mesna at a glance
Medicine class
Uroprotective and detoxifying agent
Usual role
Helps prevent bladder toxicity and blood in the urine caused by urotoxic ifosfamide or cyclophosphamide treatment
Available forms
Given intravenously or by mouth as tablets; injection solution may sometimes be mixed into a flavoured drink
Food
Food does not affect mesna absorption or urinary elimination
What is mesna used for?
The selected products are licensed to prevent urinary-tract toxicity in people receiving ifosfamide or cyclophosphamide at doses considered harmful to the urinary tract.
Prevention of haemorrhagic cystitis
Prevention of microscopic or visible blood in the urine caused by urotoxic ifosfamide or cyclophosphamide
How does mesna work?
Mesna is converted in the bloodstream mainly to dimesna and transported to the kidneys. In the urinary tract it is changed back to active mesna, where it reacts with harmful metabolites of ifosfamide and cyclophosphamide and reduces their ability to injure the bladder lining.
mesna preparations and strengths
Tablet
Route: Oral
Strengths: 400 mg, 600 mg
How to take mesna
Mesna must be coordinated precisely with ifosfamide or cyclophosphamide. Follow the treatment team's instructions rather than changing its timing yourself.
Tablets can be taken with or without food.
Intravenous mesna is administered by a healthcare professional.
When specifically directed, injection solution intended for oral use may be mixed with a flavoured soft drink and kept refrigerated in a sealed container for no longer than 24 hours.
Maintain the fluid intake advised by the treatment team and empty your bladder normally.
If you vomit after oral mesna, contact the treatment team promptly because intravenous replacement may be needed.
mesna side effects
Common or expected effects
- Headache or light-headedness
- Tiredness, drowsiness or flu-like symptoms
- Feeling sick or diarrhoea
- Abdominal pain or colic
- Fever, flushing or rash
- Infusion-site pain, swelling, itching or redness with injectable mesna
Get urgent medical advice
- Anaphylaxis or severe hypersensitivity, including breathing difficulty, facial or throat swelling, fainting or low blood pressure
- Blistering, peeling or ulcerating skin or mucosal reactions
- DRESS: rash with fever, swollen lymph nodes, blood-cell changes or internal-organ involvement
- Visible blood or clots in the urine despite mesna
mesna in pregnancy
Human pregnancy information for mesna is limited. If specialist-led ifosfamide or cyclophosphamide treatment is considered necessary during pregnancy, mesna should also be given for bladder protection. The overall chemotherapy risks and benefits require specialist discussion.
mesna while breastfeeding
Do not breastfeed while receiving mesna with ifosfamide or cyclophosphamide. Discuss feeding options with the specialist team before treatment begins.
mesna interactions
The selected product information does not identify a clinically important interaction that reduces the effects of ifosfamide, cyclophosphamide or other listed anticancer medicines. Mesna can interfere with some urine and laboratory tests, so laboratories should be told it is being used.
Common questions about mesna
Answers are fully visible for fast scanning and source review.
Does mesna treat cancer?
No. Mesna protects the urinary tract from harmful metabolites of ifosfamide or cyclophosphamide; it is not an anticancer treatment.
Does mesna completely prevent bladder damage?
No. Blood in the urine and haemorrhagic cystitis can still occur, so hydration and urine monitoring remain important.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.