8600 Rockville Pike A Methodological Review of Drug-Related Toxicological Studies in Saudi Arabia. eCollection 2023 Mar. Mesna comes as a tablet to take by mouth. Although previous reports had suggested that the sulfhydryl-containing compound mesna might be superior to forced diuresis in preventing he 3. You can ask your pharmacist or healthcare provider for information about Mesna injection that is written for health professionals. The dosing schedule should be repeated on each day that ifosfamide is administered. If severe hematuria develops when mesna is given according to the recommended dosage schedule, dosage reductions or discontinuation of ifosfamide therapy may be required. When Mesna was administered together with these doses of ifosfamide, the incidence of hematuria was less than 7%. It works by protecting the bladder against some of the harmful effects of certain chemotherapy medications. Results: Store at 20 to 25C (68 to 77F) [see USP for Controlled Room Temperature]. Patients should be monitored accordingly. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. Before Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. If severe hematuria develops when mesna is given according to the recommended dosage schedule, dosage reductions or discontinuation of ifosfamide therapy may be required. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. Clinical studies of Mesna did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Prevention of ifosfamide-induced hemorrhagic cystitis: Standard-dose ifosfamide (manufacturers labeling): IV: Each mesna dose is equal to 20% of the daily ifosfamide dose given for 3 doses: With the ifosfamide dose (hour 0), hour 4, and at hour 8 after the ifosfamide dose (total daily mesna dose is 60% of the daily ifosfamide dose). Ifosfamide/cyclophosphamide toxicities: Mesna is intended for the prevention of hemorrhagic cystitis and will not prevent or alleviate other toxicities associated with ifosfamide or cyclophosphamide. The Nephrotoxicity of Drugs Used in Causal Oncological Therapies. bolus dose of mesna at 20% of ifosfamide dosage, given at same time as ifosfamide, followed by two doses of mesna tablets P.O. and P.O. It has a reported half-life of 22 minutes, is quickly excreted by the kidneys after infusion, and accumulates in the bladder, where it detoxifies urotoxic Continuous IV infusion: Dosing regimens variable: ASCO guidelines: Mesna dose (as an IV bolus) equal to 20% of the ifosfamide dose, followed by a continuous IV infusion of mesna at 40% of the ifosfamide dose; continue mesna infusion for 12 to 24 hours after completion of ifosfamide infusion (Hensley, 2009). Hematuria: Monitor urine for hematuria. Disclaimer. Prevention of cyclophosphamide-induced hemorrhagic cystitis in patients with rheumatic or autoimmune disorders (off-label use; based on limited data): IV: Each mesna dose is equal to 20% of the daily cyclophosphamide dose given for 3 doses, 15 to 30 minutes prior to cyclophosphamide (hour 0), and 4 and 8 hours after cyclophosphamide (if administering mesna orally, each oral mesna dose is equal to 40% of the daily cyclophosphamide dose, with the first dose administered 2 hours prior to cyclophosphamide, and 4 and 8 hours after cyclophosphamide) (Monach 2010) or each mesna dose is equal to 20% of the daily cyclophosphamide dose given for 3 doses at 3, 6, and 8 hours following cyclophosphamide each day for 4 days (Moyo 2002). Talk with the doctor about the risks and side effects that may happen with ifosfamide. Recommended Intravenous Dosing Schedule. Plasma concentrations of Mesna exceed those of diMesna after intravenous administration. The multidose vials may be stored and used for up to 8 days after initial puncture. Reactions may occur with the first mesna exposure, or after several months of treatment. Patients should receive adequate hydration during treatment. The addition of glacial acetic acid can be used to differentiate between a false positive result (cherry-red color that fades) and a true positive result (red-violet color that intensifies). Copyright, 2023. A total of 718 patients' medical records were reviewed. Note: Mesna dosing schedule should be repeated each day ifosfamide is administered. Mesna dosing schedule is typically repeated with each day cyclophosphamide is received; mesna dosing should be adjusted if cyclophosphamide dose is adjusted (decreased or increased) to maintain the mesna-to-cyclophosphamide ratio for the protocol; Infants, Children, and Adolescents: Standard (low)-dose cyclophosphamide: Note: Some pediatric oncology experts have defined as cyclophosphamide dose <1800 mg/m2/day in protocols. Do not take Mesna tablets or receive Mesna injection by intravenous (IV) infusion if you are allergic to Mesna or any of the ingredients in Mesna injection. Refer to the ifosfamide prescribing information for more information on use during pregnancy. Mesna injection is not for use to reduce the risk of blood in the urine (hematuria) due to other medical conditions. URL of this page: https://medlineplus.gov/druginfo/meds/a613013.html. Males with female partners of reproductive potential should use effective contraception during mesna/ifosfamide treatment and for 3 months after the final mesna/ifosfamide dose. Avoid use of Mesna injection in premature neonates and low-birth weight infants [see Use in Specific Populations (8.4)]. government site. and transmitted securely. You may report side effects to FDA at 1-800-FDA-1088. Data were reported as numbers and percentages, and appropriate statistical tests of association were used. http://www.upandaway.org. Talk to your doctor about the risks of using this medication for your condition. Many approaches including mesna use were established to reduce this toxicity. Efficacy of Mesna for Prevention of Hemorrhagic Cystitis After High-Dose Cyclophosphamide Therapy Show all authors. 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. The recommended dosing schedule is outlined below in Table 1. This Patient Information has been approved by the U.S. Food and Drug Administration. sharing sensitive information, make sure youre on a federal In previous studies, our group demonstrated that -phellandrene (-PHE) possesses anti-inflammatory activity, which opens the door for its study in the attenuation of HC. You should also read the ifosfamide Prescribing Information for important pregnancy, contraception, and infertility information. In a clinical trial, 11 patients received intravenous Mesna 10 mg/kg to 66 mg/kg per day for 3 to 5 days. Mesna (also known as Mesnex ) is a medicine used to prevent damage to the bladder that can be caused by some anticancer medicines. Hemorrhagic cystitis produced by ifosfamide is dose dependent (Table 4). 1 INDICATIONS AND USAGE Mesna is indicated as a prophylactic agent in reducing the incidence of ifosfamide-induced hemorrhagic cystitis. Verify the pregnancy status of females of reproductive potential prior to initiation of Mesna in combination with ifosfamide. Apply for early access to the new Medicine.com Pharmacy. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. This may result in a falsely low CPK level. It is also important information to carry with you in case of emergencies. Medically reviewed by Drugs.com. Please enable it to take advantage of the complete set of features! However, adverse reactions have occurred in premature neonates and low birth weight infants who received intravenously administered benzyl alcohol-containing drugs [see Warnings and Precautions (5.3) and Use in Specific Populations (8.4)]. Mesna (2-mercaptoethane sodium sulphonate), hyperhydration and bladder irrigation have been the most frequently used prophylactic measures to prevent treatment-related cystitis, but are not always effective. Making simple changes to your diet is the first step to being heart-healthy. Applies to the following strengths: 100 mg/mL; 400 mg. Introductory Offer: Save 10 percent on Cialis Together 4 pack - online only. Drug type: Mesna is a drug used to reduce the undesired side effects of certain chemotherapy drugs. What side effects can this medication cause? Mesna adverse reaction data are available from four Phase 1 studies in which single intravenous doses of 600-1200 mg Mesna Injection without concurrent chemotherapy were administered to a total of 53 healthy volunteers. Helps you get and maintain an erection when you need it. Prevention of further cyclophosphamide induced hemorrhagic cystitis by hyperbaric oxygen and mesna in guinea pigs. 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. Mesna is contraindicated in patients known to be hypersensitive to Mesna or to any of the excipients [see Warnings and Precautions (5.1 )]. Store diluted solutions at 25C (77F). Objective: . American Society of Clinical Oncology, Clinical Practice Guidelines (ASCO): Use of Chemotherapy and Radiotherapy Protectants. Sodium 2-mercaptoethane sulfonate (mesna) is a detoxifying agent used to prevent hemorrhagic cystitis in patients receiving chemotherapy with either high-dose cyclophosphamide or ifosfamide. Dilute solution for injection to 20 mg/mL or 50 mg/mL with orange or grape syrup. To investigate the incidence of hemorrhagic cystitis in patients receiving cyclophosphamide therapy with or without mesna. Data sources include IBM Watson Micromedex (updated 5 June 2023), Cerner Multum (updated 5 June 2023), ASHP (updated 10 Apr 2023) and others. What are the ingredients in Mesna injection? infusion is completed. Some centers have used a mesna dose equal to 100% of the ifosfamide dose as a short IV infusions 5 divided doses (0, 3, 6, 9 and 12) hours after the start of ifosfamide) (Kliegman, 2007) or as a continuous IV infusion beginning 15 to 30 minutes before the first ifosfamide dose and completed at least 12 hours after the end of the ifosfamide infusion. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine. Last updated on May 1, 2023. Mesna may cause serious side effects, including: See What is the most important information I should know about Mesna injection?. Mesna: ~22 minutes; Dimesna: ~70 minutes. Mesna helps to protect the lining of the bladder against damage from ifosfamide. Solutions diluted for infusion in D5W, NS, D51/4NS, D51/3NS, D51/2NS, or lactated Ringer's and stored at room temperature should be used within 24 hours. Central nervous system: Dizziness, drowsiness, headache, hyperesthesia, rigors, Gastrointestinal: Anorexia, constipation, diarrhea, dysgeusia (with oral administration), flatulence, nausea, unpleasant taste (with oral administration), vomiting, Neuromuscular & skeletal: Arthralgia, back pain, Respiratory: Cough, flu-like symptoms, pharyngitis, rhinitis, <1%, postmarketing and/or case reports (mesna alone or in combination): Anaphylaxis, erythema at injection site, hypersensitivity reaction, hypertension, hypotension, increased serum transaminases, increased ST segment on ECG, limb pain, malaise, myalgia, pain at injection site, tachycardia, tachypnea, thrombocytopenia. This step was followed by a comprehensive literature review using appropriate keywords in PubMed from the inception of the database until August 2019. Prevention of cyclophosphamide-induced hemorrhagic cystitis (in patients with cancer; off-label use): HDCAV/IE regimen for Ewing sarcoma: Adults <40 years of age: IV: Cycles 1, 2, 3, and 6 (cyclophosphamide-containing regimen): 2.1 g/m2/day continuous infusion (mesna dose is equivalent to the daily cyclophosphamide dose) for 2 days with cyclophosphamide infusion during cycles 1, 2, 3, and 6 (Kolb 2003). Data from an acute lymphocytic leukemia study utilizing high-dose cyclophosphamide and from an Ewing sarcoma study support the use of mesna as a preventative agent to reduce the incidence of hemorrhagic cystitis due to cyclophosphamide Kantarjian 2000, Kolb 2003. In the kidney, mesna disulfide is . Available for Android and iOS devices. Package insert / product label The total daily dose of Mesna is 60% of the ifosfamide dose. Severe hematuria despite utilization of mesna may require ifosfamide (or cyclophosphamide) dose reduction or discontinuation. 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