MESNA

COMMON BRAND NAME(S): Mesnex

GENERIC NAME(S): MESNA

Description: Mesna is used to prevent urothelial toxicity associated with oxazaphosphorine, ifosfamide or cyclophosphamide. It acts in the kidney; reacting with thiol groups of urotoxic metabolites (e.g. acrolein) of ifosfamide and cyclophosphamide. It is used as a mucolytic in the management of some respiratory tract conditions e.g. cystic fibrosis where other mucolytics have failed. It acts by reducing the viscosity of pulmonary secretions; the drug’s free sulfhydryl group is thought to reduce disulfide linkages of mucoproteins.

Pharmacokinetics:

Absorption: Oral bioavailability: 45-79%. Time to plasma peak: 2-3 hr.

Distribution: No tissue penetration. Protein-binding: 69-75%.

Metabolism: In blood, rapidly oxidised to mesna disulfide and then reduced back to mesna after glomerular filtration into renal tubules.

Excretion: Via urine: As unchanged drug (18-26%) and metabolites. Half-life elimination: Mesna: 24 minutes; Mesna disulfide: 72 minutes.

Uses

This medication 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.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This drug may also be used to reduce the risk of bleeding in the bladder caused by another cancer chemotherapy drug called cyclophosphamide.

How to use mesna

Read the Patient Information Leaflet provided by your pharmacist before you start taking mesna and each time you get a refill. If you have any questions, consult your doctor or pharmacist.

Take this medication by mouth. Follow the dosing schedule as directed by your doctor. Dosage is based on your body size and your dose of ifosfamide (or cyclophosphamide).

While taking this medication, drink at least a quart (4 cups or 1 liter) of liquid each day unless directed otherwise by your doctor. Doing so will also help to reduce the bladder side effects from ifosfamide.

Tell your doctor immediately if you vomit within 2 hours of taking a dose. Your doctor will determine if you should repeat the dose or receive mesna by injection into a vein.

Mesna is very effective in reducing the risk of hemorrhagic cystitis in most patients. However, it may not work in a small number of patients. Therefore, tell your doctor immediately if you notice that your urine is pink, red, or bloody.

Side effects

Headache, flushing, dizziness, drowsiness, nausea, vomiting, loss of appetite, diarrhea, constipation, sensitive skin, or flu-like symptoms (e.g., sore throat, fever, chills, shivering, cough, body aches) may occur. If any of these effects persist or worsen, 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 immediately if any of these unlikely but serious side effects occur: chest pain, fast heartbeat, swelling ankles/feet, muscle weakness.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Precautions

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.

Interactions:

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use.

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.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

Overdose & Brands

If overdose is suspected, contact a poison control center or emergency room immediately.

Notes

Do not share this medication with others.

This medication does not protect you from other side effects of ifosfamide. Consult your doctor or pharmacist for more information on how to manage other side effects.

Small amounts of blood in the urine cannot be seen without a microscope. Therefore, a laboratory test to check for blood in your urine should be performed before each dose of ifosfamide to monitor how well mesna is working. Consult your doctor for more details.

Missed Dose

It is important to take each dose of this medication as scheduled. If you miss a dose, take it as soon as you remember and contact your doctor for further instructions. Do not double the dose to catch up.

Storage

Store at room temperature between 68-77 degrees F (20-25 degrees C) away from heat and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Brands:

Available Brands:

Mesnex

Also marketed as:

Mistabron [ UCB ]

MESNA

Uses

Side effects

Precautions

Overdose & Brands

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