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mesna (oral/injection)

Generic Name: mesna (oral/injection) (MEZ nah)
Brand Name: Mesnex

What is mesna?

Mesna is a detoxifying agent. It reduces the harmful effects of the cancer medicine ifosfamide (Ifex).

Mesna is used to prevent bleeding in the bladder (hemorrhagic cystitis) during chemotherapy with ifosfamide (Ifex).

Mesna will not prevent other side effects caused by ifosfamide.

Mesna may also be used for purposes not listed in this medication guide.

What is the most important information I should know about mesna?

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

What should I discuss with my healthcare provider before using mesna?

You should not use this medicine if you are allergic to mesna or similar medicines.

To make sure mesna is safe for you, tell your doctor if you have:

  • an allergy to any medicine that contains sulfur;

  • an autoimmune disorder such as lupus or rheumatoid arthritis; or

  • if you are being treated with a cancer medicine called cyclophosphamide.

FDA pregnancy category B. Mesna is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether mesna passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

Do not give this medicine to a child without medical advice.

How is mesna given?

Before and during your treatment with mesna, you may need frequent urine tests.

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Oral mesna is taken by mouth. Mesna injection is injected into a vein through an IV. Mesna is usually given in a series of 3 injections, or as a single injection followed by 2 oral doses.

A healthcare provider will give you the injection at the same time you receive ifosfamide. Oral mesna is usually taken 2 and 6 hours after you receive ifosfamide. Follow your doctor's dosing instructions carefully.

Call your doctor if you vomit within 2 hours after taking oral mesna. You may need to take another oral dose or receive a mesna injection.

Drink at least 1 quart (32 ounces) of liquid each day while you are using mesna.

Call your doctor if you have red or pink urine. This may be a sign that your mesna dose needs to be changed.

This medication can cause false results with certain urine tests. Tell any doctor who treats you that you are using mesna.

Store mesna tablets at room temperature away from moisture and heat.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose of mesna.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using mesna?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Mesna side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • chest pain, trouble breathing;

  • easy bruising or bleeding (nosebleeds, bleeding gums);

  • anemia (low red blood cells)--pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating; or

  • low potassium--confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling.

Common side effects may include:

  • nausea, vomiting, stomach pain, loss of appetite;

  • constipation;

  • weakness, tired feeling;

  • headache, dizziness;

  • increased sweating; or

  • fever, chills, sore throat, cough, flu symptoms.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Mesna dosing 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)

Comments:
-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

What other drugs will affect mesna?

Other drugs may interact with mesna, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about mesna.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.01. Revision Date: 2013-12-12, 3:02:14 PM.

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