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Showing drug card for Mannitol (DB00742)

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Version 2.5
Creation Date 2005-06-13 13:24:05
Update Date 2009-06-23 18:07:51
Primary Accession Number DB00742
Secondary Accession Number
  • APRD01083
  • EXPT02246
Name Mannitol
Drug Type
  • Approved
  • Investigational
  • Small Molecule
Description 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. Mannitol may also be used for the promotion of diuresis before irreversible renal failure becomes established; the promotion of urinary excretion of toxic substances; as an Antiglaucoma agent; and as a renal function diagnostic aid.
Synonyms
  1. Cordycepic acid
  2. D-Mannitol
  3. mannitol
Brand Names
  1. Bronchitol
  2. Diosmol
  3. Hexanhexol
  4. Hexitol
  5. Isotol
  6. Manicol
  7. Maniton-S
  8. Manna sugar
  9. Mannazucker
  10. Mannidex
  11. Mannigen
  12. Mannistol
  13. Mannit
  14. Mannite
  15. Mannitol 10%
  16. Mannitol 10% In Plastic Container
  17. Mannitol 15%
  18. Mannitol 15% In Plastic Container
  19. Mannitol 20%
  20. Mannitol 20% In Plastic Container
  21. Mannitol 25%
  22. Mannitol 5%
  23. Mannitol 5% In Plastic Container
  24. Mannitol BP
  25. Mushroom sugar
  26. Osmitrol
  27. Osmitrol 10% In Water
  28. Osmitrol 15% In Water
  29. Osmitrol 20% In Water
  30. Osmitrol 5% In Water
  31. Osmosal
  32. Resectisol
  33. Resectisol In Plastic Container
  34. SDM-25
  35. d-mannitol extra pure
Brand Mixtures
  1. Cystosol W 3% Hexitols (Mannitol + Sorbitol)
  2. Sorbitol Mannitol Irrigation (Mannitol + Sorbitol)
Chemical IUPAC Name hexane-1,2,3,4,5,6-hexol
Chemical Formula C6H14O6
Chemical Structure Structure
CAS Registry Number 69-65-8
InChI Identifier InChI=1/C6H14O6/c7-1-3(9)5(11)6(12)4(10)2-8/h3-12H,1-2H2
InChI Key FBPFZTCFMRRESA-UHFFFAOYAI
KEGG Drug D00062 Link Image
KEGG Compound C00392 Link Image
PubChem Compound 453 Link Image
PubChem Substance 3682 Link Image
ChEBI ID 16899 Link Image
PharmGKB ID PA450320 Link Image
HET ID AHM Link Image
GenBank ID Not Available
Drug ID Number [DIN] 02243176 Link Image
RxList Link http://www.rxlist.com/cgi/generic4/osmitrol.htm Link Image
PDRhealth Link Not Available
Wikipedia Link http://en.wikipedia.org/wiki/Mannitol Link Image
FDA Label
Material Safety Data Sheet (MSDS)
Synthesis Reference Not Available
Average Molecular Weight 182.1718
Monoisotopic Molecular Weight 182.0790
State Solid
Melting Point 168 oC
Experimental Water Solubility 216 mg/mL Source: PhysProp
Predicted Water Solubility 2.29e+02 mg/mL Calculated using ALOGPS
Experimental LogP/Hydrophobicity -3.9 Source: PhysProp
Predicted LogP -2.68 Calculated using ALOGPS
Experimental LogS Not Available
Predicted LogS 0.10 Calculated using ALOGPS
Experimental Caco2 Permeability -6.21 [ADME Research, USCD]
pKa/Isoelectric Point Not Available
Mass Spectrum Not Available
MOL File Show Link Image | Download Link Image
SDF File Show Link Image | Download Link Image
PDB File Show Link Image | Download Link Image
2D Structure
3D Structure
Experimental PDB ID 1M2W Link Image
Experimental PDB File Show
Experimental PDB Structure
Isomeric SMILES OC[C@H](O)[C@H](O)[C@@H](O)[C@@H](O)CO
Canonical SMILES OCC(O)C(O)C(O)C(O)CO
Drug Category
  • Diuretics, Osmotic
  • Sweetening Agents
ATC Codes
AHFS Codes
  • 36:68.00
  • 40:28.12
  • 40:36.00
Indication 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.
Pharmacology 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.
Mechanism of Action 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).
Absorption Approximately 7% of ingested mannitol is absorbed during gastrointestinal perfusion in uremic patients.
Toxicity LD50=1700 mg/kg (rat oral)
Protein Binding None
Biotransformation Mannitol is metabolized only slightly, if at all, to glycogen in the liver.
Half Life 100 minutes
Dosage Forms
Form Route
Liquid Intravenous
Liquid Irrigation
Solution Intravenous
Patient Information Not Available
Contraindications Show Link Image
Interactions Show Link Image
Drug Interactions Not Available
Food Interactions Not Available
Pathways Not Available
General References
  1. Cruz J, Minoja G, Okuchi K: Improving clinical outcomes from acute subdural hematomas with the emergency preoperative administration of high doses of mannitol: a randomized trial. Neurosurgery. 2001 Oct;49(4):864-71. [PubMed Link Image]
  2. Cruz J, Minoja G, Okuchi K: Major clinical and physiological benefits of early high doses of mannitol for intraparenchymal temporal lobe hemorrhages with abnormal pupillary widening: a randomized trial. Neurosurgery. 2002 Sep;51(3):628-37; discussion 637-8. [PubMed Link Image]
  3. Cruz J, Minoja G, Okuchi K, Facco E: Successful use of the new high-dose mannitol treatment in patients with Glasgow Coma Scale scores of 3 and bilateral abnormal pupillary widening: a randomized trial. J Neurosurg. 2004 Mar;100(3):376-83. [PubMed Link Image]
  4. Wakai A, Roberts I, Schierhout G: Mannitol for acute traumatic brain injury. Cochrane Database Syst Rev. 2005 Oct 19;(4):CD001049. [PubMed Link Image]
  5. Roberts I, Smith R, Evans S: Doubts over head injury studies. BMJ. 2007 Feb 24;334(7590):392-4. [PubMed Link Image]
  6. Wang YM, van Eys J: Nutritional significance of fructose and sugar alcohols. Annu Rev Nutr. 1981;1:437-75. [PubMed Link Image]
  7. Wikipedia Link Image
  8. RxList Link Image
Organisms Affected
  • Humans and other mammals
Targets
  1. DNA
  2. Mannitol dehydrogenase
Drug Target 1 [top]
Target 1 ID 874
Target 1 Name DNA
Target 1 Synonyms
  1. Deoxyribonucleic acid
Target 1 Gene Name Not Available
Target 1 Protein Sequence Not Available
Target 1 Number of Residues 0
Target 1 Molecular Weight 7656 (double strand)
Target 1 Theoretical pI Not Available
Target 1 GO Classification
Function
information storage
information transfer
Process
DNA replication and chromosomal cycle
DNA replication
DNA-dependent DNA replication
DNA replication, synthesis of RNA primer
transcription
transcription, DNA dependent
Component
cell
intracellular
nucleus
mitochondria
Target 1 General Function Biological information storage and information transfer
Target 1 Specific Function DNA is the molecule of heredity, as it is responsible for the genetic propagation of most inherited traits. It is a polynucleic acid that carries genetic information on cell growth, division, and function. DNA consists of two long strands of nucleotides twisted into a double helix and held together by hydrogen bonds. The sequence of nucleotides determines hereditary characteristics. Each strand serves as the template for subsequent DNA replication and as a template for mRNA production, leading to protein synthesis via ribosomes.
Target 1 Pathways
Name SMPDB Link KEGG Link
DNA polymerase map03030 Link Image
RNA polymerase map03020 Link Image
Target 1 Reactions
  • DNA + DNA polymerase + nNTP = 2 DNA + nNDP; DNA + RNA polymerase + NTP = mRNA + nNDP
Target 1 Pfam Domain Function Not Available
Target 1 Signals
  • None
Target 1 Transmembrane Regions
  • None
Target 1 Essentiality Essential
Target 1 GenBank ID Protein Not Available
Target 1 UniProtKB/Swiss-Prot ID Not Available
Target 1 UniProtKB/Swiss-Prot Entry Name Not Available
Target 1 PDB ID 1BNA Link Image
Target 1 PDB File Show
Target 1 3D Structure
Target 1 Cellular Location
  • Nucleus and mitochondria
Target 1 Gene Sequence >Example: Dickerson dodecamer 
CGCGAATTCGCG
Target 1 GenBank Gene ID
Target 1 GeneCard ID Not Available
Target 1 GenAtlas ID Not Available
Target 1 HGNC ID Not Available
Target 1 Chromosome Location Not Available
Target 1 Locus All loci
Target 1 SNPs Not Available
Target 1 General References
  1. Nadeau D, Marchand C: Change in the kinetics of sulphacetamide tissue distribution in Walker tumor-bearing rats. Drug Metab Dispos. 1975 Nov-Dec;3(6):565-76. [PubMed Link Image]
Target 1 Drug References
  1. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed Link Image]
  2. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [PubMed Link Image]
Drug Target 2 [top]
Target 2 ID 4476
Target 2 Name Mannitol dehydrogenase
Target 2 Synonyms
  1. EC 1.1.1.67
Target 2 Gene Name mtlD
Target 2 Protein Sequence >Mannitol dehydrogenase 
MKLNKQNLTQLAPEVKLPAYTLADTRQGIAHIGVGGFHRAHQAYYTDALMNTGEGLDWSI
CGVGLRSEDRKARDDLAGQDYLFTLYELGDTDDTEVRVIGSISDMLLAEDSAQALIDKLA
SPEIRIVSLTITEGGYCIDDSNGEFMAHLPQIQHDLAHPSSPKTVFGFICAALTQRRAAG
IPAFTVMSCDNLPHNGAVTRKALLAFAALHNAELHDWIKAHVSFPNAMVDRITPMTSTAH
RLQLHDEHGIDDAWPVVCEPFVQWVLEDKFVNGRPAWEKVGVQFTDDVTPYEEMKIGLLN
GSHLALTYLGFLKGYRFVHETMNDPLFVAYMRAYMDLDVTPNLAPVPGIDLTDYKQTLVD
RFSNQAIADQLERVCSDGSSKFPKFTVPTINRLIADGRETERAALVVAAWALYLKGVDEN
GVSYTIPDPRAEFCQGLVSDDALISQRLLAVEEIFGTAIPNSPEFVAAFERCYGSLRDNG
VTTTLKHLLKKPV
Target 2 Number of Residues 501
Target 2 Molecular Weight 54498
Target 2 Theoretical pI 4.95
Target 2 GO Classification
Function
catalytic activity
Process
physiological process
metabolism
Component
Not Available
Target 2 General Function Involved in oxidoreductase activity
Target 2 Specific Function Not Available
Target 2 Pathways Not Available
Target 2 Reactions Not Available
Target 2 Pfam Domain Function
Target 2 Signals
  • None
Target 2 Transmembrane Regions
  • None
Target 2 Essentiality Essential
Target 2 GenBank ID Protein Not Available
Target 2 UniProtKB/Swiss-Prot ID O08355 Link Image
Target 2 UniProtKB/Swiss-Prot Entry Name O08355_PSEFL Link Image
Target 2 PDB ID 1LJ8 Link Image
Target 2 PDB File Show
Target 2 3D Structure
Target 2 Cellular Location Not Available
Target 2 Gene Sequence >1482 bp 
ATGAAACTGAATAAGCAGAACCTCACCCAGCTGGCGCCCGAAGTGAAATTGCCAGCCTAT
ACGCTTGCCGACACACGCCAGGGCATCGCCCATATCGGCGTCGGCGGCTTCCATCGCGCG
CACCAGGCGTATTACACCGATGCGCTGATGAATACCGGCGAGGGCCTGGACTGGAGCATC
TGCGGCGTTGGCCTGCGCAGCGAGGACCGCAAGGCCCGCGATGACCTGGCCGGCCAGGAC
TACCTGTTCACCCTGTACGAACTGGGCGACACCGACGACACCGAAGTGCGCGTGATCGGC
TCGATCAGCGACATGCTGCTGGCCGAAGACAGCGCCCAGGCATTGATCGATAAACTGGCC
AGCCCCGAGATTCGCATCGTCTCGCTGACCATCACCGAAGGCGGCTACTGCATCGACGAC
AGCAACGGCGAATTCATGGCCCACTTGCCGCAGATCCAGCACGACCTGGCTCATCCGTCG
TCGCCAAAAACCGTGTTCGGCTTTATCTGCGCGGCATTGACCCAGCGCCGCGCGGCCGGC
ATCCCGGCGTTTACCGTGATGTCCTGCGATAACCTGCCCCACAATGGCGCTGTCACGCGC
AAGGCACTGCTGGCGTTCGCCGCCCTGCACAACGCCGAGCTGCATGACTGGATCAAGGCC
CATGTGAGCTTCCCGAACGCCATGGTCGACCGCATCACGCCGATGACCAGCACCGCCCAC
CGCCTGCAACTGCACGATGAACACGGCATCGACGATGCCTGGCCAGTTGTTTGCGAACCC
TTTGTGCAGTGGGTACTGGAAGACAAATTCGTCAACGGCCGCCCGGCGTGGGAAAAGGTT
GGCGTGCAGTTCACCGACGATGTGACACCCTATGAAGAGATGAAGATCGGCTTGCTCAAC
GGCAGCCACCTGGCCCTGACCTACCTGGGTTTTCTCAAGGGCTATCGGTTTGTGCACGAG
ACCATGAACGACCCGCTGTTCGTGGCCTACATGCGCGCCTACATGGACCTCGACGTCACG
CCAAACCTCGCGCCGGTACCGGGCATCGACCTGACCGACTACAAGCAGACCCTGGTGGAC
CGCTTCTCCAACCAGGCGATTGCCGACCAGTTGGAACGGGTGTGTTCGGATGGCTCGTCG
AAGTTTCCCAAGTTCACCGTGCCGACCATCAACCGCCTGATTGCCGACGGCCGTGAGACC
GAGCGTGCAGCACTGGTCGTCGCGGCCTGGGCCTTGTATTTGAAGGGTGTGGATGAGAAT
GGCGTGAGCTACACAATCCCCGATCCGCGCGCCGAGTTCTGCCAGGGGCTGGTGAGTGAC
GATGCACTGATCAGCCAGCGGTTGCTGGCAGTGGAAGAGATTTTCGGTACGGCTATTCCC
AACTCGCCTGAGTTTGTGGCAGCGTTCGAGCGGTGCTATGGGAGCCTGCGTGATAACGGC
GTCACCACTACCCTGAAGCACCTCCTGAAGAAACCGGTTTAA
Target 2 GenBank Gene ID
Target 2 GeneCard ID Not Available
Target 2 GenAtlas ID Not Available
Target 2 HGNC ID Not Available
Target 2 Chromosome Location Not Available
Target 2 Locus Not Available
Target 2 SNPs SNPJam Report Link Image
Target 2 General References
  1. Kavanagh KL, Klimacek M, Nidetzky B, Wilson DK: Crystal structure of Pseudomonas fluorescens mannitol 2-dehydrogenase binary and ternary complexes. Specificity and catalytic mechanism. J Biol Chem. 2002 Nov 8;277(45):43433-42. Epub 2002 Aug 23. [PubMed Link Image]
  2. Brunker P, Altenbuchner J, Kulbe KD, Mattes R: Cloning, nucleotide sequence and expression of a mannitol dehydrogenase gene from Pseudomonas fluorescens DSM 50106 in Escherichia coli. Biochim Biophys Acta. 1997 Mar 20;1351(1-2):157-67. [PubMed Link Image]
  3. Brunker P, Altenbuchner J, Mattes R: Structure and function of the genes involved in mannitol, arabitol and glucitol utilization from Pseudomonas fluorescens DSM50106. Gene. 1998 Jan 5;206(1):117-26. [PubMed Link Image]
Target 2 Drug References Not Available

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