MANNITOL Challenge Test

Mannitol Challenge Test

What is Mannitol Challenge Test?

Challenge tests are types of tests that measure if your lung function changes after you breathe in specific chemicals. A challenge study with Mannitol may be done to see if you have exercise-induced asthma or how well your asthma medicine is working.

What can I Expect During a Mannitol Challenge Test (MCT)?

If you have asthma, your airways will tighten. During the MCT, you will inhale a very gradual increasing dosage of Mannitol.

If your breathing does not change with the first dosage, you will be asked to inhale progressively a larger dosage of Mannitol. If your airways tighten at any point, you will be given an inhaled bronchodilator medicine that will re-open your airways.

Often, the person administering the test will know that your airways are tightening before you do because of the breathing test (spirometry) you will be asked to perform before and after each step of the test.

Is There a Chance That I May Not be Able to Have the Mannitol Challenge Test MCT?

There are several reasons you may not be able to undergo the MCT. You should not have the test for the following reasons:

  • Allergy to Mannitol
  • Your lung function is too low after the first spirometry test
  • Heart attack or stroke in the last 3 months
  • Uncontrolled blood pressure
  • Certain types of blood vessel problems (e.g., aortic, or cerebral aneurysm)
  • Pregnant or nursing

When in doubt about whether you should have this test, ask your health care provider, and discuss your concerns with your doctor.

Pre-Test Instructions

  • Please allow about 1-2 hours to complete the test
  • Do not eat or drink any caffeine-containing products such as coffee, tea, cola drinks, energy drinks, or chocolate on the day of the test. The caffeine in these products can act as a weak bronchodilator and result in inaccurate test results
  • Do not exercise for at least 6 hours before the test
  • Do not smoke 6 hours prior to testing
  • If you have any respiratory symptoms on the day of your test, inform the technician prior to testing
  • Do not take any breathing medication before the test, as directed below:

Drug Name

Stop the drugs before 

mentioned hours

Quick acting bronchodilators such as:

·      Albuterol (ProventiL Ventolin, ProAir)

·      Salbutamol, Etutalin

·      Fenoterol (berotec )

·      Terbutaline (bricanyl)

12 hours

Cromolyn sodium (Intal)

12 hours

Antihistamines such as:

·      Cetirizine (zyrtec), Levocetirizine (XazaL)

·      Fexofenadine (Fexon, Telfas) or Loratadine (clarityne), Desloratadine (Aerius, Azomyr)

·      Ebastine (EbasteL), Bilastine (8ilaxten)

·      Dexchlorpheniramine, Others

72 hours

Leukotriene modifiers such as:

Montelukast (Singular) or Zillirlukast (Accolate)

24 hours

Ipratropium bromide (Altrovent) or ipratropium /albuterol (combivent)

24 hours

Combination products such as:

Budesonide/Formoterol (Symbicort) or fiuticasone/Salmeterol (Advair)/Serofio/ Seretide/Relvar/Foster/Flutiform

48 hours

Nedocromil (Tilad)

48 hours

·      Long-acting bronchodilators such as Formoterol (Foradil), Sameterol (Serevent) or tiotropium (Spiriva)

·      Theophylline medicines (TheoDur, Theolair, Theo24)

72 hours


Post-Test Instructions:

  • You may resume any medications that were withheld before the test
  • You may experience wheezing or coughing for 30 to 60 minutes after the procedure. You may need to use a bronchodilator to relieve these symptoms
  • You may experience headache, sore throat, nausea, rhinorrhea, or dizziness during the test

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