Mesna
About Mesna
Mesna is an oral prescription medicine used to protect the bladder from irritation and bleeding during chemotherapy treatments, specifically with medicines like ifosfamide. Chemotherapy drugs can break down into harmful substances in your urine, and Mesna works directly in your bladder to neutralise these toxins before they cause damage.
Because this medicine must be in your system at the exact time chemotherapy toxins reach your bladder, you must take it precisely on the schedule your doctor provides, even if you feel well. You can take these tablets with or without food, but drinking large amounts of water throughout the day is crucial to help flush your bladder. Increasing your fluid intake is one of the most important lifestyle habits to support this treatment.
While Mesna is highly effective at protecting your bladder, some people may experience common side effects such as nausea, vomiting, diarrhoea, or a temporary change in taste. You should consult your doctor immediately if you notice signs of an allergic reaction, severe stomach pain, or blood in your urine.
Do not take this if you have had a severe allergic reaction to Mesna or other thiol compounds in the past. Talk to your doctor before starting this medicine if you have autoimmune diseases like rheumatoid arthritis or lupus, as these conditions may increase your risk of skin reactions.
This medicine may interact with certain laboratory urine tests, causing false results, so let your healthcare team know you are taking it. If you are pregnant, planning to become pregnant, breastfeeding, or are an older adult, discuss the risks and benefits with your doctor to ensure this treatment is safe for you
Uses of Mesna
Medicinal Benefits
Mesna helps protect your bladder from the harmful effects of certain chemotherapy medicines, making cancer treatment safer and more comfortable.
Benefits may include:
- Helps prevent painful urination, bladder spasms, and bleeding in the urinary tract caused by certain chemotherapy medicines.
- Protects the bladder, helping you stay on schedule with your cancer treatment and reducing the chance of treatment delays due to bladder complications.
- Available as an oral tablet, allowing you to continue bladder protection at home and reducing the need for prolonged hospital stays or additional intravenous treatments.
Directions for Use
- Swallow the tablet whole with a full glass of water. Do not crush, chew, or break the tablet, as it has a very strong, unpleasant taste and a protective coating.
- Take each dose exactly at the times prescribed by your healthcare team. The timing of Mesna is highly critical; it is typically taken at specific hour intervals (such as 2 and 6 hours) after your chemotherapy dose.
- If you vomit within two hours of taking your dose, contact your doctor or nurse immediately, as you may need to take another dose or receive the medicine through an injection.
- Always follow your doctor's exact instructions regarding timing and fluid intake.
Storage
Side Effects of Mesna
Common Side Effects (Usually mild):
- Nausea and vomiting
- Diarrhoea or upset stomach
- Temporary unpleasant taste in the mouth
- Headache or feeling unusually tired
- Limb or joint pain
Serious Side Effects (Call a doctor right away):
- Signs of an allergic reaction, including hives, itching, or swelling of the face, lips, or throat
- Severe skin rash, peeling, or blistering
- Blood in your urine or pink/red-colored urine
- Chest pain or rapid heart rate
- Severe dizziness or shortness of breath
Medicines Containing this Salt
View AllDrug Warnings
- Check your urine colour: Monitor your urine closely. If it looks pink, red, or dark, or if you see visible blood clots, contact your healthcare provider immediately.
- Stick to the clock: Set alarms on your phone or use a timer to ensure you take each dose at the exact hours recommended after your chemotherapy.
- Inform laboratory staff: Tell any technician drawing blood or testing your urine that you are taking Mesna, as it can cause false-positive results on urine ketone tests.
- Watch for skin reactions: Rare but serious skin reactions can occur. Inspect your skin daily for new rashes, hives, or peeling, and report changes to your doctor right away.
- Keep a dosing log: Write down the exact times you take your chemotherapy and your Mesna doses to share with your oncology team at your next visit.
Drug Interactions
- While Mesna does not have many common direct drug-drug interactions, it is designed to be taken alongside specific chemotherapy drugs like ifosfamide. Always provide your doctor with a complete list of all prescription medicines, over-the-counter drugs, vitamins, and herbal supplements you are taking.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
cautionMesna if taken along with alcohol may increase drowsiness, so it should not be taken along with alcohol.
Pregnancy
cautionMesna is a category B pregnancy medicines. It has not shown any harm to the baby but should only be taken if a doctor prescribes you.
Breast Feeding
unsafeMesna should not be taken if you are breastfeeding as it is known to pass through the breast milk and harm the baby. Maintain a gap of 1 week after stopping Mesna before breastfeeding.
Driving
unsafeMesna is known to cause blurred vision and drowsiness. So, do not drive or operate machinery which requires concentration.
Liver
cautionLet your doctor know if you have any history of liver diseases before receiving Mesna. Your doctor will weigh the benefits and any potential risks before administering it to you.
Kidney
cautionLet your doctor know if you have any history of kidney diseases before using Mesna. Your doctor will weigh the benefits and any potential risks before prescribing it to you.
Children
cautionThe safety and efficacy of Mesna have not been established in children. Moreover, Mesna contains benzyl alcohol, which is known to cause a gasping syndrome in children.
Habit Forming
Diet & Lifestyle Advise
- Drink plenty of fluids: Aim to drink at least 1 to 2 litres (about 4 to 8 large glasses) of water or clear fluids every day during your treatment. Proper hydration dilutes your urine and helps Mesna flush toxins out of your bladder quickly.
- Avoid bladder irritants: Limit your intake of caffeine, alcohol, and highly acidic drinks (like grapefruit or orange juice) while taking this medicine, as they can further irritate an already sensitive bladder lining.
- Empty your bladder frequently: Do not hold your urine. Urinate as soon as you feel the urge, especially before going to bed and during the night, to prevent chemotherapy toxins from sitting in your bladder for long periods.
- Eat small, frequent meals: If you experience nausea from your chemotherapy or Mesna, eating small, bland meals throughout the day (such as crackers, toast, or rice) can help keep your stomach settled.
Special Advise
- Regular blood and urine test are required while you are taking Mesna.
- Mesna may interfere with enzymatic creatinine phosphokinase (CPK) activity tests that use a thiol compound (N-acetylcysteine) for CPK reactivation. This may result in a falsely low CPK level. Inform your doctor about the use of Mesna.
- Mesna may interfere with a certain laboratory test (for urinary ketones), possibly causing false test results. Make sure laboratory personnel, and all your doctors know you use this drug.
Patients Concern
Disease/Condition Glossary
Ifosfamide-induced Hemorrhagic cystitis: It is a condition that causes bleeding in the urine due to the effect of anticancer agents (Ifosfamide). It occurs when an individual undergoes planned chemotherapy (for cancer treatment). During chemotherapy, an anticancer medication called 'ifosfamide' causes inflammation and bleeding of the bladder, which is passed into the urine. The colour of urine may vary from pink to red in colour.
FAQs
Mesna is used to prevent Hemorrhagic cystitis (a condition that causes bleeding in the urine due to the effect of anticancer agents (Ifosfamide). It reduces the risk of inflammation and bleeding in the bladder due to other anti-cancer medications.
Our body breaks down the anticancer agent like ifosfamide or cyclophosphamide to form a chemical known as acrolein, that can harm and irritate the bladder. Mesna works by making this natural chemical less harmful or toxic. However, Mesna does not change ifosfamide's anti-cancer effects.
No, Mesna should not be taken along with anti-coagulant like warfarin, heparin or coumarin as it might increase the risk of bleeding and lead to serious complications.
An autoimmune disorder is a condition in which the immune system attacks healthy parts of the body and causes pain, swelling, and damage. Some of the autoimmune disorders are rheumatoid arthritis, systemic lupus erythematosus or nephritis.
If you observe any change in the urine colour (like if you have red/pink-coloured urine), please inform your doctor.
In addition to the bladder bleeding in hemorrhagic cystitis, an individual might also experience bladder wall scarring, decreased size (atrophy) of the bladder, and severe systemic infection (urosepsis) and urinary obstruction.
No, Mesna is not a chemotherapy or cytotoxic drug.
Use of Mesna in patients with used in patients with overactive immune system (rheumatoid arthritis, lupus, nephritis) may increase your risk for a Mesna allergy.
Gasping syndrome is a life-threatening condition in neonates characterised by multi-system failure and death following the administration of benzyl alcohol. Consult your doctor for further advice.
Yes, you can take Mesna with or without food. However, it is important to stay highly consistent and follow any specific instructions given by your healthcare team. If you experience nausea, taking it with a small, light meal may help. Talk to your doctor if you struggle to keep the medication down.
If you vomit within 2 hours of taking your oral dose, your body may not have absorbed the medicine fully. Contact your oncology nurse or doctor immediately. They will advise you on whether to take another dose or receive an intravenous alternative.
It is best to avoid alcohol while taking Mesna and undergoing chemotherapy. Alcohol can dehydrate your body, which makes it harder to flush chemotherapy toxins out of your bladder, and it can worsen side effects like nausea and headaches. Talk to your doctor for personalised advice.
Mesna needs to be in your bladder at the exact same time the toxic byproducts of your chemotherapy are filtering through. If you take it too early or too late, your bladder lining will not be protected, which increases the risk of bleeding. If you miss a scheduled time, talk to your doctor immediately.
You should drink at least 1 to 2 litres of fluid daily during your treatment unless your doctor advises otherwise. This constant flow of fluids helps dilute the chemotherapy toxins and ensures the protective medicine works effectively. Talk to your doctor to find out the exact fluid target for your body.
No, Mesna does not treat cancer itself, and it does not affect how well your chemotherapy works against cancer cells. Its sole job is supportive care, specifically protecting your bladder from the harsh side effects of your chemotherapy drugs. Talk to your doctor if you have questions about your overall cancer treatment.
Yes, Mesna can interfere with urine dipstick tests, particularly those testing for ketones. It can cause a false-positive result or make the reading unclear. Always inform your laboratory technicians and doctors that you are taking this medicine before any tests.
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