Patient Education Quick Reference Guide Diablo Valley Oncology/Hematology Medical Group Phone Number: 925-677-5041

Uses For This Medication

  • Mesna is used to decrease the risk of developing hemorrhagic cystitis (bleeding in the bladder) from high dose cyclophosphamide or ifosfamide, both of which are chemotherapy medications. Hemorrhagic cystitis is a condition that can cause bleeding and bloody urine from damage to the bladder lining.
  • This medication may also be given for other conditions as determined by your doctor.

How This Medication Works

Mesna belongs to the general group of medications known as chemoprotective agents. Mesna works by reacting with toxic breakdown products of cyclophosphamide or ifosfamide and making them harmless, so that the bladder tissue is not damaged.   Benefits of This Medication Mesna has been shown to reduce the development of hemorrhagic cystitis in patients receiving high dose cyclophosphamide or ifosfamide.  

Who Should Not Take This Medication

You should not take this medication if you:
  • Are allergic to mesna or to other thiol compounds.
  Precautions to be Aware of Before Taking This Medication

Allergy related precautions

Mesna may cause allergic reactions. These allergic reactions can cause a rash or angioedema (the development of large welts below the surface of the skin, especially around the eyes and lips). Patients with autoimmune disorders [such as rheumatoid arthritis, systemic lupus erythmatosis (SLE), or nephritis (a type of kidney problem)] as well as those patients who receive oral mesna are at a higher risk of developing allergic reactions. Your doctor or healthcare provider will watch you carefully during and after the administration of mesna to make sure that you do not experience any allergic reactions. If an allergic reaction occurs it is treatable with medications.

Miscellaneous precautions

Mesna may not prevent the development of hemorrhagic cystitis in all patients. Therefore, your doctor or healthcare provider may examine your urine on the days that you receive ifosfamide or cyclophosphamide treatment. In addition, you should let your doctor or healthcare provider know if your urine becomes pink or red in color.   Patient specific precautions
  • This medication is used routinely in pediatric patients. However, because it is diluted in an alcohol base, it is recommended that this medication not be used in babies and infants and used with caution in older children.
  • It is not known whether this medication is safe and effective in adults older than 65 years of age. It is therefore recommended that it be used with caution in this population.

Pregnancy and Breastfeeding Precautions

  • It is not known whether or not this medication can cause fetal harm. Tell your doctor or healthcare provider right away if you or your spouse/partner becomes pregnant while on this medication.
  • It is not known whether this medication is found or excreted in breast milk. Since many medications are excreted in breast milk and because this medication can cause serious harmful reactions in infants, breastfeeding should be avoided.

Medication and Food Interactions

Before using this medication, tell your doctor or healthcare provider of all prescription or over-the- counter products you are taking, including dietary supplements or vitamins, herbal medicines and homeopathic remedies. Do not start or stop any medication without your doctor or healthcare provider’s approval.
  • It is not known whether this medication interacts with other medications you are taking.

Side Effects

  • All medications can cause side effects. However, not all patients will experience these side effects. In addition, other side effects not listed can also occur in some patients. You should call your doctor or healthcare provider if you have any questions or concerns while you are on this medication.
  • You should contact your doctor or healthcare provider if you experience any side effect(s) which don’t go away, worsen, are serious in nature, or are worrisome to you.
  • Side effects can occur when mesna is given alone or together with other chemotherapy medications. The side effects listed below are those reported in patients who received mesna alone.

More common side effects

  • Nausea, vomiting, diarrhea or constipation, loss of appetite
  • Tiredness, sleepiness
  • Sore throat, cough
  • Runny nose, nasal congestion

Less common side effects

  • Decreased white blood cells, red blood cells or platelets
  • Abdominal pain/bloating
  • Flu like symptoms including fever, chills, dizziness

Rare side effects

This is not a complete list of the rare side effects reported with mesna. For a complete list, please talk with your doctor or healthcare provider about reviewing a copy of the package insert.
  • Allergic reactions (see Precautions To Be Aware Of Before Taking This Medication) 
  • Rash 
  • Constipation 
  • Changes in blood pressure (increases and decreases)
  • Muscle pain, joint pain 
  • Heart rhythm (heart beat) changes, chest pain
  • Anxiety, confusion 
  • Hair loss 
  • Flushing 
  • Injection site reactions 
  • Headache

How To Take This Medication

  • This medication is either taken by mouth (orally) or given by injection into a vein (IV) by a healthcare professional. This medication can be given in different doses depending on how much ifosfamide or cyclophoshpamide you are receiving, your weight, and whether you are receiving IV or oral mesna. If you are taking this medication orally, be sure to take it exactly as directed by your doctor or healthcare provider. If you are unable to take this medication as directed contact your health care provider immediately. If you do not understand these instructions, ask your doctor or healthcare provider to explain them to you.
  • Depending on your chemotherapy treatment schedule, mesna may be given before and after each dose of chemotherapy or it may be mixed in the same bag with your chemotherapy.
  • If you are taking the oral form of mesna, you should take the tablets or oral liquid at the exact time that your doctor tells you. If you miss a dose, take it as soon as you remember, and contact your doctor for more instructions. Do not double your dose to make up for the missed dose. If you vomit within 2 hours of taking oral mesna, contact your doctor or healthcare provider.
  • If you are taking the oral liquid form of mesna, this can be mixed with a glass of cold grape juice or soda to mask the taste of this medication.
  • Unless your doctor tells you otherwise, you should drink at least a quart (4 cups) of fluid a day while you are receiving mesna.
  • In the unlikely event of an overdose of this medication contact your doctor, your local poison control center at 1-800-222-1222, or emergency services immediately.

Proper Storage

  • If you are receiving the IV form of mesna, it is unlikely that you will need to store this medication. However, in the event that you do, the unopened containers should be stored in the refrigerator.
  • If you are taking the oral liquid form of mesna, the oral liquid should be stored in the refrigerator.
  • If you are taking the oral tablet form of mesna, the tablets should be stored at room temperature.
  • Keep this medication out of the reach of children or pets.
  • Ask your doctor or healthcare provider how to dispose of any medication that you no longer use.