Mesna

A to Z Drug Facts

Mesna

  Action
  Indications
  Contraindications
  Route/Dosage
  Interactions
  Lab Test Interferences
  Adverse Reactions
  Precautions
Patient Care Considerations
  Administration/Storage
  Assessment/Interventions
  Patient/Family Education


(MESS-nah)
Mesnex
Tablets: 400 mg
Injection: 100 mg/mL
Class: Uroprotectant

  Action Mesna is used to reduce the incidence of ifosfamide-induced hemorrhagic cystitis. The mesna disulfide is reduced to the free thiol compound, which reacts chemically with the urotoxic ifosfamide metabolites resulting in their detoxification. At doses of 2 to 4 g the terminal elimination half-life is approximately 7 hr. It is rapidly eliminated by the kidneys.

  Indications Prevention of ifosfamide-induced hemorrhagic cystitis.

Prevention of cyclophosphamide-induced hemorrhagic cystitis.

  Contraindications Standard considerations.

  Route/Dosage

Prevention of Ifosfamide-Induced Hemorrhagic Cystitis

Adults: IV Mesna dose is 20% of ifosfamide dose at time of, 4 hr after, and 8 hr after each ifosfamide dose (eg, for ifosfamide 1200 mg/m2, give mesna 240 mg/m2 at 0, 4, and 8 hr after each ifosfamide dose). The total daily dose of mesna is 60% of the ifosfamide dose. Repeat this dosing schedule on each day that ifosfamide is administered. When the dosage of ifosfamide is adjusted, modify the dose of mensa accordingly. Some clinicians recommend giving additional mesna at the same infusion rate for 8 to 24 hr after the ifosfamide infusion finishes.

Adults: PO Following the initial IV mesna dose (20% of ifosfamide dose), the oral mesna dose is 40% of ifosfamide dose 2 and 6 hr after each ifosfamide dose.

  Interactions None well documented.

  Lab Test Interferences A false positive test for urinary ketones may arise in patients treated with mesna.

  Adverse Reactions

DERMATOLOGIC: Macular rash; pruritus. GI: Nausea; vomiting; diarrhea; soft stools; dysgeusia. GU: Hematuria. HYPERSENSITIVITY: Severe allergic reactions consisting of fever, tachycardia, and macular rash.

  Precautions

Pregnancy: Category B. Lactation: Excretion in breast milk is unknown. Benzyl alcohol: Benzyl alcohol, contained in this product as a preservative, has been associated with a fatal “gasping syndrome” in premature infants. Hematuria: Mesna does not prevent hemorrhagic cystitis in all patients. Up to 6% treated have developed hematuria (more than 50 rbc/hpf or WHO grade 2 and above). Hypersensitivity reactions: Allergic reactions were reported ranging from mild hypersensitivity to systemic anaphylactic reactions. Ifosfamide toxicities: Mesna prevents ifosfamide-induced hemorrhagic cystitis. It will not prevent or alleviate other adverse reactions or toxicities associated with ifosfamide therapy.


PATIENT CARE CONSIDERATIONS


  Administration/Storage

PO

  Assessment/Interventions

  Patient/Family Education

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Copyright
© 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts