MESNA
Background and Date of Approval
Mesna is a cytoprotectant agent belonging to the class of haemorrhagic cystitis inhibitors. Mesna received FDA approval in 1998 for the management of haemorrhagic cystitis.
Uses
Mesna is an intravenously administered drug. This medicine is used to reduce the risk of hemorrhagic cystitis (a condition that causes bladder inflammation and can result in serious bleeding) in people who receive ifosfamide (a medication used for treating cancer). It protects against some of the harmful effects of certain chemotherapy medications.
How is it administered?
Mesna is available as an intravenous injection. The drug should be administered only by healthcare professionals experienced with cancer chemotherapy. Your physician will determine the dose and frequency of administration based on the type of cancer and severity of the disease. Do not self-administer the injection.
Side Effects
The common side effects of Mesna are chest pain, swelling in the face, feet, and hands, hair loss, excessive sweating, decreased potassium levels, abdominal pain, constipation, diarrhea, loss of appetite, nausea, vomiting, anemia, changes in the blood count levels, backache, confusion, dizziness, headache, fever, tiredness. Other serious side effects include rash, and hypersensitivity reactions.
Warnings
The medicine is intended to cause severe hypersensitivity reactions. Inform your physician if you face any symptoms of fever, swelling of your face, lips, mouth, or tongue, trouble breathing or wheezing, itching, burning, skin rash or hives, skin redness, or swelling after taking this medicine. Skin rash and swelling in the skin have also been reported with the use of this medicine. This medicine is not indicated to use in neonates, premature and low-birth-weight infants.
Precautions
Notify your physician if you are pregnant or breastfeeding or have severe liver and bladder problems. Female patients should use effective contraception during the treatment with this medicine in combination with other anticancer medication and for 6 months after the last dose. Do not take this injection if you are allergic to mesna or any other ingredients of this medicine. Inform your healthcare provider about all the medicines you take, including prescription medications, over-the-counter medications, recent vaccinations, nutritional and vitamin supplements, and herbal products. Certain medications may interact with mesna and reduce their effectiveness by causing undesirable side effects. Your healthcare professional may advise you to take certain blood tests to monitor the effectiveness and side effects of the therapy.
Word of Advice
Store mesna at 20°C to 25°C in the refrigerator. Do not freeze. Keep the injection out of reach of children and pets. If you have missed any dosing appointments, inform your doctor and arrange them promptly. Increase fluid intake to promote urination and help reduce the risk of kidney complications. Aim for 1 to 2 litres of fluid daily. Male patients with female partners must use reliable contraception during treatment and for 3 months following the final dose. Do not breastfeed during mesna treatment and for 1 week after the last dose. Your doctor may conduct regular laboratory tests to assess treatment efficacy and monitor for any adverse effects.
References
HIGHLIGHTS OF PRESCRIBING INFORMATION - Mesna [revised on 2014] [cited 2023 Apr 6]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/019884s013lbl.pdf Boehringer-Ingelheim, Mesna [Revised on March 2014] [ Accessed on 06 April 2023], https://docs.boehringer-ingelheim.com/Prescribing%20Information/PIs/Ben%20Venue_Bedford%20Labs/55390-045-01%20MSN%201G/5539004501 V Reddy, Winston NR; Mesna; NCBI Bookshelf; [Revised on Nov 2020] [Accessed on 06th April 2023], https://www.ncbi.nlm.nih.gov/books/NBK556021/
Frequently Asked Questions
What if mesna does not work for me?
There are alternative medicines that may work for you based on your disease condition and other factors. Your doctor will decide the alternative treatment tha works best for you.
Is there any special diet that I should follow while taking mesna?
There are no special restrictions on the diet. If your doctor or any other healthcare professional tells you to avoid certain food, then avoid it. Diet restrictions may vary from patient to patient. Consult your doctor for more advice.
Why is mesna contraindicated in neonates, premature and low-birth-weight babies?
The preservative benzyl alcohol added in the mesna has been associated with serious adverse reactions and death in neonates and premature infants. Consult your doctor for more information.
Can old-age patients take mesna?
Dose selection should be cautiously made in older age people receiving mesna. Your physician will decide the dose and duration of the therapy.
What are the precautions I should follow while receiving mesna?
Drink 1 to 2 liters of fluid each day during the therapy with mesna. Inform your physician of any symptoms of bleeding or skin reactions.
Is hair loss caused by mesna reversible?
Hair loss is a common side effect of Mesna. It is reversible, but it depends totally on the severity of the hair loss and varies from person to person. Consult your doctor if you have severe hair loss.