Mannitolo

Mannitolo, also known as mannitol, is a sugar alcohol (a hexitol) with the formula C6H14O6. It occurs naturally in certain plants and marine organisms and is produced commercially by hydrogenating mannose or by enzymatic processes. Mannitolo is highly soluble in water and is not appreciably metabolized by human enzymes; it is excreted unchanged by the kidneys and therefore acts as an osmotic agent. Its osmotic activity draws water into the intestinal lumen when taken orally, and into the renal tubules when given parenterally.

Medically, mannitolo is used intravenously as an osmotic diuretic to reduce intracranial pressure and cerebral edema, and to maintain urine production in acute kidney injury or during certain surgeries. It can also be employed to reduce intraocular pressure in acute settings. In addition, it has long been used as an osmotic laxative in bowel cleansing regimens.

In the food industry, mannitolo is used as a low-calorie sweetener and bulking agent; in the EU it is designated as the food additive E421. It is about half as sweet as sucrose and provides roughly 2 kcal per gram. It is used in sugar-free products, chewing gums, and dental-friendly formulations. Excessive intake can cause osmotic diarrhea and abdominal cramps.

Safety and regulation: adverse effects include dehydration, electrolyte disturbances, and, if given rapidly or in patients with kidney problems, fluid overload. It is contraindicated in anuria and in some cases of severe kidney disease or congestive heart failure. Administration requires medical supervision and monitoring of fluid and electrolyte balance.