mesna (Intravenous route)

MES-na

Commonly used brand name(s)

In the U.S.

  • Mesnex

Available Dosage Forms:

  • Solution

Therapeutic Class: Hemorrhagic Cystitis Inhibitor

Uses For mesna

Mesna injection is used to reduce the harmful effects of some cancer medicines (eg, ifosfamide) on the bladder.

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mesna is to be given only by or under the direct supervision of your doctor.

Before Using mesna

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For mesna, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to mesna or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of mesna injection n the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of mesna injection in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving mesna injection.

Pregnancy

Pregnancy Category Explanation
All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding

Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving mesna, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using mesna with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Warfarin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of mesna. Make sure you tell your doctor if you have any other medical problems, especially:

  • Allergy to thiol compounds (eg, amifostine), history of—Use with caution. May increase risk of an allergic reaction to occur again.

Proper Use of mesna

A nurse or other trained health professional will give you mesna in a hospital. mesna is given through a needle placed in one of your veins.

mesna is given on a fixed schedule. It may be given after receiving ifosfamide, 4 hours, and 8 hours after each dose of ifosfamide.

Drink extra fluids (1 to 2 liters per day) so you will pass more urine while you are using mesna. This may help prevent bladder and kidney problems.

Missed Dose

mesna needs to be given on a fixed schedule. If you miss a dose or forget to use your medicine, call your doctor or pharmacist for instructions.

Precautions While Using mesna

It is very important that your doctor check you closely to make sure mesna is working properly. Urine tests will be needed to check for unwanted effects.

mesna may cause serious allergic reactions, including anaphylaxis. Anaphylaxis requires immediate medical attention. The most serious signs of this reaction are very fast or irregular breathing, gasping for breath, wheezing, or fainting. Other signs may include changes in color of the skin of the face, very fast but irregular heartbeat or pulse, hive-like swellings on the skin, and puffiness or swellings of the eyelids or around the eyes. If these side effects occur, get emergency help at once.

Serious skin reactions can occur with mesna. Check with your doctor right away if you have blistering, peeling, or loose skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while you are using mesna.

mesna contains benzyl alcohol which may cause serious reactions to premature or low-birthweight infants. Discuss this with your doctor if you are concerned.

Make sure any doctor or dentist who treats you knows that you are using mesna. mesna may affect the results of certain medical tests.

mesna Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
  • Black, tarry stools
  • bleeding gums
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • blood in the urine or stools
  • chest pain
  • chills
  • convulsions
  • cough
  • decreased urination
  • dizziness
  • dry mouth
  • fainting
  • fast, pounding, or irregular heartbeat or pulse
  • fever
  • increased thirst
  • irregular heartbeat
  • lightheadedness
  • loss of appetite
  • mood changes
  • muscle pain or cramps
  • nausea or vomiting
  • numbness or tingling in the hands, feet, or lips
  • painful or difficult urination
  • pinpoint red spots on the skin
  • rapid breathing
  • rapid weight gain
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • sunken eyes
  • swelling
  • swollen glands
  • tightness in the chest
  • trouble breathing
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • unusual weight gain or loss
  • wrinkled skin
Less common
  • Blurred vision
  • confusion
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • rapid breathing
  • sweating
Incidence not known
  • Coughing or spitting up blood
  • dark urine
  • general tiredness and weakness
  • headache
  • light-colored stools
  • nervousness
  • pounding in the ears
  • slow or fast heartbeat
  • upper right abdominal or stomach pain
  • yellow eyes and skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Abdominal or stomach pain
  • back pain
  • bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
  • diarrhea
  • difficulty having a bowel movement (stool)
  • hair loss
  • increased sweating
  • lack or loss of strength
  • sleepiness or unusual drowsiness
  • trouble sleeping
  • weight loss
Less common
  • Acid or sour stomach
  • belching
  • feeling of warmth
  • heartburn
  • indigestion
  • redness of the face, neck, arms, and occasionally, upper chest
  • stomach discomfort or upset
Incidence not known
  • Change or loss of taste

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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