Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Plasma concentrations of mesna exceed those of dimesna after oral or intravenous administration. Sodium content. If the patien… Oral bioavailability averaged 58% (range 45 to 71%) for free mesna and 89% (range 74 to 104%) for total mesna based on plasma AUC data from 8 healthy volunteers who received 1200 mg oral or intravenous doses. Warnings and Precautions, Benzyl Alcohol Toxicity (Mesna is a cytoprotective agent indicated as a prophylactic agent in reducing the incidence of ifosfamide-induced hemorrhagic cystitis. Symptoms associated with “gasping syndrome” and other potential adverse reactions include gradual neurological deterioration, seizures, intracranial hemorrhage, hematological abnormalities, skin breakdown, hepatic and renal failure, hypotension, bradycardia, and cardiovascular collapse. IFO is a pro-drug that is metabolized in the liver by cytochrome P450 mixed-function oxidase enzymes to form isofo… Mesna has a plasma clearance of 1.23 L/h/kg.No long-term studies in animals have been performed to evaluate the carcinogenic potential of mesna.No studies on male or female fertility were conducted. Black, tarry stools; bleeding gums Refer to the ifosfamide prescribing information for more information on use during lactation. Mesna does not prevent hemorrhagic cystitis in all patients. Ifosfamide can cause fetal harm when administered to a pregnant woman. Use diluted solutions within 24 hours.Do not mix mesna injection with epirubicin, cyclophosphamide, cisplatin, carboplatin, and nitrogen mustard.The benzyl alcohol contained in mesna injection vials can reduce the stability of ifosfamide. Refer to the ifosfamide prescribing information for more information on contraception and effects on fertility.Mesna injection contains the preservative benzyl alcohol which has been associated with serious adverse reactions and death when administered intravenously to premature neonates and low birth weight infantsClinical studies of mesna did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. In addition, constipation was reported by healthy volunteers who had received repeated doses of intravenous mesna.

In healthy volunteers, mesna was commonly associated with a rapid (within 24 hours) decrease in lymphocyte count, which was generally reversible within one week of administration.Because mesna is used in combination with ifosfamide or ifosfamide-containing chemotherapy regimens, it is difficult to distinguish the adverse reactions which may be due to MESNEX from those caused by the concomitantly administered cytotoxic agents.Adverse reactions reasonably associated with mesna administered intravenously and orally in four controlled studies in which patients received ifosfamide or ifosfamide-containing regimens are presented in .Table 3: Adverse Reactions in ≥ 5% of Patients Receiving Mesna in combination The following adverse reactions have been reported in the postmarketing experience of patients receiving mesna in combination with ifosfamide or similar drugs, making it difficult to distinguish the adverse reactions which may be due to mesna from those caused by the concomitantly administered cytotoxic agents. Patients also received ifosfamide or cyclophosphamide. The most frequently reported side effects (observed in two or more healthy volunteers) for healthy volunteers receiving single doses of mesna injection alone were headache, injection site reactions, flushing, dizziness, nausea, vomiting, somnolence, diarrhea, anorexia, fever, pharyngitis, hyperesthesia, influenza-like symptoms, and coughing. Along with its needed effects, mesna may cause some unwanted effects. See full prescribing information for mesna. Fortunately, risks of chemotherapy-induced hemorrhagic cystitis have been decreased through the use of 2-mercaptoethane sulfonate Na (MESNA), … It is best to assume that a bacterial urinary tract infection is present until cultures return as no growth. However, adverse reactions have occurred in premature neonates and low birth weight infants who received intravenously administered benzyl alcohol-containing drugs Because of the potential for serious adverse reactions in a breastfed child, advise lactating women not to breastfeed during treatment and for 1 week after the last dose of mesna or Ifosfamide.Mesna is used in combination with ifosfamide or other cytotoxic agents.

The active ingredient, mesna, is a synthetic sulfhydryl compound designated as sodium-2-mercaptoethane sulfonate with a molecular formula of C2H5NaO3S2 and a molecular weight of 164.18. Avoid use of mesna in premature neonates and low-birth weight infants. Mesna tablets contain lactose.

Due to inconsistencies between the drug labels on DailyMed and the pill images provided by Ifosfamide is excreted in breast milk. Following intravenous administration of a single 800 mg dose, approximately 32% and 33% of the administered dose was eliminated in the urine in 24 hours as mesna and dimesna, respectively.