Indications:

Mesna is used therapeutically to reduce the incidence of haemorrhagic cystitis and haematuria when a patient receives ifosfamide or cyclophosphamide for cancer chemotherapy

Contraindications:

In individuals with a known hypersensitivity to it.

Adverse reactions:

Because mesna is used in combination with ifosfamide or ifosfamide-containing regimens, it is difficult to distinguish the adverse reactions that may be caused by mesna from those caused by coadministered cytotoxic agents. The following adverse reactions are reasonably associated with mesna administration in patients also receiving ifosfamide or ifosfamide-containing regimens. Cardiovascular Tachycardia (6%); hypotension (5%); ST-segment elevation (postmarketing). CNS Fatigue (20%); anorexia (18%); headache (11%); somnolence (10%); insomnia (9%); dizziness (8%); anxiety, confusion (6%). Dermatologic Alopecia (11%); flushing (5%); injection site reaction including pain and erythema (postmarketing). GI Nausea (54%); vomiting (38%); constipation (24%); diarrhea (14%); dyspepsia (5%). Genitourinary Hematuria (7%). Hepatic Increased liver enzymes (postmarketing). Hematologic-Lymphatic Leukopenia (21%); thrombocytopenia, anemia (18%); granulocytopenia (13%). Metabolic-Nutritional Hypokalemia (9%); dehydration (6%). Musculoskeletal Myalgia (postmarketing). Respiratory Dyspnea (9%); coughing (8%); pneumonia (7%); tachypnea (postmarketing). Miscellaneous Fever (20%); asthenia (18%); abdominal pain (15%); chest pain, pain, increased sweating, injection site reaction (8%); back pain (7%); edema (8%); peripheral edema (7%); face edema, pallor (5%); allergic reactions, limb pain, malaise (postmarketing).

Interactions:

None well documented.

Warnings:

Pregnancy Category B. Lactation Undetermined. Children Safety and efficacy not established. Hypersensitivity Allergic reactions were reported ranging from mild hypersensitivity to systemic anaphylactic reactions. 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). Ifosfamide toxicities Mesna prevents ifosfamide-induced hemorrhagic cystitis. It will not prevent or alleviate other adverse reactions or toxicities associated with ifosfamide therapy. Advise patient, family, or caregiver to review the patient information sheet before using the first time and with each course of therapy. Advise patient, family, or caregiver that injectable medication will be prepared and administered by a health care provider in a health care setting. Review dosing schedule with patient, family, or caregiver. Instruct patient to take tablets at the exact times given to them by health care provider. Advise patient that if a dose is missed, to take it as soon as remembered and then contact health care provider for further instructions. Caution patient not to double the dose. Advise patient taking tablets to contact health care provider immediately if vomiting occurs within 2 h of taking the dose. Advise patient to drink at least 4 cups (1 quart) of liquid each day that mesna is being used. Advise patient, family, or caregiver to immediately report any of the following to health care provider: red or pink-colored urine; rash; itching; hives. Advise patient, family, or caregiver to report any of the following to health care provider: persistent nausea, vomiting, diarrhea, appetite loss.

Form:

SOLUTION FOR INJECTION