Mesnex (mesna) is indicated as a prophylactic agent in reducing the incidence of ifosfamide-induced hemorrhagic cystitis.

For the prophylaxis of ifosfamide induced hemorrhagic cystitis, Mesnex (mesna) may be given on a fractionated dosing schedule of three bolus intravenous injections or a single bolus injection followed by two oral administrations of Mesnex (mesna) Tablets as outlined below.

Intravenous Schedule

Mesnex (mesna) is given as intravenous bolus injections in a dosage equal to 20% of the ifosfamide dosage (w/w) at the time of ifosfamide administration and 4 and 8 hours after each dose of ifosfamide. The total daily dose of mesna is 60% of the ifosfamide dose.

The recommended dosing schedule is outlined below:

Intravenous and Oral Dosing

Mesnex (mesna) Injection is given as intravenous bolus injections in a dosage equal to 20% of the ifosfamide dosage (w/w) at the time of ifosfamide administration. Mesnex (mesna) Tablets are given orally in a dosage equal to 40% of the ifosfamide dose 2 and 6 hours after each dose of ifosfamide. The total daily dose of mesna is 100% of the ifosfamide dose.

The recommended dosing schedule is outlined below:

Patients who vomit within two hours of taking oral mesna should repeat the dose or receive intravenous mesna. The efficacy and safety of this ratio of IV and PO mesna has not been established as being effective for daily doses of IFEX® higher than 2.0 g/m².

The dosing schedule should be repeated on each day that ifosfamide is administered. When the dosage of ifos-famide is adjusted (either increased or decreased), the ratio of Mesnex (mesna) to IFEX should be maintained.

Preparation of Intravenous Solutions/Stability

The Mesnex (mesna) multidose vials may be stored and used for up to 8 days.

For IV administration the drug can be diluted by adding the Mesnex (mesna) Injection solution to any of the following fluids obtaining final concentrations of 20 mg mesna/mL: 5% Dextrose Injection, USP

5% Dextrose and 0.2% Sodium Chloride Injection, USP
5% Dextrose and 0.33% Sodium Chloride Injection, USP
5% Dextrose and 0.45% Sodium Chloride Injection, USP
0.92% Sodium Chloride Injection, USP
Lactated Ringer's Injection, USP

For example:

One mL of Mesnex (mesna) Injection multidose vial 100 mg/mL may be added to 4 mL of any of the solutions listed above to create a final concentration of 20 mg mesna/mL.

Diluted solutions are chemically and physically stable for 24 hours at 25° C (77° F).

Mesna is not compatible with cisplatin or carboplatin.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration.

Mesnex® (mesna) Injection 100 mg/mL

NDC 0015-3563-02 - 1 g Multidose Vial, Box of 1 vial of 10 mL

NDC 0015-3563-03 - 1 g Multidose Vial, Box of 10 vials of 10 mL

Mesnex® (mesna) Tablets

NDC 0015-3565-12 - 400 mg scored tablets, Boxes containing 10 blisters per card Store at controlled room temperature 20° C to 25° C (68° F to 77° F).

Distributed by: Bristol-Myers Squibb Company Princeton, New Jersey 08543 USA. Mesnex® (mesna) Tablets manufactured for: Baxter Healthcare Corporation, Deerfield, IL 60015 USA. Issued May 2002. FDA rev date: 1/30/2003

Last reviewed on RxList: 10/8/2008
This monograph has been modified to include the generic and brand name in many instances.