Pronunciation:

MES-na

Brand Names:

• Mesnex

Dosage Forms:

• Solution

Classifications:

Therapeutic—

Hemorrhagic Cystitis Inhibitor

Uses of This Medicine:

Mesna injection is used to lower the risk of inflammation and bleeding of the bladder (hemorrhagic cystitis) in patients who receive ifosfamide (cancer medicine).

This medicine is to be given only by or under the direct supervision of your doctor.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of mesna injection in the pediatric population. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of mesna injection in the elderly. However, elderly patients are more likely to have age-related liver, kidney, and heart problems, which may require caution and an adjustment in the dose for patients receiving mesna injection.

Breast-feeding—

Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Warfarin

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Allergy to thiol compounds (eg, amifostine), history of—Use with caution. May increase risk of an allergic reaction to occur again.

Proper Use of This Medicine:

A nurse or other trained health professional will give you this medicine in a medical facility. It is given through a needle placed into one of your veins.

This medicine is given on a fixed schedule. It may be given after receiving ifosfamide, 4 hours, and 8 hours after each dose of ifosfamide.

Drink extra fluids (1 to 2 liters per day) so you will pass more urine while you are receiving this medicine. This may help prevent bladder and kidney problems.

Missed dose—

This medicine needs to be given on a fixed schedule. If you miss a dose or forget to use your medicine, call your doctor or pharmacist for instructions.

Precautions While Using This Medicine:

It is very important that your doctor check your progress closely while receiving this medicine to make sure this medicine is working properly. Blood and urine tests will be needed to check for unwanted effects.

This medicine is used together with ifosfamide. Ifosfamide can harm your unborn baby while you are pregnant. It may also cause birth defects if the father is receiving it when his sexual partner becomes pregnant. Use an effective form of birth control during treatment with this medicine in combination with ifosfamide and for 6 months after the last dose. Male patients with female partners should use an effective form of birth control during treatment and for 3 months after the last dose. If you think you have become pregnant while receiving this medicine, tell your doctor right away.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. The most serious signs of this reaction are very fast or irregular breathing, gasping for breath, or fainting. Other signs may include changes in facial skin color, very fast but irregular heartbeat or pulse, hive-like swellings on the skin, and puffiness or swellings of the eyelids or around the eyes. If these side effects occur, get emergency help at once.

Serious skin reactions can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while you are receiving this medicine.

This medicine contains benzyl alcohol which may cause serious reactions to premature or low-birth weight infants. Talk to your doctor if you have concerns about this.

Make sure any doctor or dentist who treats you knows that you are receiving this medicine. It may affect the results of certain medical tests.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

Black, tarry stools

bleeding gums

bloating or swelling of the face, arms, hands, lower legs, or feet

blood in the urine or stools

chest pain

chills

cough

decreased urination

dizziness

dry mouth

fainting

fast, pounding, or irregular heartbeat or pulse

fever

increased thirst

lightheadedness

loss of appetite

mood changes

muscle pain or cramps

nausea

numbness or tingling in the hands, feet, or lips

painful or difficult urination

pinpoint red spots on the skin

rapid breathing

rapid weight gain

seizures

sore throat

sores, ulcers, or white spots on the lips or in the mouth

sunken eyes

swelling

swollen glands

tightness in the chest

trouble breathing

unusual bleeding or bruising

unusual tiredness or weakness

unusual weight gain or loss

vomiting

wrinkled skin

Less common

Blurred vision

confusion

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

sweating

Incidence not known

Coughing or spitting up blood

dark urine

general tiredness and weakness

headache

light-colored stools

nervousness

pounding in the ears

slow heartbeat

upper right abdominal or stomach pain

yellow eyes and skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Back pain

bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site

diarrhea

difficulty having a bowel movement

hair loss

increased sweating

lack or loss of strength

sleepiness or unusual drowsiness

stomach pain

trouble sleeping

weight loss

Less common

Belching

feeling of warmth

heartburn

indigestion

redness of the face, neck, arms, and occasionally, upper chest

stomach discomfort or upset

Incidence not known

Change or loss of taste

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.