Indications
Mesna is used to protect the bladder during treatment with the cancer medicines Ifosfamide and high-dose Cyclophosphamide. These medicines can cause haemorrhagic cystitis, which means painful inflammation and bleeding of the bladder lining. Mesna is given alongside them to lower this risk.
How It Works
When Ifosfamide and Cyclophosphamide are broken down in the body, they produce an irritating substance called acrolein that collects in the urine. Mesna passes into the urine and binds to acrolein, turning it into a harmless compound that is flushed out. It acts mainly in the urinary tract and does not reduce the anti-cancer effect of the chemotherapy.
Dosage and Administration
Mesna is given as an injection into a vein by a doctor or nurse, and some treatment plans continue it as tablets by mouth. The dose and timing are matched to the chemotherapy schedule and are worked out by the cancer specialist. Take or receive it exactly as prescribed, and do not skip doses, because the protection only works if Mesna is present while the irritating substance is in the urine.
Interactions
Mesna is usually given together with chemotherapy and is not known to weaken it. It can cause a false positive result on urine tests for ketones, so tell the laboratory or doctor that you are receiving it. Always give your care team a full list of your other medicines.
Contraindications
Mesna should not be used by people who have had an allergic reaction to Mesna or to other medicines that contain a thiol (sulphur) group.
Side Effects
Side effects can be hard to separate from those of the chemotherapy. Those linked to Mesna include:
- Nausea, vomiting, diarrhoea or stomach pain
- Headache, tiredness or dizziness
- An unpleasant taste in the mouth, especially with tablets
- Flushing, rash or irritation at the injection site
Get urgent medical help if you notice blood in your urine, pain when passing urine, a widespread rash, blistering or peeling skin, swelling of the face or throat, or difficulty breathing.
Pregnancy and Lactation
Mesna is given with chemotherapy that can harm an unborn baby, so pregnancy should be avoided during treatment and the specialist will discuss contraception. Breastfeeding is not advised during chemotherapy. Discuss any pregnancy plans with your doctor.
Precautions and Warnings
Drink plenty of fluids as advised, and pass urine often during treatment. Mesna protects only the bladder and does not prevent other side effects of chemotherapy such as low blood counts or hair loss. Allergic reactions appear to be more common in people with autoimmune conditions such as lupus. If you vomit soon after a tablet dose, tell your care team, as you may need an injection instead.
Overdose
There is no specific antidote. An overdose may cause nausea, vomiting, diarrhoea and stomach pain. Because Mesna is given under medical supervision, overdose is uncommon; contact your care team at once if you think too much was taken.
Therapeutic Class
Uroprotective agent (detoxifying agent used with chemotherapy).
Storage
Injections are stored by the hospital as directed on the pack. Keep tablets below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.