to renal disease
  • Severe dehydration
  • Severe pulmonary congestion or pulmonary edema
  • Intracranial bleeding (unless during craniotomy - human label)
  • Disrupted capillary membrane in the brain (can leak into interstitium and worsen edema)
  • Pulmonary oedema
  • Intracranial haemorrhage (relative contraindication; labelled 'use with care' but commonly used in traumatic brain injury)

不良反應

  • Fluid and electrolyte imbalances (especially hypernatremia)
  • Volume overload (if oliguria persists)
  • Nausea and vomiting
  • Pulmonary edema
  • Congestive heart failure (CHF)
  • Tachycardia
  • Dizziness and headache (CNS effects)
  • Circulatory overload (at high doses)
  • Acidosis (at high doses)
  • Thrombophlebitis
  • Extravasation injury (oedema and skin necrosis)
  • Diarrhoea (if administered orally)
  • Acute renal failure (rare)

注意事項

​Important Warnings:​

  • Halt therapy if progressive heart failure, pulmonary congestion, or progressive renal failure/damage (increasing oliguria/azotemia) develops.
  • ​Hydration:​ Adequate fluid replacement must be administered to dehydrated animals before mannitol therapy begins. Use with caution in hypovolemic patients as it can enhance hypotension.
  • ​Crystallization:​ Crystals frequently form in solutions >15%. Be certain crystals are dissolved (by warming) before administering. An ​in-line IV filter (5 micron)​ is highly recommended.
  • ​Blood Products:​ Do not give with whole blood products unless at least 20 mEq/L of NaCl is added, otherwise pseudoagglutination may result.
  • ​Glaucoma:​ Relatively contraindicated for treating secondary glaucomas, as it may cross the damaged blood-aqueous barrier and increase IOP.

藥物交互作用

Lithium

Mannitol can increase the renal elimination of lithium

Sotalol

Mannitol's effects on potassium and magnesium may increase the risk for QT prolongation

Potassium-depleting diureticsModerate

May exacerbate diuretic-induced hypokalaemia

Beta-blockersModerate

Concurrent use with potassium-depleting diuretics requires caution

CiclosporinMajor

Nephrotoxicity has been described with concurrent use in humans

Whole bloodMajor

Mannitol should never be added to whole blood for transfusion or given through the same IV set

KCl or NaClMajor

Do not add to concentrated mannitol solutions (20% or 25%) as a precipitate may form

監測

  • Serum electrolytes (especially sodium)
  • Serum osmolality
  • BUN and serum creatinine
  • Urine output
  • Central venous pressure (CVP), if possible
  • Lung auscultation (to monitor for pulmonary edema)
  • Intracranial pressure (ICP) or neurological status
  • Intraocular pressure (IOP)
  • Hydration status and body weight
  • Serum electrolytes (especially potassium and sodium)
  • Renal function (BUN, creatinine)
  • Acid-base balance

藥物動力學

吸收

Administered IV in veterinary medicine. In humans, up to 17% of an oral dose is excreted unchanged in the urine.

分佈

Distributed to the extracellular compartment. Does not penetrate the eye or the CNS unless the patient has received very high doses, is acidotic, or there is a loss of integrity of the blood-brain barrier.

代謝

Only 7-10% of mannitol is metabolized.

排除

The remainder is excreted unchanged in the urine. Elimination half-life in adult humans is ~100 minutes. Half-lives in cattle and sheep are reported to be between 40-60 minutes.

過量

Inadvertent overdosage can cause excessive excretion of sodium, potassium, and chloride. If urine output is inadequate, water intoxication or pulmonary edema may occur.

​Treatment:​

  • Halt mannitol administration immediately.
  • Monitor and correct electrolyte and fluid imbalances.
  • Hemodialysis is effective in clearing mannitol from the bloodstream.

可用產品

劑型

  • Injection: 5%, 10%, 15%, 20%, 25%
  • Injectable: 10% solution (50 g/500 ml)
  • Injectable: 15% solution (75 g/500 ml)
  • Injectable: 20% solution (100 g/500 ml)

獸醫用

  • Unapproved, veterinary-labeled products may be available.

人用標示

  • Mannitol Injection: 5% (50 mg/mL), 10% (100 mg/mL), 15% (150 mg/mL), 20% (200 mg/mL), 25% (250 mg/mL)
  • Mannitol Solution: 5 grams/100 mL
  • Mannitol 10% IV infusion
  • Mannitol 15% IV infusion
  • Mannitol 20% IV infusion

各地核准狀態

European Union✓ 已核准處方藥EMA
🐕 Dogs🐈 Cats

Available as POM (Prescription Only Medicine).

United Kingdom✓ 已核准處方藥VMD
🐕 Dogs🐈 Cats

Available as POM-V.

暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

儲存與穩定性

Store at room temperature; avoid freezing. Crystallization may occur at low temperatures in concentrations greater than 15%. Resolubilize crystals by heating the bottle in hot water (up to 80°C) and cool to body temperature before administering. An in-line IV filter (5 micron) is highly recommended when administering concentrated solutions.

飼主須知

甘露醇是一種急救藥物，必須由專業獸醫人員在具備完善監測設備的醫院環境中給藥。

由於它會引起體內液體的快速轉移，獸醫團隊將會密切監測您寵物的水合狀態、電解質和排尿量，以確保安全並達到最佳療效。

VetSheet 藥物參考供合格獸醫專業人員作臨床決策輔助之用，不能取代專業判斷或廠商最新仿單。