Uses of Mesna: - Ifosfamide-induced hemorrhagic cystitis Urothelial toxicity Hypersensitivity to thiol-containing compounds.

How to use Mesna Disulfide: Your doctor or nurse will give you this medicine. Kindly do not self administer. Administration: IV Preparation Reconstitute w/ D5W, NS, dextrose/saline or LR to a final concentration of 20 mg/mL IV Administration IVP: bolus 15 min before ifosfamide Intermittent infusion over 15-30 min Continuous Infusion: may be added to ifosfamide/cyclophosphamide in infusion bag Additive compatibility w/ cyclophosphamide shown only in D5W & LR Adult Dose: Intravenous Prophylaxis against urothelial toxicity With Ifosfamide 240 mg/sq.meter (if receiving 1.2 g/sq.meter ifosfamide dose) IVP 15 minutes before & 4 & 8 hours after ifosfamide admin OR 240 mg/sq.meter (if receiving 1.2 g/sq.meter ifosfamide dose) IVP 15 minutes before & 480 mg/sq.meter PO 2 & 6 hours after ifosfamide admin Adjust dose accordingly if ifosfamide dose changes Also given by alternative IVP regimens, intermittent infusion or continuous infusion-

Mesna is incompatible in vitro with cisplatin and nitrogen mustard.

Hypersensitivity to thiol-containing compounds.

Common - Nausea - Headache - Lightheadedness - Lethargy - Abdominal pain - Flushing (sense of warmth in the face, ears, neck and trunk) - Diarrhea - Rash - Fever - Flu-like symptoms >10% Nausea (>50%),Vomiting (29%),Anorexia.Asthenia,Fatigue,Fever,Abdominal pain,Constipation,Anemia,Granulocytopenia,Leukopenia,Thrombocytopenia,Alopecia 1-10% Anxiety,Confusion,Dizziness,Headache,Insomnia,Pain,Somnolence,Chest pain,Edema,Flushing,Tachycardia,Cough,Dyspnea,Pneumonia,Diarrhea,Hematuria,Hypokalemia,Back pain,Dehydration,Injection site reaction,Pallor Potentially Fatal: May cause haemorrhagic cystitis, systemic anaphylactic reactions.

Precaution: Protective effect applies only to the urinary tract; pregnancy, lactation. Patients with auto-immune disorders. IV formulation may contain benzyl alcohol as a preservative; avoid in neonates or infants. Instruct patients to seek medical attention if discolouration of urine occurs. During treatment, monitor urine for erythrocytes and haematuria. Maintain adequate hydration in all patients. Patients who vomit within 2 hr of oral dose should repeat dose or receive IV dose. Lactation: not known if excreted in breast milk, do not nurse

Mesna is used to prevent urothelial toxicity associated with oxazaphosphorine, ifosfamide or cyclophosphamide. It acts in the kidney; reacting with thiol groups of urotoxic metabolites (e.g. acrolein) of ifosfamide and cyclophosphamide. It is used as a mucolytic in the management of some respiratory tract conditions e.g. cystic fibrosis where other mucolytics have failed. It acts by reducing the viscosity of pulmonary secretions; the drug's free sulfhydryl group is thought to reduce disulfide linkages of mucoproteins.