Mesnex®

Posted on October 18th, 2010 by

Class: Chemoprotectant

Generic Name: Mesna (MEZ-neh)
Trade Name: Mesnex®

How is this drug used? Mesna is FDA approved to reduce or prevent the incident of hemorrhagic cystitis (bleeding of the bladder) caused by the chemotherapy agent ifosfamide. In addition, once a drug has been determined to be safe and is approved by the FDA, physicians often use the drug for the treatment of medical conditions other than its specific FDA approval.

What is the mechanism of action? Mesna binds to and inactivates the substances from ifosfamide that cause irritation to the lining of the bladder and bleeding. By inactivating these substances, hemorrhagic cystitis is reduced or prevented.

How is mesna given (administered)? Mesna can be given into a vein (intravenous) or in tablet form by mouth. The intravenous formulation may also be mixed in a liquid solution and administered orally.

How are patients monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with mesna in combination with ifosfamide chemotherapy.  Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver.  Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy.

Patients are also monitored for a rare, but potentially serious allergic-type reaction to mesna. Although patients will be monitored for this reaction, they should tell or contact their healthcare provider immediately if they experience hives or rash, difficulty breathing, closing of the throat, wheezing, and swelling of facial features.

What are the common (occur in 30% or more of patients) side effects of treatment with the combination of mesna and ifosfamide?

• Nausea and vomiting

What are the less common (occur in 10% to 29% of patients) side effects of treatment with the combination of mesna and ifosfamide?

• Constipation
• Low levels of white blood cells- increases risk of infections
• Fatigue
• Fever
• Loss of appetite resulting in extreme weight loss
• Low levels of platelets- increases risk of bleeding
• Low levels of red blood cells- increases risk of anemia
• Abdominal pain
• Hair loss
• Headache
• Dizziness
• Flushing
• Cold-like symptoms (sore throat, cough)
• Diarrhea

Because mesna is given with ifosfamide, it is difficult to distinguish when reactions are due to mesna from those of ifosfamide.

This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.

Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.

What can patients do to help alleviate or prevent discomfort and side effects?

• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)

Are there any special precautions patients should be aware of before starting treatment?

• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.

When should patients notify their physician?

• Blood in the urine (pink or red urine)
• Diarrhea
• Nausea and vomiting
• Signs of infection – fever, chills, cough, sore throat
• Signs of infection – redness, swelling, pus, painful urination
• Extreme or prolonged fatigue
• Unexplained bleeding or bruising – nosebleeds, bruising, black or tarry stools, blood in the urine
• Severe abdominal pain
• Symptoms of an allergic reaction – rash, hives, difficulty breathing, wheezing, closing of the throat and/or swelling of facial features
• Dizziness, confusion or severe anxiety
• Difficulty breathing
• Chest pain or noticeable changes in heart rate or rhythm
• Extreme weight loss
• Injection site reactions (pain, swelling)

What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers.  A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.

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Tags: Chemotherapy, M

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