Cytoprotective and supportive care agents:
Indications for MESNEX:
Prophylactic agent in reducing the incidence of ifosfamide-induced hemorrhagic cystitis.
Limitations of Use:
Not indicated to reduce the risk of hematuria due to other conditions (eg, thrombocytopenia).
See full labeling. IV schedule: give as IV bolus inj in a dosage equal to 20% of the ifosfamide dose at the time of ifosfamide administration and 4 and 8hrs after each dose of ifosfamide; total daily dose is 60% the ifosfamide dose. IV and oral schedule: give as IV bolus inj in a dosage equal to 20% of the ifosfamide dose at the time of ifosfamide administration, followed by the tablets given orally in a dosage equal to 40% of the ifosfamide dose 2 and 6hrs after each dose of ifosfamide; total daily dose is 100% of the ifosfamide dose. Repeat schedule on each day ifosfamide is given. If vomiting occurs within 2hrs of oral mesna, repeat dose or give IV mesna.
Monitor urine for the presence of hematuria each day prior to ifosfamide therapy; consider dose reduction or discontinue ifosfamide if severe hematuria occurs. Hypersensitivity to thiol compounds. Discontinue and treat if hypersensitivity or serious skin reactions (eg, SJS, TEN) occur. Maintain adequate hydration. Inj: avoid in premature neonates and low-birth weight infants. Elderly. Pregnancy: exclude status prior to initiation. Use effective contraception during and for 6 months (females) or 3 months (males w. female partners) after the last dose. Nursing mothers: not recommended (during and for 1 week after the last dose).
May cause false (+) ketones in nitroprusside sodium-based urine tests and ascorbic acid in Tillman's urine tests. May interfere with enzymatic CPK activity tests.
With ifosfamide: nausea, vomiting, constipation, leukopenia, fatigue, fever, anorexia, thrombocytopenia, anemia, granulocytopenia, diarrhea, asthenia, abdominal pain, headache, alopecia, somnolence.
Patients taking mesna should drink at least a quart of liquid a day.
Tabs—10; Multidose vials—1, 10