Mesna
(Redirected from Mistabron)
What is Mesna?[edit | edit source]
- Mesna (Mesnex) is a cytoprotective agent used to prevent hemorrhagic cystitis (bleeding in the bladder) caused by the anticancer drug ifosfamide.
What are the uses of this medicine?[edit | edit source]
- Mesna (Mesnex) is a prescription medicine used to reduce the risk of inflammation and bleeding of the bladder (hemorrhagic cystitis) in people who receive ifosfamide (a medicine used to treat cancer).
Limitation of Use:
- Mesnex is not for use to reduce the risk of blood in the urine (hematuria) due to other medical conditions.
How does this medicine work?[edit | edit source]
- Mesna reacts chemically with the urotoxic ifosfamide metabolites, acrolein and 4-hydroxy-ifosfamide, resulting in their detoxification.
- The first step in the detoxification process is the binding of mesna to 4-hydroxy-ifosfamide forming a non-urotoxic 4-sulfoethylthioifosfamide.
- Mesna also binds to the double bonds of acrolein and to other urotoxic metabolites and inhibits their effects on the bladder.
Who Should Not Use this medicine ?[edit | edit source]
This medicine cannot be used in patients who:
- are allergic to mesna or any of the ingredients in Mesnex.
What drug interactions can this medicine cause?[edit | edit source]
- Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.
Is this medicine FDA approved?[edit | edit source]
- Mesna was approved for medical use in the United States in 1988.
How should this medicine be used?[edit | edit source]
Recommended dosage:
- Mesnex may be given on a fractionated dosing schedule of three bolus intravenous injections or a single bolus injection followed by two oral administrations of Mesnex tablets as below:
Intravenous Dosing Schedule:
0 Hours | 4 Hours | 8 Hours | |
---|---|---|---|
Ifosfamide | 1.2 g/m2 | - | - |
Mesnex injection | 240 mg/m2 | 240 mg/m2 | 240 mg/m2 |
Intravenous and Oral Dosing Schedule:
0 Hours | 2 Hours | 6 Hours | |
---|---|---|---|
Ifosfamide | 1.2 g/m2 | - | - |
Mesnex injection | 240 mg/m2 | - | - |
Mesnex tablets | - | 480 mg/m2 | 480 mg/m2 |
Administration:
- Mesnex is given on the same day that you receive ifosfamide.
- Mesnex can be given by an intravenous (IV) infusion into a vein or tablets taken by mouth.
You will receive Mesnex in one of two ways:
- Mesnex intravenous (IV) infusion into a vein at the time you receive ifosfamide and 4 and 8 hours after you receive ifosfamide, OR
- Mesnex intravenous (IV) infusion into a vein at the time you receive ifosfamide and Mesnex tablets taken by mouth 2 and 6 hours after you receive ifosfamide.
- Take Mesnex tablets at the exact times and the exact dose your healthcare provider tells you to take it.
- During treatment with Mesnex intravenous (IV) infusion or Mesnex tablets, you should drink 4 to 8 cups of liquid (1 to 2 liters) each day.
What are the dosage forms and brand names of this medicine?[edit | edit source]
This medicine is available in fallowing doasage form:
- As Injection: 1g (100 mg/mL) Multidose vials
- Tablets: 400 mg with functional score
This medicine is available in fallowing brand namesː
- Mesnex
What side effects can this medication cause?[edit | edit source]
The most common side effects of this medicine include:
- nausea
- vomiting
- constipation
- decreased white blood cell count
- tiredness
- fever
- decreased appetite
- decreased platelet count
- decreased red blood cell count
- diarrhea
- weakness
- stomach (abdomen) pain
- headache
- hair loss
- sleepiness
Mesnex may cause serious side effects, including:
- serious allergic reactions and skin reactions
What special precautions should I follow?[edit | edit source]
- Mesnex may cause systemic hypersensitivity reactions, including anaphylaxis. Anaphylactic reactions have been reported. Less severe hypersensitivity reactions may also occur. Monitor patients. If a reaction occurs, discontinue Mesnex and provide supportive care.
- Skin rash with eosinophilia and systemic symptoms, Stevens-Johnson syndrome, and toxic epidermal necrolysis have occurred. Skin rash, urticaria, and angioedema have also been seen. Monitor patients. If a reaction occurs, discontinue Mesnex and provide supportive care.
- Serious and fatal adverse reactions can occur in premature neonates and low-birth weight infants treated with benzyl alcohol-preserved drugs, including Mesnex injection. Avoid use in premature neonates and low-birth weight infants.
- False positive tests for urinary ketones and interference with enzymatic CPK activity tests have been seen.
- Mesnex is a thiol compound, i.e., a sulfhydryl (SH) group-containing organic compound. Hypersensitivity reactions to mesna and to amifostine, another thiol compound, have been reported.
What to do in case of emergency/overdose?[edit | edit source]
Symptoms of overdosage may include:
- nausea
- vomiting
- diarrhea
- fever
- hypotension
- shortness of breath
- asthma exacerbation
- rash
- flushing
Management of overdosage:
- There is no known antidote for Mesnex.
- In the event of an overdose, appropriate supportive treatment should be initiated.
Can this medicine be used in pregnancy?[edit | edit source]
- Mesnex is used in combination with ifosfamide or other cytotoxic agents.
- Ifosfamide can cause fetal harm when administered to a pregnant woman.
Can this medicine be used in children?[edit | edit source]
- Mesnex injection contains the preservative benzyl alcohol which has been associated with serious adverse reactions and death when administered intravenously to premature neonates and low birth weight infants.
- Avoid use of Mesnex injection in premature neonates and low-birth weight infants.
What are the active and inactive ingredients in this medicine?[edit | edit source]
Active ingredient: mesna
Inactive ingredients:
- Mesnex injection: edetate disodium, sodium hydroxide, and benzyl alcohol as a preservative.
- Mesnex tablets: calcium phosphate, cornstarch, hydroxypropylmethylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, povidone, simethicone, and titanium dioxide.
Who manufactures and distributes this medicine?[edit | edit source]
Manufactured by:
- Baxter Healthcare Corporation, Deerfield, IL USA
- Made in Germany
- Baxter and Mesnex are registered trademarks of Baxter International Inc.
What should I know about storage and disposal of this medication?[edit | edit source]
- Store Mesnex tablets at room temperature between 68°F to 77°F (20°C to 25°C).
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