Informational only — Not medical advice. Always consult a licensed healthcare provider.

Shasthya স্বাস্থ্য · Health, made simple
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Indications

Urinary Tract Infection

Mesna is used as a preventive medicine against hemorrhagic cystitis caused by ifosfamide. Hemorrhagic cystitis is a condition where the bladder becomes irritated and bleeds. Mesna is also used to prevent the same bladder problem when it is caused by high dose cyclophospamide.

⚠️ Always consult a registered physician before taking any medicine.

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.

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.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor 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.