Classifications: chemoprotectant; detoxifying agent; Therapeutic: detoxifying agent
Pregnancy Category: B
100 mg/mL injection
400 mg tablet
Detoxifying agent used to inhibit the hemorrhagic cystitis induced by ifosfamide.
Reacts chemically with urotoxic ifosfamide metabolites, resulting in their detoxification, and thus significantly decreases
the incidence of hematuria.
Prophylaxis for ifosfamide-induced hemorrhagic cystitis. Not effective in preventing hematuria due to other pathologic conditions
such as thrombocytopenia.
Reduces the incidence of cyclophosphamide-induced hemorrhagic cystitis.
Hypersensitivity to mesna or other thiol compounds; neonates; lactation.
Autoimmune diseases; infants (injection) pregnancy (category B).
Route & Dosage
- Note: To be effective, mesna must be administered with each dose of ifosfamide.
PREPARE: Direct: Add 4 mL of D5W, NS, or RL for each 100 mg of mesna to yield 20 mg/mL.
ADMINISTER: Direct: Give a single dose by direct IV over 60 sec.
INCOMPATIBILITIES Solution/additive: Carboplatin, cisplatin, ifosfamide with epirubicin. Y-site: Amphotericin B cholesteryl complex.
- Inspect parenteral drug products visually for particulate matter and discoloration prior to administration.
- Discard any unused portion of the ampul because drug oxidizes on contact with air.
- Refrigerate diluted solutions or use within 6 h of mixing even though diluted solutions are chemically and physically stable
for 24 h at 25° C (77° F).
- Store unopened ampul at 15°30° C (59°86° F) unless otherwise specified.
Adverse Effects (≥1%)GI: Bad taste in mouth, soft stools,
Diagnostic Test Interference
May produce a false-positive result in test for urinary ketones.
May decrease the effect of warfarin.
Rapidly oxidized in liver to active metabolite
dimesna; dimesna is further metabolized in kidney. Elimination:
65% in urine within 24 h. Half-Life:
Mesna 0.36 h, dimesna 1.17 h.
Assessment & Drug Effects
- Monitor urine for hematuria.
- Be aware that a false-positive test for urinary ketones may arise in patients treated with mesna. In this test, a red-violet
color develops that, with the addition of glacial acetic acid, will turn to violet.
- About 6% of patients treated with mesna along with ifosfamide still develop hematuria.
Patient & Family Education
- Mesna prevents ifosfamide-induced hemorrhagic cystitis; it will not prevent or alleviate other adverse reactions or toxicities
associated with ifosfamide therapy.
- Report any unusual or allergic reactions to physician.
- Check with physician before using any new prescription or OTC medicine.