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Mesna

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Overview

What is Mesna?

Mesna injection is a detoxifying agent to inhibit the hemorrhagic cystitis induced by ifosfamide. The active ingredient, mesna, is a synthetic sulfhydryl compound designated as sodium-2-mercaptoethane sulfonate with a molecular formula of CHNaOS and a molecular weight of 164.18. Its structural formula is as follows:

HS—CH—CHSO—Na

Mesna Injection is a sterile, nonpyrogenic, aqueous solution of clear and colorless appearance in clear glass multidose vials for intravenous administration. Mesna Injection contains 100 mg/mL mesna, 0.25 mg/mL edetate disodium and sodium hydroxide for pH adjustment. Mesna Injection multidose vials also contain 10.4 mg/mL of benzyl alcohol as a preservative. The solution has a pH range of between 7.5 and 8.5.



What does Mesna look like?



What are the available doses of Mesna?

•  Mesna Injection: 1 g (100 mg/mL) Multi-Dose vials (3)

What should I talk to my health care provider before I take Mesna?

•  Pregnancy: Use only if clearly needed. (8.1)•  Nursing mothers: Women should not breastfeed during therapy. (8.3)•  Geriatric use: Dose selection should be cautious. (8.5)

How should I use Mesna?

Mesna Injection is indicated as a prophylactic agent in reducing the incidence of ifosfamide-induced hemorrhagic cystitis.

Limitation of Use

Mesna injection may be given on a fractionated dosing schedule of three bolus intravenous injections as outlined below.

Mesna injection is given as intravenous bolus injections in a dosage equal to 20% of the ifosfamide dosage weight by weight (w/w) at the time of ifosfamide administration and 4 and 8 hours after each dose of ifosfamide. The total daily dose of mesna injection is 60% of the ifosfamide dose. The recommended dosing schedule is outlined below in Table 1.

T

able 1.  Recommended Intravenous Dosing Schedule

1


What interacts with Mesna?

Sorry No Records found


What are the warnings of Mesna?

Sorry No Records found


What are the precautions of Mesna?

Sorry No Records found


What are the side effects of Mesna?

Sorry No records found


What should I look out for while using Mesna?

Mesna injection is contraindicated in patients known to be hypersensitive to mesna or to any of the excipients


What might happen if I take too much Mesna?

There is no known antidote for mesna injection.

In a clinical trial, 11 patients received intravenous mesna injection 10 mg/kg to 66 mg/kg per day for 3 to 5 days. Patients also received ifosfamide or cyclophosphamide. Adverse reactions included nausea, vomiting, diarrhea and fever. An increased rate of these adverse reactions has also been found in oxazaphosphorine-treated patients receiving ≥80 mg mesna injection per kg per day intravenously compared with patients receiving lower doses or hydration treatment only.

Postmarketing, administration of 4.5 g to 6.9 g of mesna resulted in hypersensitivity reactions including mild hypotension, shortness of breath, asthma exacerbation, rash, and flushing.


How should I store and handle Mesna?

Store at 20º to 25ºC (68º to 77ºF); excursions permitted to 15º to 30ºC (59º to 86ºF) [see USP Controlled Room Temperature].Mesna Injection is supplied as follows: NDC 47781-622-22 10 mL multidose vial; 1 vial per carton NDC 47781-622-91 10 mL multidose vial; 10 vials per cartonMesna Injection is supplied as follows: NDC 47781-622-22 10 mL multidose vial; 1 vial per carton NDC 47781-622-91 10 mL multidose vial; 10 vials per carton


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Clinical Information

Chemical Structure

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Clinical Pharmacology

Mesna reacts chemically with the urotoxic ifosfamide metabolites, acrolein and 4-hydroxy-ifosfamide, resulting in their detoxification. The first step in the detoxification process is the binding of mesna to 4-hydroxy­ ifosfamide forming a non-urotoxic 4-sulfoethylthioifosfamide. Mesna also binds to the double bonds of acrolein and to other urotoxic metabolites and inhibits their effects on the bladder.

Non-Clinical Toxicology
Mesna injection is contraindicated in patients known to be hypersensitive to mesna or to any of the excipients

Mesna may cause systemic hypersensitivity reactions, including anaphylaxis. These reactions may include fever, cardiovascular symptoms (hypotension, tachycardia), acute renal impairment, hypoxia, respiratory distress, urticaria, angioedema, laboratory signs of disseminated intravascular coagulation, hematological abnormalities, increased liver enzymes, nausea, vomiting, arthralgia, and myalgia. These reactions may occur with the first exposure or after several months of exposure. Monitor for signs or symptoms. Discontinue mesna and provide supportive care.

The following are discussed in more detail in other sections of the labeling.

        • Hypersensitivity Reactions         • Dermatological Toxicity         • Benzyl Alcohol Toxicity         • Laboratory Test Interferences         • Use in Patients with a History of Adverse Reactions to Thiol Compounds

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Reference

This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"

While we update our database periodically, we cannot guarantee it is always updated to the latest version.

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Professional

Clonazepam Description Each single-scored tablet, for oral administration, contains 0.5 mg, 1 mg, or 2 mg Clonazepam, USP, a benzodiazepine. Each tablet also contains corn starch, lactose monohydrate, magnesium stearate, microcrystalline cellulose, and povidone. Clonazepam tablets USP 0.5 mg contain Yellow D&C No. 10 Aluminum Lake. Clonazepam tablets USP 1 mg contain Yellow D&C No. 10 Aluminum Lake, as well as FD&C Blue No. 1 Aluminum Lake. Chemically, Clonazepam, USP is 5-(o-chlorophenyl)-1,3-dihydro-7-nitro-2H-1,4-benzodiazepin-2-one. It is a light yellow crystalline powder. It has the following structural formula: C15H10ClN3O3 M.W. 315.72
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Tips

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Interactions

Interactions

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