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a sulfhydryl compound given orally or intravenously together with a urotoxic antineoplastic agent such as ifosfamide or cyclophosphamide because it inactivates some of their metabolites and thus lessens damage to the bladder.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.


Mesnex, Uromitexan (CA) (UK)

Pharmacologic class: Detoxifying agent

Therapeutic class: Hemorrhagic cystitis inhibitor

Pregnancy risk category B


Reacts in kidney with urotoxic ifosfamide metabolites (acrolein and 4-hydroxy-ifosfamide), resulting in their detoxification. Also binds to double bonds of acrolein and to other urotoxic metabolites.


Injection: 100 mg/ml in 10-ml vials

Tablets (coated): 400 mg

Indications and dosages

To prevent hemorrhagic cystitis in patients receiving ifosfamide

Adults: Combination I.V. and P.O. regimen-Single I.V. bolus dose of mesna at 20% of ifosfamide dosage, given at same time as ifosfamide, followed by two doses of mesna tablets P.O. at 40% of ifosfamide dosage given 2 and 6 hours after ifosfamide dose. I.V. regimen-I.V. bolus of mesna at 20% of ifosfamide dosage given at same time as ifosfamide, repeated 4 and 8 hours after each ifosfamide dose.

Dosage adjustment

• Children


• Hypersensitivity to drug or other thiol compounds


Use cautiously in:

• autoimmune disorders

• pregnant or breastfeeding patients.


• Dilute with dextrose 5% in water, dextrose 5% in normal saline solution, dextrose 5% in 0.2% sodium chloride solution, dextrose 5% in 0.33% sodium chloride solution, dextrose 5% in 0.45% sodium chloride solution, normal saline solution, or lactated Ringer's solution for injection.

• Give I.V. bolus over at least 1 minute with ifosfamide dose and at prescribed intervals after ifosfamide doses.

Don't use multidose vial (contains benzyl alcohol) in neonates or infants. In older children, use with caution.

• If patient vomits within 2 hours of oral mesna dose, repeat oral dose or switch to I.V. route.

Adverse reactions

CNS: fatigue, malaise, irritability, headache, dizziness, drowsiness, hyperesthesia, rigors

CV: hypertension, hypotension, ST-segment elevation, tachycardia

EENT: conjunctivitis, pharyngitis, rhinitis

GI: nausea, vomiting, diarrhea, constipation, anorexia, flatulence

Hematologic: hematuria

Musculoskeletal: back pain, joint pain, myalgia

Respiratory: coughing, tachypnea, bronchospasm

Skin: flushing, rash

Other: arm or leg pain, injection site reactions, fever, flulike symptoms, allergic reactions


Drug-diagnostic tests. Hepatic enzymes: increased levels

Urinary erythrocytes: false-positive or false-negative results

Urine tests using Ames Multistix: false-positive for ketonuria

Patient monitoring

• Monitor nutritional and hydration status.

• Monitor vital signs and ECG. Watch closely for blood pressure changes and tachycardia.

• Assess body temperature. Stay alert for fever, flulike symptoms, and EENT infections.

• Monitor respiratory status carefully. Watch closely for cough, bronchospasm, and tachypnea.

Patient teaching

• Inform patient that drug may cause significant adverse effects. Reassure him that he will be monitored closely.

• Encourage patient to request analgesics or other pain-relief measures for headache, back or joint pain, hyperesthesia, or muscle ache.

Advise patient to immediately report breathing difficulties and allergic symptoms.

• Inform patient about drug's adverse CNS effects. Explain safety measures used to prevent injury.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the tests mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved


An agent that may act as an antioxidant, protecting the urogenital tract from toxic effects of ifosfamide and cyclophosphamide by binding them with its sulfhydryl-moieties, thereby reducing the incidence of haemorrhagic cystitis and haematuria. 

Adverse effects
Rash, itching, diarrheoa, nausea, vomiting.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.


Oncology A uroprotective agent that protects the urogenital tract from toxicity of ifosfamide and cyclophosphamide Adverse effects Rash, itching, diarrhea, N&V. See Cyclophosphamide, Ifosfamide.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.


A drug used to prevent damage to the urinary tract of people being treated with the anticancer drugs cyclophosphamide or ifosfamide. A brand name is Uromitexan.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005

Patient discussion about mesna

Q. my dad has msa, he has recently started seeing things, eg aliens, government consp.ext not fully reconzing lov does not reconize loved ones while having these episodes, becomes anxious and ill manered just not like my dad at all, he's so quite and polite normally.

A. Multi Systems Atrophy = MSA

Try this:
Get in touch with the credence group - they know very very much.

More discussions about mesna
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