mesna

REMS

Prevention of ifosfamide-induced hemorrhagic cystitis.

Unlabeled Use:

Prevention of cyclophosphamide-induced hemorrhagic cystitis.

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity to mesna or other thiol (rubber) compounds;
Lactation: Lactation.

Use Cautiously in:

OB: Safety not established in pregnancy;
Pedi: Injection contains benzyl alcohol, which can cause potentially fatal gasping syndrome in neonates.

Adv. Reactions/Side Effects ⬆ ⬇

Derm: flushing

GI: anorexia, diarrhea, nausea, unpleasant taste, vomiting

Local: injection site reactions

Neuro: dizziness, drowsiness, headache

Misc: flu-like symptoms

Interactions ⬆ ⬇

Drug-drug:

None reported.

Availability ⬆ ⬇

(Generic available)

Solution for injection: 100 mg/mL
Tablets: 400 mg

Route/Dosage ⬆ ⬇

IV (Adults ): Give a dose of mesna equal to 20% of the ifosfamide dose at the same time as ifosfamide and 4 and 8 hr after.
PO IV (Adults ): Give a dose of IV mesna equal to 20% of the ifosfamide dose at the same time as ifosfamide; then give PO mesna equal to 40% of the ifosfamide dose 2 and 6 hr after ifosfamide (total mesna dose is 100% of ifosfamide dose).

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Binds to the toxic metabolites of ifosfamide in the kidneys.

Therapeutic effects:

Prevents hemorrhagic cystitis from ifosfamide.

Classifications ⬆ ⬇

Therapeutic Classification: antidotes

Pharmacologic Classification: ifosfamide detoxifying agents

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability; 45–79% absorbed after oral administration. Following IV with PO dosing ↑ systemic exposure.

Distribution: Minimally distributed to tissues.

Metabolism/Excretion: Rapidly converted to mesna disulfide, then back to mesna in the kidneys, where it binds to toxic metabolites of ifosfamide (18–26% excreted as free mesna in urine after IV and PO dosing).

Half-Life: Mesna: 0.36 hr (IV); 1.2–8.3 hr (IV followed by PO); Mesna disulfide: 1.17 hr.

Canadian Brand Names ⬆ ⬇

Time/Action Profile ⬆ ⬇

(detoxifying action)

ROUTE	ONSET	PEAK	DURATION
PO, IV	rapid	unknown	4 hr

Patient/Family Teaching ⬆ ⬇

Inform patient that unpleasant taste may occur during administration.
Advise patient to notify health care provider if nausea, vomiting, or diarrhea persists or is severe.
Rep: Advise women of reproductive potential to use effective contraception during therapy and for 6 mo after last dose and to avoid breastfeeding during therapy and for 1 wk after last dose. Advise men with female partners of reproductive potential to use effective contraception during therapy and for 3 mo after last dose. Advise patient to notify health care provider immediately if pregnancy is suspected.

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Indications ⬇