Mesna

From Anvita Health Wiki

Contents 1 Introduction 2 Indications 3 Contraindications 4 Dosage 5 Storage 6 Pharmacokinetics 7 Adverse-effects 8 Drug-interactions 9 Test-interactions 10 Mechanism-of-action 11 More General Terms 12 Additional Terms 13 Internet Database 14 References

Introduction

• main ingredient is 2-mercaptoethanesulfonate.

• Tradename: Mesnex

Indications

• uroprotective agent used to decrease the incidence of hemorrhagic cystitis in patients receiving cyclophosphamide or ifosfamide

Contraindications

• * incompatible with cisplatin
  

Dosage

• mesna is used in combination with cyclophosphamide & ifosfamide

• 60% of ifosfamide or cyclophosphamide dose

• 20% before 20% 4 hours after 20% 8 hours after ifosfamide or cyclophosphamide dose, or
• equal to ifosfamide or cyclophosphamide dose, delivered continuously
• dose just prior to chemotherapy should be IV
• 4 & 8 hours doses may be oral or IV
• oral doses should be mixed in tomato juice, orange juice, or a carbonated drink

• Injection: 100 mg/mL (2 mL, 4 mL, 10 mL).

Storage

• Diluted solutions are stable for 24 hours at room temerature, but recommendations are for refrigeration & use within 6 hours.

Pharmacokinetics

• rapidly oxidized in blood to dimesna which is eliminated in the urine
• dimesna is reabsorbed by the kidney & converted to mesna
• 50% is absorbed orally
• elimination 1/2life is 1 hour
  

• elimination via urine
• 1/2life = 1 hour

Adverse-effects

• not common (1-10%)

• hypotension, malaise, headache, diarrhea, nausea/vomiting (mild), taste disturbance, limb pain, soft stools

• uncommon (< 1%)

• rash, itching

Drug-interactions

• mesna inhibits anti- neoplastic effects of cisplatin & carboplatin

Test-interactions

• false positive urine ketone test

Mechanism-of-action

• sulfhydryl compound that binds to irritating metabolites of ifosfamide & cyclophosphamide producing a non-toxic thiol ether
• slows the rate of acrolein formation

More General Terms

• thiol; sulhydryl compound; mercaptan
• antidote

Additional Terms

• cyclophosphamide (Cytoxan, Neosar, Procytox {Canadian}) [CPM, CTX, CYT, NSC 26271]
• ifosfamide (Ifex, Friedman acid)

Internet Database

PubChem: 29769
PubChem: 598
PubChem: 4077

References

1. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
2. Kaiser Permanente Northern California Regional Drug Formulary, 1998

mesna; 2-mercaptoethane sulfonate; 2-sulfanylethanesulfonic acid (Mesnex, Uromitexan, Mistabronco)