Mesna Brand Name– Mesnex
What is Mesna
Mesna (sodium 2-mercaptoethanesulfonate) is a chemoprotectant that protects against hemorrhagic cystitis from ifosfamide and other oxazaphosphorine chemotherapy agents (e.g., cyclophosphamide).
Chemoprotectants differ from other rescue medications such as hematopoietic rescue with colony-stimulating factors or replacement therapy with leucovorin in that they are administered prior to the chemotherapy to prevent toxicities.
Mesna provides more effective urinary prophylaxis of hemorrhagic cystitis than other regimens consisting of fluids, administration of diuretics and forced diuresis, and intravesical administration of other sulfhydryl-compounds such as N-acetylcysteine.
Mesna is a superior uroprotectant agent as compared to other sulfhydryl compounds because it remains in the intravascular fluid, is concentrated in the bladder, and is less likely to be absorbed by tumor cells.
Mesna does not interfere with the antitumor activity of ifosfamide or cyclophosphamide. Mesna is indicated as a prophylaxis agent to reduce the incidence of ifosfamide-induced hemorrhagic cystitis.
The FDA approved mesna injection in 1988 and mesna tablets in March 2002.
Indications
- hemorrhagic cystitis
For prophylaxis of ifosfamide-induced or cyclophosphamide-induced†hemorrhagic cystitis
NOTE: Mesna has been designated an orphan drug by the FDA for this indication.
Side Effects
- abdominal pain
- alopecia
- anaphylactoid reactions
- anemia
- angioedema
- anorexia
- anxiety
- arthralgia
- asthenia
- back pain
- bullous rash
- chest pain (unspecified)
- chills
- colic
- confusion
- conjunctivitis
- constipation
- cough
- dehydration
- diarrhea
- disseminated intravascular coagulation (DIC)
- dizziness
- drowsiness
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- dysgeusia
- dyspepsia
- dyspnea
- dysuria
- edema
- elevated hepatic enzymes
- erythema
- fatigue
- fever
- flatulence
- flushing
- headache
- hematuria
- hemoptysis
- hepatitis
- hyperesthesia
- hyperhidrosis
- hypertension
- hypokalemia
- hypotension
- hypoxia
- influenza
- injection site reaction
- insomnia
- leukopenia
- lymphadenopathy
- malaise
- myalgia
- nasal congestion
- nausea
- pallor
- paresthesias
- peripheral edema
- pharyngitis
- photophobia
- pruritus
- rash
- rhinitis
- seizures
- sinus tachycardia
- skin ulcer
- Stevens-Johnson syndrome
- stomatitis
- thrombocytopenia
- toxic epidermal necrolysis
- urticaria
- vomiting
- xerostomia
Monitoring Parameters
- pregnancy testing
- urinalysis
Contraindications
- autoimmune disease
- benzyl alcohol hypersensitivity
- breast-feeding
- contraception requirements
- hematuria
- infants
- laboratory test interference
- neonates
- polyarteritis nodosa
- pregnancy
- pregnancy testing
- rheumatoid arthritis
- systemic lupus erythematosus (SLE)
Mesna is contraindicated in patients with hypersensitivity to thiol compounds.
Interactions
There are no drug interactions associated with Mesna products.
