(MAN ga nees)
Trace element added to total parenteral nutrition (TPN) solution to prevent manganese deficiency; orally as a dietary supplement
Direct IM or IV injection
Adequate intake: Oral:
Males: 2.3 mg/day; Females: 1.8 mg/day
Pregnancy: 2 mg/day
Lactation: 2.6 mg/day
Deficiency prevention: IV: 150-800 mcg/day usually administered in TPN solutions
Refer to adult dosing.
Adequate intake: Oral:
0-6 months: 0.003 mg/day
7-12 months: 0.6 mg/day
1-3 years: 1.2 mg/day
4-8 years: 1.5 mg/day
9-13 years: Males: 1.9 mg/day; Females: 1.6 mg/day
14-18 years: Males: 2.2 mg/day; Females: 1.6 mg/day
Deficiency prevention: IV: 2-10 mcg/kg/day usually administered in TPN solutions
Note: Use caution in premature neonates; manganese chloride solution for injection contains aluminum.
Use caution; manganese chloride solution for injection contains aluminum.
Use caution; dose may need to be decreased or withheld.
Capsule, tablet: May be administered with a meal.
Solution for injection: Do not administer IM or by direct IV injection; acidic pH of the solution may cause tissue irritations and it is hypotonic; administer after dilution in volume of fluid ≥100 mL
Capsule/tablet (dietary supplement): Store in a cool, dry place.
Solution for injection: Store at controlled room temperature of 20 ‚ °C to 25 ‚ °C (68 ‚ °F to 77 ‚ °F). Compatible with electrolytes usually present in amino acid/dextrose solution used for TPN solutions; after admixture, discard unused portion immediately.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Capsule, Oral, as chelated:
MN-50: Elemental manganese 16.67 mg
Solution, Intravenous, as chloride:
Generic: Elemental manganese 0.1 mg/mL (10 mL)
Solution, Intravenous, as sulfate [preservative free]:
Generic: Elemental manganese 0.1 mg/mL (10 mL)
Tablet, Oral, as aspartate:
Generic: 93 mg [elemental manganese 25 mg]
Tablet, Oral, as chelated:
Mangimin: Elemental manganese 10 mg [corn free, rye free, wheat free]
Generic: Elemental manganese 15 mg, Elemental manganese 50 mg
Tablet, Oral, as gluconate:
Generic: 50 mg [elemental manganese 5.7 mg]
There are no known significant interactions.
Periodic manganese plasma level
Disease-related concerns:
- Biliary tract impairment: Use with caution in patients with biliary tract impairment; dose may need to be decreased or withheld.
- Hepatic impairment: Use with caution in patients with hepatic impairment; dose may need to be decreased or withheld.
Dosage form specific issues:
- Aluminum: The parenteral product may contain aluminum; toxic aluminum concentrations may be seen with high doses, prolonged use, or renal dysfunction. Premature neonates are at higher risk due to immature renal function and aluminum intake from other parenteral sources. Parenteral aluminum exposure of >4 to 5 mcg/kg/day is associated with CNS and bone toxicity; tissue loading may occur at lower doses (Federal Register, 2002). See manufacturer 's labeling.
Other warnings/precautions:
- Appropriate use: Due to its highly acidic pH (pH 2.0), direct IV or IM injection is contraindicated; may result in severe tissue damage.
C
Animal reproduction studies have not been conducted. Manganese crosses the placenta and can be detected in placental tissue and cord blood (Osada, 2002).
Cofactor in many enzyme systems, stimulates synthesis of cholesterol and fatty acids in liver, and influences mucopolysaccharide synthesis
Poor
Concentrated in mitochondria of pituitary gland, pancreas, liver, kidney, and bone
Bile (primarily); urine (negligible)
- Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
- Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating, and advising patients.