Mesna

Mesna is a prescription medication used for the prevention of ifosfamide-induced hemorrhagic cystitis.

• Mesna is available under the following different brand names: Mesnex

Adult dosage

Injectable solution

• 100mg/mL

Tablet

• 400mg

Prevention of Ifosfamide Induced Hemorrhagic Cystitis

• 240 mg/m² (if receiving 1.2 g/m² ifosfamide dose) IVP 15 minutes before & 4 & 8 hours after ifosfamide admin OR  
• 240 mg/m² (if receiving 1.2 g/m² ifosfamide dose) IVP 15 minutes before & 480 mg/m² of mesna tablets orally 2 & 6 hours after ifosfamide admin

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Mesna include:

• nausea, 
• vomiting, 
• stomach pain,
• loss of appetite,
• diarrhea,
• constipation,
• weakness, 
• tiredness, 
• drowsiness,
• headache,
• hair loss, or
• fever, flu-like symptoms.

Serious side effects of Mesna include:

• fever, 
• nausea, 
• vomiting,
• joint or muscle pain,
• hives, 
• rash or redness, 
• skin pain or swelling,
• blisters or peeling of the skin,
• feeling light-headed, 
• trouble breathing,
• racing heartbeats,
• mouth sores, or swelling in the face or throat,
• chest pain, trouble breathing;
• easy bruising or bleeding (nosebleeds, bleeding gums);
• low red blood cells (anemia)--pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet; or
• low potassium level--leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness, or limp feeling.

Rare side effects of Mesna include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Mesna has no noted severe interactions with any other drugs.
• Mesna has no noted serious interactions with any other drugs.
• Mesna has no noted moderate interactions with any other drugs.
• Mesna has no noted minor interactions with any other drugs. 

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns.

Contraindications

• Hypersensitivity to mesna or other thiol compounds

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Mesna?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Mesna?”

Cautions

• Does NOT prevent nephrotoxicity, myelosuppression, or neurotoxicity
• Contains benzyl alcohol as a preservative ( associated with potentially fatal "Gasping Syndrome" in preemies)
• Will not prevent hemorrhagic cystitis in all patients; examine morning urine specimen for hematuria before ifosfamide or cyclophosphamide treatment
• Does not prevent or improve other toxicities associated with ifosfamide or cyclophosphamide
• If the patient vomits within 2 hours after an oral dose, repeat dose or give IV
• Mesna does not prevent thrombocytopenia-related hematuria
• The injection contains preservative benzyl alcohol which has been associated with serious adverse reactions and death when administered intravenously to premature neonates and low birth weight infants; avoid the use

Pregnancy and Lactation

• The drug is used in combination with ifosfamide or other cytotoxic agents; ifosfamide can cause fetal harm when administered to a pregnant woman; refer to the ifosfamide prescribing information for more information on use during pregnancy
• Mesna injection contains the preservative benzyl alcohol; because benzyl alcohol is rapidly metabolized by a pregnant woman, benzyl alcohol exposure in the fetus is unlikely.
• Pregnancy testing
  • Verify pregnancy status of females of reproductive potential before initiation of the drug in combination with ifosfamide
• Contraception
  • Females: Advise females of reproductive potential to use effective contraception during treatment in combination with ifosfamide and for 6 months after the last dose
  • Males: Advise males with female partners of reproductive potential to use effective contraception during treatment in combination with ifosfamide and for 3 months after the last dose
• Lactation
  • Used in combination with ifosfamide or other cytotoxic agents; ifosfamide is excreted in breast milk; refer to the ifosfamide prescribing information for more information on use during lactation; there are no data on the presence of mesna in human or animal milk, effect on the breastfed child, or milk production
  • The formulation contains preservative benzyl alcohol; because benzyl alcohol is rapidly metabolized by a lactating woman, benzyl alcohol exposure in a breastfed infant is unlikely; because of the potential for serious adverse reactions in a breastfed child, advise lactating women not to breastfeed during treatment and for 1 week after the last dose.