Generic
Mesna
5 brands available in the market
At a glance
Mesna is used to prevent ifosfamide-induced hemorrhagic cystitis. It reacts with urotoxic ifosfamide metabolites (acrolein) in the kidney to detoxify them.
Description
Mesna was developed as a prophylactic agent to reduce the risk of ifosfamide-induced hemorrhagic cystitis. It is rapidly oxidized to its major metabolite, Mesna disulfide, which remains in the intravascular compartment and is rapidly eliminated by the kidneys. In the kidney, Mesna disulfide is reduced to the free thiol compound, Mesna, which reacts chemically with urotoxic ifosfamide metabolites (acrolein and 4-hydroxy-ifosfamide), resulting in their detoxification.
Indications
- Prophylaxis of ifosfamide-induced hemorrhagic cystitis
- Prophylaxis of high-dose cyclophosphamide-induced hemorrhagic cystitis
Therapeutic class
Antidote Preparations
Pharmacological class
Cystitis Prophylactic Agent
Pharmacology
Mesna detoxifies urotoxic ifosfamide metabolites (acrolein and 4-hydroxy-ifosfamide) by reacting with them, reducing the risk of bladder bleeding and inflammation.
Mechanism of action
Detoxifies ifosfamide's urotoxic metabolites to prevent bladder damage.
Dosage
Adult Dose (IV):
- 20% (w/w) of ifosfamide dose as IV bolus at the time of ifosfamide administration and 4 and 8 hours after
- Total daily dose: 60% of ifosfamide dose
- Alternative: 20% IV bolus + 40% oral (2 and 6 hours after)
Administration
- Administered IV by doctor or nurse only; do not self-administer
- Given as IV injection or infusion
- IV solution can be diluted with 5% Dextrose, 0.9% Sodium Chloride, Lactated Ringer's
Missed dose
Not generally applicable (hospital administered); consult doctor if needed.
Side effects
Common Side Effects:
- Nausea
- Headache
- Lightheadedness
- Lethargy
- Abdominal pain
- Flushing
- Diarrhea
- Rash
- Fever
- Flu-like symptoms
- Hypotension, tachycardia
Precautions & warnings
- Drink at least 1 litre of fluid daily
- Seek immediate medical attention for severe allergic reactions (rash, itching, breathing difficulty, swelling of mouth/face/lips/tongue)
- Caution when driving or operating machinery (may cause drowsiness, dizziness, blurred vision)
- Will be monitored for blood or protein in urine
- Higher risk of allergic reactions in patients with autoimmune disorders
Contraindications
- Hypersensitivity to Mesna or thiol-containing compounds
Drug interactions
- Incompatible in vitro with cisplatin and nitrogen mustard
Food interactions
Safety with alcohol is not known; consult your doctor.
Use in pregnancy
Use in Pregnancy: Mesna is generally considered safe during pregnancy (Category B); animal studies have shown low or no adverse effects to the developing baby.
Pregnancy Category: B — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Mesna is unsafe during breastfeeding; may pass into breast milk and harm the baby.
Pediatric use
Caution in neonates and infants due to benzyl alcohol content; do not use multidose vial in neonates or infants.
Geriatric use
Elderly may require dose adjustment (based on renal function).
Renal / hepatic impairment
Renal Impairment: Limited information available; consult your doctor.
Hepatic Impairment: Limited information available; consult your doctor.
Overdose effects
Overdose may cause diarrhea, tremor, convulsions, dyspnea, cyanosis; no specific antidote.
Storage conditions
No specific storage conditions; keep out of reach of children.
Chemical structure
Mesna