Interactions : אינטראקציות

4.5 Interaction with other medicinal products and other forms of interaction

Concurrent use of other diuretics may potentiate the effects of mannitol and dose adjustments may be required.

Mannitol increases the elimination of medicinal products excreted through urine (e.g. lithium and methotrexate) and, therefore, concomitant use of mannitol may impair the response to these medicinal products.

Patients receiving concomitant cyclosporine should be closely monitored for signs of nephrotoxicity.

Other potential interactions are with aminoglycosides (potentiation of their ototoxic effects by mannitol), depolarising neuromuscular blocking drugs (enhancement of their effects by mannitol), oral anticoagulants (mannitol may reduce their effects by increasing the concentration of clotting factors secondary to dehydration) and digitalis (if hypokalaemia follows mannitol treatment, there is a risk of digitalis toxicity), although there is limited evidence of such interactions occurring in humans.

It should not be administered concomitantly with blood.

If it is essential that blood be given simultaneously, at least 20 milliequivalents of sodium chloride should be added to each litre of mannitol solution to avoid pseudoagglutination.