Mesna is available as a 100-mg/mL solution in 10-mL multidose vials.3739; 3740; 3741 Each mL of solution also contains edetate disodium 0.25 mg, benzyl alcohol 10.4 mg, and sodium hydroxide to adjust the pH.3739; 3740; 3741
pH
The pH of mesna injection falls within the range of 6.5 to 8.5, depending on the specific product.3739; 3740; 3741
Trade Name(s)
Mesnex
Mesna may be administered by intravenous injection or infusion.4; 3739; 3740; 3741 Infusion is usually performed over 15 to 30 minutes, but continuous infusion has also been utilized.4 Dilution to a concentration of 20 mg/mL in a compatible solution is recommended for intravenous infusion.4; 3739; 3740; 3741
Intact vials of mesna should be stored at controlled room temperature.3739; 3740; 3741 The solution is clear and may be colorless3739; 3740 to light pink,3741 and is not light sensitive.72 Multidose vials may be stored and used for up to 8 days after initial entry.3739; 3740; 3741
Diluted solutions of mesna should be stored at 25°C and used within 24 hours.3739; 3740; 3741
pH Effects
Mesna and ifosfamide have been found to be stable in combined admixtures.72; 1380; 1494; 1495; 1496 However, mesna has been found to undergo more extensive decomposition when mixed with ifosfamide in an infusion solution made alkaline with sodium bicarbonate. At pH 8, mesna was stable for 6 hours, but lost about 13% in 24 hours and 23% in 48 hours. Ifosfamide underwent only 6% loss in 24 hours, but lost 14% in 48 hours.2281
Syringes
The short-term use of plastic syringes for preparing mesna infusions appears to be satisfactory. However, extended storage of mesna in a plastic and a glass syringe resulted in the formation of dark or thread-like particles and a change in viscosity after 12 hours at room temperature.72
Mesna (Asta Pharma) 100 mg/mL was packaged as 10 mL in 20-mL polypropylene syringes (Becton Dickinson). Samples having the air expelled from the syringes were stored at 5, 24, and 35°C, and samples with air drawn into the syringes were stored at 24°C. After 9 days of storage, little or no change in the mesna concentration was found in all samples with no air present. The maximum loss was less than 4% found in the samples stored at 35°C. However, the syringes containing air exhibited 10% loss in 8 days at 24°C. Minimizing the exposure of mesna to air during storage was recommended to slow the formation of dimesna.2181
Drugs in Syringe Compatibility
Y-Site Injection Compatibility (1:1 Mixture)
Additional Compatibility Information
Ifosfamide
Manufacturers state that benzyl alcohol contained in mesna injection solution can reduce the stability of ifosfamide; therefore, when admixed with mesna, the final concentration of ifosfamide should not exceed 50 mg/mL.3739; 3740; 3741
For a list of references cited in the text of this monograph, search the monograph titled References.