Osmotic diuretic that increases urine output by elevating the osmolarity of the glomerular filtrate, thereby reducing water reabsorption.

Promote diuresis in acute renal failure (oliguric phase)

Reduce intracranial pressure and cerebral edema

Lower elevated intraocular pressure

Promote excretion of toxic substances

Total dose: 50–200 g/day

Infuse IV to maintain urine output of 30–50 mL/hr

Metabolic: Electrolyte imbalance, acidosis, dehydration

CNS: Headache, dizziness, convulsions

CV: Pulmonary edema, hypotension, hypertension, tachycardia

GI: Nausea, vomiting, diarrhea

Dermatologic: Skin necrosis, thrombophlebitis

Hypersensitivity: Urticaria

Miscellaneous: Thirst, fever, chills

Established anuria due to severe renal disease

Severe pulmonary congestion or frank pulmonary edema

Active intracranial bleeding (except during craniotomy)

Severe dehydration

Worsening renal or cardiac function during treatment

Test Dose: Recommended in severe renal impairment to assess diuretic response.

Electrolyte Monitoring: Regularly monitor sodium and potassium.

Volume Status: Risk of water intoxication and heart failure if urine output is inadequate.

Crystallization: Solution must be clear before use; crystals should be dissolved by warming (60–80°C), then cooled to body temperature.

Administration: Use filtered IV set for ≥20% solutions. Avoid mixing with blood unless necessary and supplemented with NaCl.