mesna

Generic Name: mesna (MEZ nah)

Brand Names: Mesnex

What is mesna?

Mesna is detoxifying agent. It reduces the harmful effects of certain metabolites (breakdown products) of the cancer chemotherapy medicine ifosfamide (Ifex).

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

Mesna may also be used for purposes other than those listed here.

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

It is important to drink at least one quart (4 cups) of liquid each day during treatment with mesna, whether it is taken by mouth or by injection.

If you see blood in the urine or notice that it has a pink or red color, contact your doctor as soon as possible. Some foods or dyes may cause a red color in the urine, however it will be necessary to determine if the color is due to blood in the urine.

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

Do not take mesna without first talking to your doctor if you have

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  had a previous allergic reaction to mesna or to another medicine that contains sulfur; or

  
  


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  an autoimmune disorder such as rheumatoid arthritis, systemic lupus erythematosus (SLE), or nephritis (a type of kidney problem).

  
  

You may not be able to take mesna, or you may require a dosage adjustment or special monitoring during treatment.

Mesna is in the FDA pregnancy category B. This means that it is not expected to be harmful to an unborn baby. Do not take mesna without first talking to your doctor if you are pregnant or could become pregnant during treatment. It is not known whether mesna passes into breast milk. Do not take mesna without first talking to your doctor if you are breast-feeding a baby.

How should I take mesna?

Take mesna exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each oral dose with a full glass of water.

If vomiting occurs within 2 hours of taking a dose of mesna, contact your healthcare provider.

Mesna is also available as an injection. Your healthcare provider will administer injectable mesna. If you are using injectable mesna at home, your healthcare provider will give you detailed instructions regarding preparation, administration, and storage of the medication.

It is important to drink at least one quart (4 cups) of liquid each day during treatment with mesna, whether it is taken by mouth or by injection.

A small number of patients who take mesna get blood in the urine (hematuria). Your doctor will check your urine each day that mesna is taken. Laboratory tests can detect blood in the urine that is not visible just by looking at it.

If you see blood in the urine or notice that it has a pink or red color, contact your doctor as soon as possible. Some foods or dyes may cause a red color in the urine, however it will be necessary to determine if the color is due to blood in the urine. Store mesna at room temperature away from moisture and heat.

See also: Mesna dosage (in more detail)

What happens if I miss a dose?

Contact your healthcare provider if a dose of mesna is missed.

What happens if I overdose?

Seek emergency medical attention if an overdose is suspected.

Symptoms of a mesna overdose may include diarrhea, tremor, seizures, shortness of breath, and bluish color of the skin.

What should I avoid while taking mesna?

There are no restrictions on foods, beverages, or activities during treatment with mesna unless otherwise directed by your doctor.

Mesna side effects

Seek emergency medical attention or contact your healthcare provider immediately if you experience any of the following serious side effects:

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  an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); or

  
  


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  pink or red colored urine.

  
  

Other less serious side effects may be more likely to occur. Continue to take mesna, and contact your doctor if you experience any of the following side effects:

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  nausea or vomiting;

  
  


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  decreased appetite;

  
  


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  stomach pain;

  
  


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  diarrhea;

  
  


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  dizziness;

  
  


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  flushing;

  
  


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  fever;

  
  


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  sensitive skin or skin rash;

  
  


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  paleness of the skin;

  
  


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  sleepiness;

  
  


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  coughing or cold symptoms;

  
  


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  pain, redness, or irritation at the injection site;

  
  


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  swelling or water retention; or

  
  


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  low blood pressure.

  
  

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

Mesna Dosing Information

Usual Adult Dose for Hemorrhagic Cystitis Prophylaxis:

Prevention of ifosfamide-induced cystitis:
Mesna may be given on a fractionated dosing schedule of either 3 bolus intravenous injections or a single injection followed by two oral doses. IV mesna is administered at 20% of the ifosfamide dose while oral mesna is administered at 40% of the ifosfamide dose.

IV: 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. Thus, 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.

When given with a continuous infusion of ifosfamide, mesna may be dosed on a "mg per mg" basis (e.g., 1.2 g/m2 for a 1.2 g/m2 continuous infusion of ifosfamide). 10% of the dose should be given before the ifosfamide infusion and the remainder continued during and for 12 to 24 hours after the ifosfamide infusion has stopped.

Oral (to be given after one dose of IV mesna): 40% of the ifosfamide dose at 2 and 6 hours after each dose of ifosfamide. Thus, if ifosfamide were given at 1.2 g/m2, the dose of IV mesna would be 240 mg/m2 given at the time of ifosfamide administration and the dose of oral mesna would be 480 mg/m2 given at 2 and 6 hours after ifosfamide.

Usual Pediatric Dose for Hemorrhagic Cystitis Prophylaxis:

Prevention of ifosfamide-induced cystitis:
Mesna may be given on a fractionated dosing schedule of either 3 bolus intravenous injections or a single injection followed by two oral doses. IV mesna is administered at 20% of the ifosfamide dose while oral mesna is administered at 40% of the ifosfamide dose.

IV: 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. Thus, 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.

When given with a continuous infusion of ifosfamide, mesna may be dosed on a "mg per mg" basis (e.g., 1.2 g/m2 for a 1.2 g/m2 continuous infusion of ifosfamide). 10% of the dose should be given before the ifosfamide infusion and the remainder continued during and for 12 to 24 hours after the ifosfamide infusion has stopped.

Oral (to be given after one dose of IV mesna): 40% of the ifosfamide dose at 2 and 6 hours after each dose of ifosfamide. Thus, if ifosfamide were given at 1.2 g/m2, the dose of IV mesna would be 240 mg/m2 given at the time of ifosfamide administration and the dose of oral mesna would be 480 mg/m2 given at 2 and 6 hours after ifosfamide.

What other drugs will affect mesna?

It is not known whether other medicines will interact with mesna. Talk to your doctor and pharmacist before taking any other prescription or over-the-counter medicines, including vitamins, minerals and herbal products.

More mesna resources

• Mesna Side Effects (in more detail)
• Mesna Dosage
• Mesna Use in Pregnancy & Breastfeeding
• Mesna Drug Interactions
• Mesna Support Group
• 0 Reviews for Mesna - Add your own review/rating

• mesna Intravenous Advanced Consumer (Micromedex) - Includes Dosage Information


• Mesna Prescribing Information (FDA)


• Mesna Professional Patient Advice (Wolters Kluwer)


• Mesna Monograph (AHFS DI)


• Mesna MedFacts Consumer Leaflet (Wolters Kluwer)


• Mesnex Prescribing Information (FDA)


• Mesnex MedFacts Consumer Leaflet (Wolters Kluwer)

Compare mesna with other medications

• Hemorrhagic Cystitis Prophylaxis

Where can I get more information?

• Your pharmacist has more information about mesna written for health professionals that you may read.

See also: mesna side effects (in more detail)