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Overview: Mesna is used to help prevent bladder irritation and bleeding caused by a cancer medicine (ifosfamide). Mesna helps protect the bladder from harmful substances that are made when the cancer medicine is broken down in the body. Common side effects of mesna may include nausea and vomiting, constipation, diarrhea, or tiredness. Serious side effects are rare but can include allergic reactions or severe skin reactions. Get emergency help if you have a skin rash, hives, or skin blistering or peeling.

Uses

What is mesna used for?

Mesna is commonly used to reduce the risk of bladder inflammation and bleeding (hemorrhagic cystitis) that can happen after using the chemotherapy medicine, ifosfamide.

Mesna may also be used for other conditions as determined by your health care provider.

How does mesna work (mechanism of action)?

Mesna works by neutralizing harmful substances in your bladder that are made when ifosfamide is broken down in the body. Mesna turns these into less toxic substances, which helps protect the bladder from damage.

How is mesna supplied (dosage forms)?

Brands and other names

  • Mesnex

Dosage forms and strengths

  • 400 mg oral tablets

Mesna is also available in an injectable form that is given by a health care provider.

How should I store mesna?

Oral Tablet. Mesna tablet should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Injection Liquid. Mesna injection is usually given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of mesna?

The most common side effects of mesna are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Nausea or vomiting
  • Constipation or diarrhea
  • Low red blood cell, white blood cell, and platelet levels
  • Tiredness or drowsiness
  • Fever
  • Loss of appetite or stomach pain  
  • Weakness
  • Headache
  • Hair loss

There may be other side effects of mesna that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of mesna?

While less common, the most serious side effects of mesna are described below, along with what to do if they happen.

Severe Allergic Reactions. Mesna may cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for drug reaction with eosinophilia and systemic symptoms. It is also sometimes called multiorgan hypersensitivity. This is a reaction that can affect multiple parts of the body, including your liver, kidneys, and heart. Stop using mesna and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Shortness of breath, trouble swallowing, or throat tightness
  • Swelling in your feet, ankles, or legs
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain
  • Dark-colored pee
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Severe Skin Reactions. Mesna can cause severe skin reactions, such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), that can lead to death if not treated. These can happen right after starting mesna or after using it for several months. If you get a rash, stop using mesna and call your health care provider right away. Get emergency help if you have any of the following symptoms of a severe skin reaction.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes
  • Flu-like symptoms, including fever, chills, and muscle aches

Warnings & Precautions

Who should not use mesna?

Allergies to Ingredients. People who are allergic to any of the following should not use mesna.

  • Benzyl alcohol
  • Mesna
  • Mesnex
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific mesna products they stock.

What should I know about mesna before using it?

Do not use mesna unless it has been prescribed to you by a health care provider. Use it as prescribed.

Do not share mesna with other people, even if they have the same condition as you. It may harm them.

Keep mesna out of the reach of children.

Your first dose of mesna will be injected into a vein (intravenous) by a health care provider at the same time as ifosfamide. Your second and third doses of mesna may also be injected into your vein or you may take tablets by mouth at certain times after receiving ifosfamide, depending on your treatment plan.

Drink 1-2 liters (4-8 cups) of fluids each day while you are using mesna.

Tell your health care provider if your pee is pink or red while using mesna. This may be a sign you have blood in your urine.

If you are able to get pregnant or get your partner pregnant, use effective birth control while using mesna. Talk to your health care provider about which methods to use and how long to use them after your last dose of mesna.

Mesna may cause false readings with certain lab tests. Tell all of your health care providers that you are using this medicine before any lab work.

Mesna injection may contain a preservative called benzyl alcohol. Benzyl alcohol should not be used in premature babies or low birth weight infants because it may cause serious side effects. Talk with your health care provider if you have concerns.

What should I tell my health care provider before using mesna?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if mesna is right for you.

In particular, make sure that you discuss any of the following.

Pregnancy. Mesna is usually used with ifosfamide and ifosfamide can cause harm to a fetus. You should not be pregnant before starting mesna. Tell your health care provider if you are pregnant or plan to become pregnant. If you become pregnant, contact your health care provider right away.

Breastfeeding. Do not breastfeed while you are using mesna and for 1 week after your last dose. Mesna is usually used with ifosfamide and ifosfamide can pass into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. 

Interactions

Does mesna interact with foods or drinks?

There are no known interactions between mesna and foods or drinks.

There are no known interactions between mesna and alcohol.

Does mesna interact with other medicines (drug interactions)?

There are no known interactions between mesna and other medicines. Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much mesna?

If you or someone else has used too much mesna, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of mesna?

Missing a dose of mesna or taking it at the wrong time can cause it to not work as well. If you miss a dose, call your health care provider right away. 

If you vomit within 2 hours of taking mesna tablets, ask your health care provider if you need to take another dose or if you should get a mesna injection.