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mesna (Oral route)

MES-na

Commonly used brand name(s)

In the U.S.

  • Mesnex

Available Dosage Forms:

  • Tablet

Therapeutic Class: Hemorrhagic Cystitis Inhibitor

Uses For mesna

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

mesna is available only with your doctor's prescription.

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 in 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 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.

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 taking 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

Take mesna exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

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.

If you vomit within 2 hours after you take mesna, call your doctor right away.

Dosing

The dose of mesna will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of mesna. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For prevention of hemorrhagic cystitis:
      • Adults—Dose must be determined by your doctor. Your dose will usually be taken 2 hours and 6 hours after each dose of ifosfamide.
      • Children—Use and dose must be determined by your doctor.

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.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using mesna

It is very important that your doctor check your progress at regular visits 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 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
  • 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 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
  • diarrhea
  • difficulty having a bowel movement (stool)
  • hair loss
  • lack or loss of strength
  • sleepiness or unusual drowsiness
  • weight loss
Less common
  • Acid or sour stomach
  • back pain
  • belching
  • feeling of warmth
  • heartburn
  • increased sweating
  • indigestion
  • redness of the face, neck, arms, and occasionally, upper chest
  • stomach discomfort or upset
  • trouble sleeping
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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