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Indications & Uses
Ifomes is indicated for:
Pharmacology
Mesna was developed to lower the risk of hemorrhagic cystitis caused by ifosfamide. It works much like the body's own cysteine-cystine system. After it enters the body, Mesna is quickly oxidized to its main metabolite, Mesna disulfide (diMesna). Mesna disulfide stays in the blood vessels and the kidneys clear it rapidly.
In the kidney, Mesna disulfide is reduced back to the free thiol compound, Mesna. This free Mesna reacts chemically with the ifosfamide metabolites that harm the urinary tract (acrolein and 4-hydroxy-ifosfamide), and so detoxifies them. The first step is that Mesna binds to 4-hydroxy-ifosfamide and forms 4-sulfoethylthioifosfamide, which does not damage the urinary tract. Mesna also binds to the double bonds of acrolein and to other urotoxic metabolites.
Mesna was tested together with ifosfamide in several human xenograft and rodent tumor model studies, though these were limited in scope. The studies used IV or IP routes, with dose ratios of up to 20-fold, given as a single course or multiple courses. In these studies Mesna did not interfere with the antitumor efficacy of ifosfamide.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Mesna is used to prevent hemorrhagic cystitis caused by ifosfamide. It can be given on a fractionated schedule, either as three bolus intravenous injections or as a single bolus injection followed by IV administration of mesna, as outlined below.
Intravenous schedule: Mesna is given as an intravenous bolus injection in a dose equal to 20% of the ifosfamide dose (w/w). The first dose goes in at the time the ifosfamide is given, and further doses follow 4 and 8 hours after each dose of ifosfamide. The total daily dose of Mesna is 60% of the ifosfamide dose.
Intravenous dosing: Mesna Injection is given as intravenous bolus injections in a dose equal to 20% of the ifosfamide dose (w/w) at the time the ifosfamide is given.
Preparation of intravenous solutions and stability: For IV use, the Mesna Injection solution can be diluted by adding it to any of these fluids, to reach a final concentration of 20 mg Mesna/ml: 5% Dextrose Injection, 5% Dextrose and 0.2% Sodium Chloride Injection, 5% Dextrose and 0.33% Sodium Chloride Injection, 5% Dextrose and 0.45% Sodium Chloride Injection, 0.92% Sodium Chloride Injection, or Lactated Ringer's Injection.
Side Effects
Mesna can cause a few common side effects. These are colic, depression, diarrhea, fatigue, headache, low blood pressure (hypotension), irritability, joint pains, limb pains, nausea, rash, a fast heartbeat (tachycardia) and vomiting.
Cautions & Contraindications
Warnings & Precautions
Allergic reactions to Mesna have been reported, from mild hypersensitivity to systemic anaphylactic reactions. Patients with automimmune disorders who were treated with cyclophosphamide and Mesna seemed to have a higher rate of allergic reactions, and most of them received Mesna orally. Mesna was developed to lower the risk of ifosfamide induced hemorrhagic cystitis. It will not prevent or ease any of the other adverse reactions or toxicities linked to ifosfamide therapy. It also doesn't prevent hemorrhagic cystitis in every patient. Up to 6% of patients treated with Mesna have developed hematuria (>50 RBC/hpf or Who grade 2 and above). So a morning urine specimen should be examined each day before lfasfamide therapy, to look for hematuria (microscopic evidence of red blood cells). If hematuria develops while Mesna is given with Ifosamide at the recommended dosage schedule, the doctor may reduce the dose or stop Ifosfamide therapy, depending on how severe the hematuria is. To lower the risk of hematuria, Mesna must be given with each dose of Ifosfamide, as outlined in the DOSAGE AND ADMINISTRATION section. Mesna is not effective in reducing the risk of hematuria caused by other pathological conditions such as thrombocytopenia. The multidose vial contains benzyl alcohol, so it should not be used in neonates or infants, and it should be used with caution in older pediatric patients.
Contraindications
Mesna must not be given to anyone who is known to be hypersensitive to Mesna itself or to any of the excipients in the product.
Pregnancy & Breastfeeding
Mesna is Pregnancy Category B. There are no adequate and well-controlled studies in pregnant women. It is also not known whether Mesna passes into human milk. Many drugs do pass into breast milk, and Mesna could cause serious adverse reactions in a nursing infant, so a decision should be made either to stop nursing or to stop the medicine, taking into account how important the medicine is to the mother.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Overdose
There is no known antidote for Mesna. In animal studies, oral doses of 6.1 g/kg were lethal to mice and 4.3 g/kg to rats. These doses are approximately 15 and 22 times the maximum recommended human dose on a body surface area basis. Before death, the animals had diarrhea, tremor, convulsions, dyspnea and cyanosis.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep Mesna in its original carton and store it at 20°-25°C. Protect it from light. Keep it out of the reach of children.
Common questions about Ifomes 400 mg/4 ml
What is Ifomes 400 mg/4 ml IV Injection?
Ifomes 400 mg/4 ml IV Injection is a medicine that contains Mesna. It is made by Beacon Pharmaceuticals PLC. It belongs to the Antidote preparations group of medicines.
What is Ifomes used for?
Ifomes is used for: Urinary Tract Infection.
What are the side effects of Ifomes?
Mesna can cause a few common side effects. These are colic, depression, diarrhea, fatigue, headache, low blood pressure (hypotension), irritability, joint pains, limb pains, nausea, rash, a fast heartbeat (tachycardia) and vomiting.
Can I take Ifomes during pregnancy or while breastfeeding?
Mesna is Pregnancy Category B. There are no adequate and well-controlled studies in pregnant women. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Ifomes?
There is no known antidote for Mesna. In animal studies, oral doses of 6.1 g/kg were lethal to mice and 4.3 g/kg to rats. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Ifomes?
Keep Mesna in its original carton and store it at 20°-25°C. Protect it from light.
Do I need a prescription for Ifomes?
Ifomes is a prescription (Rx) medicine. Take it as your doctor advises.