Mesna

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Generic Name: Mesna Brand Name(s): Generics only. No brands available.

Uses

What is Mesna used for?

Mesna is used to reduce the risk of bleeding in the bladder (hemorrhagic cystitis), which is a very serious side effect of treatment with a cancer chemotherapy drug called ifosfamide. Mesna helps to protect the lining of the bladder against damage from ifosfamide. The body breaks down ifosfamide to form a product that can harm the bladder, and mesna works by making this product less harmful. However, mesna does not change ifosfamide’s anti-cancer effects.

How should I take Mesna?

Headache, flushing, dizziness, drowsiness, nausea, vomiting, loss of appetite, diarrhea, constipation, sensitive skin, or flu-like symptoms (such as sore throat, cough, body aches) may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: fast heartbeat, swelling ankles/feet, muscle weakness.

Get medical help right away if you have any very serious side effects, including: chest pain.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever, swollen lymph nodes, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

How do I store Mesna?

Mesna is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Mesna in the bathroom or the freezer. There may be different brands of Mesna that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Mesna down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Mesna?

Before taking mesna, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: overactive immune system diseases (autoimmune disorders) that may increase your risk for a mesna allergy (e.g., rheumatoid arthritis, lupus, nephritis).

This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

Kidney function declines as you grow older. This medication is removed by the kidneys. The elderly may be more sensitive to the effects of this drug.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is not known whether this drug passes into breast milk. Since this medication is given with a cancer chemotherapy drug, breast-feeding while using mesna is not recommended. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Mesna during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Mesna. Mesna is pregnancy risk category B according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Mesna?

Headache, flushing, dizziness, drowsiness, nausea, vomiting, loss of appetite, diarrhea, constipation, sensitive skin, or flu-like symptoms (such as sore throat, cough, body aches) may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: fast heartbeat, swelling ankles/feet, muscle weakness.

Get medical help right away if you have any very serious side effects, including: chest pain.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever, swollen lymph nodes, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Mesna?

This medication may interfere with a certain laboratory test (for urinary ketones), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Mesna may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Mesna?

Mesna may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Mesna?

Mesna may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Mesna.

What is the dose of Mesna for an adult?

Usual Adult Dose for Hemorrhagic Cystitis Prophylaxis

Mesna may be given on a fractionated dosing schedule of either 3 bolus IV injections or a single injection followed by 2 oral doses. The IV formulation is administered at 20% of the ifosfamide dose while the oral formulation is administered at 40% of the ifosfamide dose.

IV: Mesna is given at 20% of the ifosfamide dose once at the time of ifosfamide administration and 20% of the ifosfamide dose 4 and 8 hours after each dose of ifosfamide (e.g., if ifosfamide were given at 1.2 g/m2, the dose of mesna would be 240 mg/m2 given at 0, 4, and 8 hours after ifosfamide)

ORAL (to be given after one dose of IV mesna): Mesna is given at 40% of the ifosfamide dose at 2 and 6 hours after each dose of ifosfamide (e.g., if ifosfamide were given at 1.2 g/m2, the IV dose of mesna would be 240 mg/m2 given at the time of ifosfamide administration and the oral dose of this drug would be 480 mg/m2 given at 2 and 6 hours after ifosfamide)

Comments:

-In order to maintain adequate protection, the recommended dosage regimen should be repeated on each day that ifosfamide is administered.

-When the dosage of ifosfamide is adjusted (either increased or decreased), the dose of mesna should also be modified accordingly.

-Adequate hydration and sufficient urinary output should be maintained, as required for ifosfamide treatment, and urine should be monitored for the presence of hematuria. If severe hematuria develops when mesna is given according to the recommended dosage schedule, dosage reductions or discontinuation of ifosfamide therapy may be required.

Use: A prophylactic agent to reduce the incidence of ifosfamide-induced hemorrhagic cystitis

Dose Adjustments

Sufficient mesna must be given to adequately protect the patient from the urotoxic effects of the oxazaphosphorine.

The duration of mesna treatment should equal that of the oxazaphosphorine treatment plus the time taken for the urinary concentration of oxazaphosphorine metabolites to fall to non-toxic levels. This usually occurs within 8 to 12 hours after the end of oxazaphosphorine treatment but may vary depending on the scheduling of oxazaphosphorine. Urinary output should be maintained at 100 mL/hr (as required for oxazaphosphorine treatment) and the urine monitored for hematuria and proteinuria throughout the treatment period.

Other Comments

Stability:

-The multidose vials may be stored and used for up to 8 days after initial puncture.

-Store diluted solutions at 25°C (77°F) and use within 24 hours.

General:

-Do not mix mesna injection with epirubicin, cyclophosphamide, cisplatin, carboplatin, and nitrogen mustard.

-The benzyl alcohol contained in mesna injection vials can reduce the stability of ifosfamide. Ifosfamide and mesna may be mixed in the same bag provided the final concentration of ifosfamide does not exceed 50 mg/mL. Higher concentrations of ifosfamide may not be compatible with mesna and may reduce the stability of ifosfamide.

-Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Any solutions which are discolored, hazy, or contain visible particulate matter should not be used.

PATIENT COUNSELING INFORMATION

-Advise the patient to discontinue mesna and seek immediate medical attention if any signs or symptoms of a hypersensitivity reaction, including systemic anaphylactic reactions occur.

-Advise the patient to take mesna at the exact time and in the exact amount as prescribed.

-Advise the patient to contact their healthcare provider if they vomit within 2 hours of taking oral mesna, or if they miss a dose of oral mesna.

-Mesna does not prevent hemorrhagic cystitis in all patients nor does it prevent or alleviate any of the other adverse reactions or toxicities associated with ifosfamide.

-Advise the patient to report to their healthcare provider if his/her urine has turned a pink or red color.

-Advise the patient to drink 1 to 2 liters of fluid each day during mesna therapy.

-Advise the patient that Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug rash with eosinophilia and systemic symptoms and bullous and ulcerative skin and mucosal reactions have occurred. Advise the patient to report to their healthcare provider if signs and symptoms of these syndromes occur.

What is the dose of Mesna for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Mesna available?

Mesna is available in the following dosage forms and strengths:

  • Intravenous kit,
  • Injectable solution,
  • Oral tablet

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Mesna, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: March 23, 2018 | Last Modified: March 23, 2018

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