Adult Dosing
Ifosfamide-induced hemorrhagic cystitis
- Start IV 240 mg/m2 total mesna dose with ifosfamide IV 1.2 g/m2, then IV 240 mg/m2 q4 hrs x2
Note:
- Total qd dose = 60% total qd ifosfamide dose
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Allergic reactions such as mild hypersensitivity to systemic anaphylactic reactions have been reported with mesna. Higher incidence of allergic reactions may occur in patients with autoimmune disorders receiving cyclophosphamide and mesna together
- Mesna does not prevent or alleviate any other adverse reactions associated with ifosfamide therapy other than reducing the incidence of ifosfamide-induced hemorrhagic cystitis
- Some cases of hematuria have been reported in patients receiving mesna; evaluate a morning specimen of urine for the presence of hematuria everyday before ifosfamide therapy. Consider reductions or discontinuation of ifosfamide therapy, depending on the severity of the hematuria, if hematuria develops on giving mesna with ifosfamide
- Risk of hematuria can be reduced by administering mesna with each dose of ifosfamide as prescribed; mesna does not reduce the risk of hematuria due to other pathological conditions such as thrombocytopenia
- Avoid using multidose vial in neonates or infants and should be used cautiously in older pediatric patients because of the benzyl alcohol content
- Patients treated with mesna may show a false positive test for urinary ketones
Cautions: Use cautiously in
- Pediatric patients
- Autoimmune disorders
Supplemental Patient Information
- Advise patients to drink at least 4 cups of liquid a day during therapy
- Instruct patients to promptly report their physicians on noticing that their urine has turned a pink or red color
- Advise patients to have their urine checked in the laboratory each day after getting mesna
Pregnancy Category:B
Breastfeeding: Safety unknown. As per manufacturer's data, because of the potential for adverse reactions in breastfed infants, a decision should be made whether to discontinue nursing or discontinue the drug, analyzing the importance of the drug to the mother.
