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mesna; 2-mercaptoethane sulfonate; 2-sulfanylethanesulfonic acid (Mesnex, Uromitexan, Mistabronco)

main ingredient is 2-mercaptoethanesulfonate. Tradename: Mesnex Indications: - uroprotective agent used to decrease the incidence of hemorrhagic cystitis in patients receiving cyclophosphamide or ifosfamide Contraindications: * incompatible with cisplatin Dosage: - mesna is used in combination with cyclophosphamide & ifosfamide - 60% of ifosfamide or cyclophosphamide dose 1] 20% before 20% 4 hours after 20% 8 hours after ifosfamide or cyclophosphamide dose, or 2] equal to ifosfamide or cyclophosphamide dose, delivered continuously 3] dose just prior to chemotherapy should be IV 4] 4 & 8 hours doses may be oral or IV 5] oral doses should be mixed in tomato juice, orange juice, or a carbonated drink Injection: 100 mg/mL (2 mL, 4 mL, 10 mL). Storage: Diluted solutions are stable for 24 hours at room temerature, but recommendations are for refrigeration & use within 6 hours. Pharmacokinetics: 1) rapidly oxidized in blood to dimesna which is eliminated in the urine 2) dimesna is reabsorbed by the kidney & converted to mesna 3) 50% is absorbed orally 4) elimination 1/2life is 1 hour Adverse effects: 1) not common (1-10%) - hypotension, malaise, headache, diarrhea, nausea/vomiting (mild), taste disturbance, limb pain, soft stools 2) uncommon (< 1%) - rash, itching Drug interactions: - mesna inhibits anti-neoplastic effects of cisplatin & carboplatin Test interactions: false positive urine ketone test Mechanism of action: 1) sulfhydryl compound that binds to irritating metabolites of ifosfamide & cyclophosphamide producing a non-toxic thiol ether 2) slows the rate of acrolein formation

Related

cyclophosphamide (Cytoxan, Neosar, Procytox {Canadian}) [CPM, CTX, CYT, NSC 26271] ifosfamide (Ifex, Friedman acid)

General

antidote thiol; sulhydryl compound; mercaptan

Properties

MISC-INFO: elimination route URINE 1/2life 1 HOUR

Database Correlations

PUBCHEM correlations

References

  1. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  2. Kaiser Permanente Northern California Regional Drug Formulary, 1998

Component-of

ifosfamide/mesna