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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.
• 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.
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
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
• 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.
• 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.
mesnaAn 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.
Rash, itching, diarrheoa, nausea, vomiting.
mesnaOncology A uroprotective agent that protects the urogenital tract from toxicity of ifosfamide and cyclophosphamide Adverse effects Rash, itching, diarrhea, N&V. See Cyclophosphamide, Ifosfamide.
mesnaA 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.
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.
Get in touch with the credence group - they know very very much.