What is it about?
Mannitol is a potentially very effective colonoscopy preparation that is very well accepted by patients. For the first time, a pharmacokinetic study was carried out on different dosages of mannitol also for to evaluate the optimal dose. The study showed that the bioavailability of the product is around 20%. The amount of drug absorbed increases with the dose; with 100 g the total amount of drug absorbed is still sufficiently reduced to guarantee a low incidence of systemic side effects. Elimination of the drug is rapid and is completed in less than 24 hours; clinical controls are therefore not necessary after the day of the colonoscopy.
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Why is it important?
Mannitol-based preparations for colonoscopy are widely used in different parts of the world but as off-label products and without a well establish the pharmacokinetic profile of the drug after oral intake. The current study for the first time confirms that the maximum blood concentration was dose-dependent, while bioavailability was similar at the three doses. All doses lead to peak mannitol concentration in the blood after 2.5 hours; the terminal half-life is short (2.5 hours), leading to complete drug elimination within 24 hours. Therefore, the occurrence of systemic side effects should be unlikely and, if occurring, self-resolving in a short time.
Perspectives
I hope that this article, together with those that will be published by the same working group on the efficacy, patient acceptability, and safety of mannitol, can help solve the problem of bowel preparation, which still today limits the availability of many patients to perform and repeat colonoscopy and, therefore, to adhere to the colon cancer screening and major inflammatory bowel disease follow-up programs.
Anna Orsatti
NTC Srl
Read the Original
This page is a summary of: Pharmacokinetics of oral mannitol for bowel preparation for colonoscopy, Clinical and Translational Science, August 2022, Wiley,
DOI: 10.1111/cts.13373.
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