Uromitexan
Generic Name
Mesna
Manufacturer
Baxter
Country
Germany (original), various
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| uromitexan 400 mg injection | ৳ 215.61 | N/A |
Description
Overview of the medicine
Mesna is a detoxifying agent used to prevent hemorrhagic cystitis, a side effect of oxazaphosphorine chemotherapy (e.g., ifosfamide, cyclophosphamide). It works by detoxifying the urotoxic metabolites in the urinary tract.
Uses & Indications
Dosage
Adults
Typically administered at 20% of the ifosfamide/cyclophosphamide dose (on a mg/mg basis) at 0, 4, and 8 hours after chemotherapy start, or as a continuous infusion equivalent to 60% of the chemotherapy dose over 24 hours. Dosage is individualized.
Elderly
No specific dose adjustments needed for elderly patients, use with caution considering overall health and renal function.
Renal_impairment
No specific dose adjustments provided, but caution is advised. Closely monitor for efficacy and toxicity.
How to Take
Administered intravenously as a bolus injection or continuous infusion. Can be diluted in 5% Dextrose in Water or 0.9% Sodium Chloride injection. Always given with oxazaphosphorine chemotherapy.
Mechanism of Action
Mesna contains a free sulfhydryl group that reacts with and inactivates urotoxic metabolites, primarily acrolein, in the urinary tract. Acrolein is a metabolite of ifosfamide and cyclophosphamide responsible for bladder toxicity.
Pharmacokinetics
Onset
Rapid onset after intravenous administration (within minutes).
Excretion
Primarily renal excretion as mesna and dimesna.
Half life
Mesna: approximately 0.36 hours; Dimesna (mesna disulfide): approximately 1.17 hours.
Absorption
Administered intravenously, mesna is rapidly absorbed into the plasma. Oral bioavailability is poor.
Metabolism
Rapidly oxidized to dimesna (mesna disulfide), which is then reduced back to mesna. Minor metabolism through sulfhydryl-alkylation.
Side Effects
Contraindications
- Hypersensitivity to mesna or any thiol-containing compounds.
- Known allergic reactions to mesna.
Drug Interactions
Cisplatin
Mesna may theoretically reduce the efficacy of cisplatin if directly mixed or given concomitantly, though clinical significance is unclear. Administer separately if possible.
Storage
Store below 25°C or at room temperature (15-30°C). Protect from light. Do not freeze. Diluted solutions should be used within 24 hours.
Overdose
There is no specific antidote for mesna overdose. Management is supportive and symptomatic. Hemodialysis may be considered in severe cases.
Pregnancy & Lactation
Pregnancy Category B. Use only if clearly needed and the potential benefit outweighs the potential risk to the fetus. It is unknown if Mesna is excreted in human milk; caution advised during lactation.
Side Effects
Contraindications
- Hypersensitivity to mesna or any thiol-containing compounds.
- Known allergic reactions to mesna.
Drug Interactions
Cisplatin
Mesna may theoretically reduce the efficacy of cisplatin if directly mixed or given concomitantly, though clinical significance is unclear. Administer separately if possible.
Storage
Store below 25°C or at room temperature (15-30°C). Protect from light. Do not freeze. Diluted solutions should be used within 24 hours.
Overdose
There is no specific antidote for mesna overdose. Management is supportive and symptomatic. Hemodialysis may be considered in severe cases.
Pregnancy & Lactation
Pregnancy Category B. Use only if clearly needed and the potential benefit outweighs the potential risk to the fetus. It is unknown if Mesna is excreted in human milk; caution advised during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years, check manufacturer's label for exact expiry.
Availability
Available in hospitals and specialized pharmacies
Approval Status
Approved by major regulatory bodies globally
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of Mesna in preventing ifosfamide- and high-dose cyclophosphamide-induced hemorrhagic cystitis.
Lab Monitoring
- Urinalysis for hematuria (blood in urine).
- Renal function tests (due to chemotherapy).
- Liver function tests (due to chemotherapy).
Doctor Notes
- Mesna should always be given with ifosfamide and high-dose cyclophosphamide to prevent urotoxicity.
- Ensure proper hydration alongside Mesna administration.
- Monitor urinalysis for hematuria during and after chemotherapy.
Patient Guidelines
- Report any signs of blood in urine or painful urination immediately.
- Maintain adequate hydration as advised by your doctor.
- Understand that Mesna is given to protect your bladder from chemotherapy side effects, not to treat cancer.
Missed Dose Advice
As Mesna is usually administered in a clinical setting with chemotherapy, a missed dose should be immediately reported to the healthcare provider for prompt administration.
Driving Precautions
Mesna may cause dizziness or fatigue. Patients should avoid driving or operating heavy machinery if they experience these side effects.
Lifestyle Advice
- Maintain good hydration throughout the chemotherapy course as it helps in flushing out toxic metabolites.
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