Mesna
- Atc Codes:R05CB05#V03AF01
- CAS Codes:19767-45-4#3375-50-6
- PHARMGKB ID:19767-45-4#3375-50-6
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Genes that may be involved
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Uromitexan; Belgium: Uromitexan; Bulgaria: Uromitexan; Cyprus: Uromitexan; Czech Republic: Uromitexan; Denmark: Uromitexan; Estonia: Uromitexan; Finland: Uromitexan; France: Uromitexan; Germany: Mesna, Uromitexan; Greece: Uromitexan; Hungary: Uromitexan; Ireland: Uromitexan; Italy: Uromitexan; Latvia: Uromitexan; Lithuania: Uromitexan; Luxembourg: Uromitexan; Malta: Mesna; Netherlands: Uromitexan; Poland: Uromitexan; Portugal: Uromitexan; Romania: Uromitexan; Slovakia: Uromitexan; Sweden: Uromitexan; UK: Uromitexan.
North America
Canada: Mesna, Uromitexan; USA: Mesna, Mesnex.
Latin America
Argentina: Mesna, Mestian, Varimesna; Brazil: Mesna, Mitexan; Mexico: Mescryo, Mesna, Mesnil, Mesodal, Uromes, Uroprot.
Asia
Japan: Uromitexan.
Drug combinations
Mesna and Ifosfamide
Chemistry
Mesna: C~2~H~5~NaO~3~S~2~. Mw: 164.18. (1) Ethanesulfonic acid, 2-mercapto-, monosodium salt; (2) Sodium 2-mercaptoethanesulfonate. CAS-19767-45-4; CAS-3375-50-6 (2-mercaptoethanesulfonic acid)(1990).
Pharmacologic Category
Protective Agents. Antidote. Uroprotectant. (ATC-Code: R05CB05; V03AF01).
Mechanism of action
In blood, mesna is oxidized to dimesna which is in turn reduced in kidney back to mesna, supplying free thiol group which binds to and inactivates acrolein, urotoxic metabolite of ifosfamide and cyclophosphamide.
Therapeutic use
Preventative agent to reduce incidence of ifosfamide-induced hemorrhagic cystitis.
Pregnancy and lactiation implications
Teratogenic effects not observed in animal studies. Use during pregnancy only if clearly needed. Use not recommended during lactation.
Unlabeled use
Preventative agent to reduce incidence of cyclophosphamide-induced hemorrhagic cystitis with high-dose cyclophosphamide.
Contraindications
Hypersensitivity to mesna or other thiol compounds, or any component of the formulation.
Warnings and precautions
Allergic reactions reported (from mild hypersensitivity to systemic anaphylactic reactions). Patients with autoimmune disorders receiving cyclophosphamide and mesna may be at increased risk. If hematuria develops, ifosfamide/cyclophosphamide dose should be reduced or discontinued. Will not prevent or alleviate toxicities associated with ifosfamide or cyclophosphamide, other than hemorrhagic cystitis. Mesna will not reduce risk of thrombocytopenia-related hematuria. I.V. formulation contains benzyl alcohol («gasping syndrome» in neonates). Patients should receive adequate hydration during treatment.