Indications |
Oral Prophylaxis against urothelial toxicity Adult: Refer to individual and local protocol. Dose calculated according to cytotoxic dose. Normally given at a dose ≥cytotoxic dose. Duration of treatment should be as long as cytotoxic treatment; plus the time it takes for concentration of antineoplastic metabolites in urine to fall. Child: Refer to individual and local protocol. Intravenous Prophylaxis against urothelial toxicity Adult: Refer to individual and local protocol. Dose calculated according to cytotoxic dose. Normally given at a dose ≥cytotoxic dose. Duration of treatment should be as long as cytotoxic treatment; plus the time it takes for concentration of antineoplastic metabolites in urine to fall. Administered either by short (15-30 minutes) or continuous (24 hr) infusion. Child: Refer to individual and local protocol. Has been used in children >4 mth. Inhalation Mucolytic in cystic fibrosis Adult: Used when other mucolytics have failed to reduce sputum viscosity. 3-6 ml of 20% solution is nebulised bid. Child: Used when other mucolytics have failed to reduce sputum viscosity. 3-6ml of 20% solution is nebulised bid. Reconstitution: Dilute in flavoured syrup, water, milk, carbonated drinks or apple or orange juice. |
Contraindications |
Hypersensitivity to thiol-containing compounds. |
Warnings / Precautions |
Protective effect applies only to the urinary tract; pregnancy, lactation. Patients with auto-immune disorders. IV formulation may contain benzyl alcohol as a preservative; avoid in neonates or infants. Instruct patients to seek medical attention if discolouration of urine occurs. During treatment, monitor urine for erythrocytes and haematuria. Maintain adequate hydration in all patients. Patients who vomit within 2 hr of oral dose should repeat dose or receive IV dose. |
Adverse Reactions |
Nausea, vomiting, colic, diarrhoea, anorexia, dyspepsia, unpleasant taste, constipation; headache, malaise, fatigue, depression, irritability, somnolence, hyperaesthesia, dizziness, confusion; rash, pruritus, generalised urticaria, alopecia, inj site reactions, flushing; leucopenia, thrombocytopenia, anaemia, granulocytopenia, chest pain, oedema (peripheral, facial and periorbital), hypotension, tachycardia, hypertension, increased heart rate, ST-segment elevation; dyspnoea, coughing, pneumonia, tachypnea; fever; hypocalcaemia; increased sweating; back pain, limb pain, myalgia; increased hepatic enzyme concentrations; pharyngitis; ulceration of mucous membranes. In patients receiving oral and/or IV mesna and were specifically not treated with concurrent cytotoxic therapy: flatulence; rhinitis; rigors; back pain; rash; conjunctivitis; arthralgia. Inhalation: bronchospasm. Potentially Fatal: May cause haemorrhagic cystitis, systemic anaphylactic reactions. |
Lab Interactions |
False-positive result in diagnostic tests for urinary ketones and may produce a false-positive or negative result in diagnostic tests for urinary erythrocytes. |
Mechanism of Actions |
Mesna is used to prevent urothelial toxicity associated with oxazaphosphorine, ifosfamide or cyclophosphamide. It acts in the kidney; reacting with thiol groups of urotoxic metabolites (e.g. acrolein) of ifosfamide and cyclophosphamide. It is used as a mucolytic in the management of some respiratory tract conditions e.g. cystic fibrosis where other mucolytics have failed. It acts by reducing the viscosity of pulmonary secretions; the drug's free sulfhydryl group is thought to reduce disulfide linkages of mucoproteins. Absorption: Oral bioavailability: 45-79%. Time to plasma peak: 2-3 hr. Distribution: No tissue penetration. Protein-binding: 69-75%. Metabolism: In blood, rapidly oxidised to mesna disulfide and then reduced back to mesna after glomerular filtration into renal tubules. Excretion: Via urine: As unchanged drug (18-26%) and metabolites. Half-life elimination: Mesna: 24 minutes; Mesna disulfide: 72 minutes. |
Storage Conditions |
Inhalation: Inj: 15-30°C. Multi-dose vials may be used for 8 days after 1st entry. Discard single use vials immediately after use; mesna is easily oxidised when exposed to the atmospere. After dilution with a suitable diluent, concentrations of mesna 20 mg/ml are chemically and physically stable for 24 hr at 25°C. Intravenous: Inj: 15-30°C. Multi-dose vials may be used for 8 days after 1st entry. Discard single use vials immediately after use; mesna is easily oxidised when exposed to the atmosphere. After dilution with a suitable diluent, concentrations of mesna 20 mg/ml are chemically and physically stable for 24 hr at 25°C. Do store in glass or plastic syringes with Luer-Lok® fittings for >12 hr as particulates may form. Chemically stable for at least 24 hr when admixed with ifosfamide and cyclophosphamide in 5% dextrose or lactated Ringer's. Oral: Tablet: Store at 20-25°C. Oral solution: Solutions containing mesna 20 or 50 mg/ml in flavoured syrup are stable for 7 days at 25°C. Solutions containing mesna 2, 10 or 50 mg/ml in carbonated drinks or apple or orange juice are stable for at least 24 hr at 5°C. |
ATC Classification |
R05CB05 - mesna ; Belongs to the class of mucolytics. Used in the treatment of wet cough. V03AF01 - mesna ; Belongs to the class of detoxifying agents used in antineoplastic treatment. |
Storage |
Inhalation: Inj: 15-30°C. Multi-dose vials may be used for 8 days after 1st entry. Discard single use vials immediately after use; mesna is easily oxidised when exposed to the atmospere. After dilution with a suitable diluent, concentrations of mesna 20 mg/ml are chemically and physically stable for 24 hr at 25°C. Intravenous: Inj: 15-30°C. Multi-dose vials may be used for 8 days after 1st entry. Discard single use vials immediately after use; mesna is easily oxidised when exposed to the atmosphere. After dilution with a suitable diluent, concentrations of mesna 20 mg/ml are chemically and physically stable for 24 hr at 25°C. Do store in glass or plastic syringes with Luer-Lok® fittings for >12 hr as particulates may form. Chemically stable for at least 24 hr when admixed with ifosfamide and cyclophosphamide in 5% dextrose or lactated Ringer's. Oral: Tablet: Store at 20-25°C. Oral solution: Solutions containing mesna 20 or 50 mg/ml in flavoured syrup are stable for 7 days at 25°C. Solutions containing mesna 2, 10 or 50 mg/ml in carbonated drinks or apple or orange juice are stable for at least 24 hr at 5°C. |
Available As |
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Mesna
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Mesna Containing Brands
Mesna is used in following diseases
Drug - Drug Interactions of Mesna
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