Applies to the following strength(s): 100 mg/mL ; 400 mg
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Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Hemorrhagic Cystitis Prophylaxis
Mesna may be given on a fractionated dosing schedule of either 3 bolus IV injections or a single injection followed by 2 oral doses. The IV formulation is administered at 20% of the ifosfamide dose while the oral formulation is administered at 40% of the ifosfamide dose.
IV: Mesna is given at 20% of the ifosfamide dose once at the time of ifosfamide administration and 20% of the ifosfamide dose 4 and 8 hours after each dose of ifosfamide (e.g., if ifosfamide were given at 1.2 g/m2, the dose of mesna would be 240 mg/m2 given at 0, 4, and 8 hours after ifosfamide)
ORAL (to be given after one dose of IV mesna): Mesna is given at 40% of the ifosfamide dose at 2 and 6 hours after each dose of ifosfamide (e.g., if ifosfamide were given at 1.2 g/m2, the IV dose of mesna would be 240 mg/m2 given at the time of ifosfamide administration and the oral dose of this drug would be 480 mg/m2 given at 2 and 6 hours after ifosfamide)
-In order to maintain adequate protection, the recommended dosage regimen should be repeated on each day that ifosfamide is administered.
-When the dosage of ifosfamide is adjusted (either increased or decreased), the dose of mesna should also be modified accordingly.
-Adequate hydration and sufficient urinary output should be maintained, as required for ifosfamide treatment, and urine should be monitored for the presence of hematuria. If severe hematuria develops when mesna is given according to the recommended dosage schedule, dosage reductions or discontinuation of ifosfamide therapy may be required.
Use: A prophylactic agent to reduce the incidence of ifosfamide-induced hemorrhagic cystitis
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
Data not available
Sufficient mesna must be given to adequately protect the patient from the urotoxic effects of the oxazaphosphorine.
The duration of mesna treatment should equal that of the oxazaphosphorine treatment plus the time taken for the urinary concentration of oxazaphosphorine metabolites to fall to non-toxic levels. This usually occurs within 8 to 12 hours after the end of oxazaphosphorine treatment but may vary depending on the scheduling of oxazaphosphorine. Urinary output should be maintained at 100 mL/hr (as required for oxazaphosphorine treatment) and the urine monitored for hematuria and proteinuria throughout the treatment period.
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Data not available
-The multidose vials may be stored and used for up to 8 days after initial puncture.
-Store diluted solutions at 25°C (77°F) and use within 24 hours.
-Do not mix mesna injection with epirubicin, cyclophosphamide, cisplatin, carboplatin, and nitrogen mustard.
-The benzyl alcohol contained in mesna injection vials can reduce the stability of ifosfamide. Ifosfamide and mesna may be mixed in the same bag provided the final concentration of ifosfamide does not exceed 50 mg/mL. Higher concentrations of ifosfamide may not be compatible with mesna and may reduce the stability of ifosfamide.
-Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Any solutions which are discolored, hazy, or contain visible particulate matter should not be used.
PATIENT COUNSELING INFORMATION
-Advise the patient to discontinue mesna and seek immediate medical attention if any signs or symptoms of a hypersensitivity reaction, including systemic anaphylactic reactions occur.
-Advise the patient to take mesna at the exact time and in the exact amount as prescribed.
-Advise the patient to contact their healthcare provider if they vomit within 2 hours of taking oral mesna, or if they miss a dose of oral mesna.
-Mesna does not prevent hemorrhagic cystitis in all patients nor does it prevent or alleviate any of the other adverse reactions or toxicities associated with ifosfamide.
-Advise the patient to report to their healthcare provider if his/her urine has turned a pink or red color.
-Advise the patient to drink 1 to 2 liters of fluid each day during mesna therapy.
-Advise the patient that Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug rash with eosinophilia and systemic symptoms and bullous and ulcerative skin and mucosal reactions have occurred. Advise the patient to report to their healthcare provider if signs and symptoms of these syndromes occur.
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- Drug class: antineoplastic detoxifying agents
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Other brands: Mesnex