Mesna Disulfide is indicated for the prevention of ifosfamide-induced hemorrhagic cystitis in patients receiving ifosfamide chemotherapy.

Cystitis

• A sufficient amount of mesna must be administered to adequately shield the patient from the urotoxic effects of the oxazaphosphorine.
• The duration of mesna treatment should match that of the oxazaphosphorine treatment, plus the time required for the urinary concentration of oxazaphosphorine metabolites to decrease to non-toxic levels. Typically, this occurs within 8-12 hours after concluding oxazaphosphorine treatment, though the timing may vary based on the oxazaphosphorine schedule. To ensure proper renal function, maintain urinary output at 100 ml/hr, as necessary for oxazaphosphorine treatment, and monitor urine for haematuria and proteinuria throughout the treatment period.
• Before administration, visually inspect parenteral drug products for particulate matter and discoloration.
• Do not use solutions that appear discolored, hazy, or contain visible particulate matter.
• For intravenous bolus administration of ifosfamide or cyclophosphamide: Mesna is administered via intravenous injection over 15-30 minutes at 20% of the simultaneously administered oxazaphosphorine on a weight-for-weight basis (w/w). Repeat the same mesna dose after 4 and 8 hours. The total mesna dose is 60% (w/w) of the oxazaphosphorine dose, and this regimen is repeated each time cytotoxic agents are used.

Adverse reactions associated with MESNA are listed from most common to least common:

• Nausea
• Vomiting
• Hematuria
• Diarrhea
• Rash
• Headache
• Fever
• Abdominal pain
• Anaphylaxis (rare)

Nausea

Vomiting

Hematuria

Rash

• Hypersensitivity Reactions: Monitor for signs of hypersensitivity reactions, including anaphylaxis. Discontinue Mesna Disulfide if severe hypersensitivity occurs.
• Fluid Status: Adequate hydration is crucial during chemotherapy to maintain urine flow and reduce the risk of urotoxicity.
• Renal Function: Monitor renal function regularly, especially in patients with pre-existing renal impairment.
• Concurrent Medications: Be cautious when administering Mesna Disulfide with other medications, as interactions may occur.
• Pregnancy and Lactation: Use Mesna Disulfide during pregnancy only if the potential benefit justifies the potential risk to the fetus. Exercise caution when breastfeeding.