Parenteral Manual

Mesna

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Alternate Name(s): 
SODIUM-2-MERCAPTOETHANE SULFONATE, UROMITEXAN
Classification: 
Uroprotector
Original Date: 
August 2005
Revised Date: 
December 2019
Indications: 
  • Used concurrently with oxazophosphorine antineoplastic agents (cyclophosphamide, ifosfamide) to prevent urinary tract toxicity (ie. hemorrhagic cystitis).
Reconstitution and Stability: 
  • Store at room temperature
  • Available as a 100 mg/mL solution, with or without preservative
  • WITH preservative: stable 48 hours refrigerated if diluted in D5W or NS
  • WITHOUT preservative (Uromexitan): stable 24 hours room temperature diluted in D5W, NS or combinations
Compatibility: 

- Solutions Compatible: D5W, NS and combinations

- Additive/Above Cassette Compatible: ifosfamide, cyclophosphamide

- Y-site Compatible: allopurinol, filgrastim, fludarabine, methotrexate, ondansetron, potassium chloride, sodium bicarbonate (diluted), TPN (amino acids/dextrose -non-acetate containing)

Incompatible: amphotericin B, cisplatin, carboplatin

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct YES
Usual dilution: 20 mg/mL
Infusion time: 2-5 minutes
IV Intermittent Infusion YES
Usual dilution: 1-20 mg/mL
Infusion time: 15 -30 minutes
IV Continuous Infusion YES, in sufficient volume to go over 24 hours

 

 

Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

  • Dose of mesna is expressed as a percentage of oxazophosphorine dose given: dosages range from 60 to 160% of the total oxazophosphorine dose
  • 25% of the total mesna dose is given concurrently with ifosfamide or cyclophosphamide and the remainder can be given as an infusion over 8-12 hours or a three bolus doses Q 3-4 H.

Note: For children < 12 kg, use preservative free mesna

Potential hazards of parenteral administration: 
  • Nausea, vomiting
  • Diarrhea, abdominal pain
  • Thrombophlebitis and irritation at injection site (rare)
  • Transient drop in blood pressure, pulse
  • Taste disturbances
Notes: 
  • May cause false positive reactions in tests for ketone bodies in urine
  • Oral mesna dose = double IV dose
References: 

1. Fresenius Kabi Canada Ltd. Product Monograph: Mesna for injection: Last revised: 30July2019. Accessed:    2Oct2019

2. Baxter Corporation. Product Monograph: Uromexitan. Last revised: 6Aug2013. Accessed: 2Oct2019

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