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**Manganese chloride** is an inorganic manganese salt used in U.S. prescription parenteral nutrition as a trace-element supplement. The marketed Manganese Chloride Injection, USP product contains manganese chloride tetrahydrate and is added to intravenous total parenteral nutrition solutions in adults to maintain manganese concentrations and prevent manganese depletion and deficiency manifestations. Released manganese acts as an essential enzymatic cofactor for multiple manganese-dependent metalloenzymes involved in intermediary metabolism and other physiologic processes; it is not a selective receptor-targeted therapy. Excessive intravenous exposure, especially with prolonged parenteral nutrition or impaired biliary excretion, can cause manganese accumulation and neurologic toxicity. ([dailymed.nlm.nih.gov](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6e979070-5035-4076-e09c-b52466be3c68))
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