An Expert Monograph on Mannitol: Chemistry, Pharmacology, and Clinical Applications

1. Drug Identification and Overview

1.1. Introduction to Mannitol

Mannitol is a small molecule drug, classified chemically as a six-carbon sugar alcohol, or polyol.[1] It is a versatile and critically important agent in modern medicine, primarily functioning as a potent osmotic diuretic.[3] Chemically, it is a hexahydric alcohol related to the sugar mannose and is a stereoisomer of sorbitol.[2] Its multifaceted utility spans a wide range of clinical scenarios. Therapeutically, it holds a vital role in emergency and critical care settings for the reduction of acutely elevated intracranial pressure (ICP) associated with cerebral edema and for lowering high intraocular pressure (IOP) in conditions like glaucoma.[1] It is also employed to promote diuresis in certain renal conditions, to facilitate the elimination of toxins, and as a diagnostic agent to measure kidney function.[1] In a distinct application, an inhaled formulation of Mannitol serves as an adjunctive therapy for managing the pulmonary symptoms of cystic fibrosis.[1]

Beyond its direct therapeutic roles, Mannitol is extensively utilized in the pharmaceutical and food industries. Its unique physicochemical properties, including chemical stability, non-hygroscopicity, and safety profile, make it a valuable pharmaceutical excipient in various dosage forms.[6] In the food sector, it functions as a low-calorie sweetener and texturizing agent.[4] The compound is identified by the DrugBank Accession Number DB00742 and the Chemical Abstracts Service (CAS) Registry Number 69-65-8.[1]

1.2. Chemical and Physical Profile

A thorough understanding of Mannitol's clinical and industrial applications begins with its fundamental chemical and physical characteristics.

Chemical Identity