Drug reference

Mesna

Antidote · Uroprotective agent

Also known as 2-mercaptoethanesulfonate, MESNEX

AntidoteUroprotective agent

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

—

none in our sources

PREGNANCY

—

not curated

Mechanism

Mesna reacts specifically with acrolein, a urotoxic metabolite of oxazaphosphorine chemotherapeutic agents like cyclophosphamide and ifosfamide. It conjugates acrolein in the urinary tract, thereby scavenging the vasicotoxic reactive metabolites and preventing urothelial toxicity.

Indications

Prevention of hemorrhagic cystitis in patients receiving ifosfamide (preferably by mouth)Prevention of hemorrhagic cystitis in patients receiving high-dose intravenous cyclophosphamide (e.g., more than 2 g)Prevention of hemorrhagic cystitis in patients who previously experienced urothelial toxicity with cyclophosphamide

Dosing

Adult: The dose of calcium levofolinate is generally half that of calcium folinate. The disodium salts of folinic acid and levofolinic acid are also used for rescue therapy following methotrexate therapy, and for use with ﬂuorouracil for colorectal cancer.…