Medical Editor: John P. Cunha, DO, FACOEP
Mesnex (mesna) is a detoxifying agent used to prevent bleeding in the bladder (hemorrhagic cystitis) during chemotherapy with ifosfamide (Ifex). Some forms of Mesnex are available in generic form. Common side effects of Mesnex include:
- stomach pain,
- loss of appetite,
- sensitive skin,
- skin rash,
- flu or cold symptoms (e.g., sore throat, fever, chills, shivering, cough, body aches),
- pale skin,
- injection site reactions (pain, redness, or irritation),
- swelling or water retention, or
- low blood pressure.
Tell your doctor if you have unlikely but serious side effects of Mesnex including:
- chest pain,
- fast heartbeat,
- swelling ankles or feet, or
- muscle weakness.
The dose of Mesnex is determined by the dose of ifosfamide being given. It is unknown if other medicines will interact with Mesnex. Tell your doctor all prescription or over-the-counter medicines and supplements you use. During pregnancy, Mesnex should be used only when prescribed. It is unknown if this drug passes into breast milk. Since this medication is given with a cancer chemotherapy drug, breastfeeding while using Mesnex is not recommended. Consult your doctor before breastfeeding.
Our Mesnex (mesna) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Seek emergency medical attention or contact your healthcare provider immediately if you experience any of the following serious side effects:
- an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); or
- pink or red colored urine.
Other less serious side effects may be more likely to occur. Continue to take mesna, and contact your doctor if you experience any of the following side effects:
- nausea or vomiting;
- decreased appetite;
- stomach pain;
- sensitive skin or skin rash;
- paleness of the skin;
- coughing or cold symptoms;
- pain, redness, or irritation at the injection site;
- swelling or water retention; or
- low blood pressure.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.
Read the entire detailed patient monograph for Mesnex (Mesna)
The following are discussed in more detail in other sections of the labeling.
- Hypersensitivity Reactions [see WARNINGS AND PRECAUTIONS
- Dermatological Toxicity [see WARNINGS AND PRECAUTIONS]
- Benzyl Alcohol Toxicity[see WARNINGS AND PRECAUTIONS]
- Laboratory Test Interferences [see WARNINGS AND PRECAUTIONS]
- Use in Patients with a History of Adverse Reactions to Thiol Compounds [see WARNINGS AND PRECAUTIONS]
Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
MESNEX adverse reaction data are available from four Phase 1 studies in which single intravenous doses of 600-1200 mg MESNEX Injection without concurrent chemotherapy were administered to a total of 53 healthy volunteers and single oral doses of 600-2400 mg of MESNEX Tablets were administered to a total of 82 healthy volunteers. The most frequently reported side effects (observed in two or more healthy volunteers) for healthy volunteers receiving single doses of MESNEX Injection alone were headache, injection site reactions, flushing, dizziness, nausea, vomiting, somnolence, diarrhea, anorexia, fever, pharyngitis, hyperesthesia, influenza-like symptoms, and coughing. In two Phase 1 multiple-dose studies where healthy volunteers received MESNEX Tablets alone or intravenous MESNEX followed by repeated doses of MESNEX Tablets, flatulence and rhinitis were reported. In addition, constipation was reported by healthy volunteers who had received repeated doses of intravenous MESNEX.
Additional adverse reactions in healthy volunteers receiving MESNEX alone included injection site reactions, abdominal pain/colic, epigastric pain/burning, mucosal irritation, lightheadedness, back pain, arthralgia, myalgia, conjunctivitis, nasal congestion, rigors, paresthesia, photophobia, fatigue, lymphadenopathy, extremity pain, malaise, chest pain, dysuria, pleuritic pain, dry mouth, dyspnea, and hyperhidrosis. In healthy volunteers, MESNEX was commonly associated with a rapid (within 24 hours) decrease in lymphocyte count, which was generally reversible within one week of administration.
Because MESNEX is used in combination with ifosfamide or ifosfamide-containing chemotherapy regimens, it is difficult to distinguish the adverse reactions which may be due to MESNEX from those caused by the concomitantly administered cytotoxic agents.
Adverse reactions reasonably associated with MESNEX administered intravenously and orally in four controlled studies in which patients received ifosfamide or ifosfamide-containing regimens are presented in Table 3.
Table 3: Adverse Reactions in ≥ 5% of
Patients Receiving MESNEX in combination with Ifosfamide-containing Regimens
|N exposed||119 (100.0%)||119 (100%)|
|Incidence of AEs||101 (84.9%)||106 (89.1%)|
|Nausea||65 (54.6)||64 (53.8)|
|Vomiting||35 (29.4)||45 (37.8)|
|Constipation||28 (23.5)||21 (17.6)|
|Leukopenia||25 (21.0)||21 (17.6)|
|Fatigue||24 (20.2)||24 (20.2)|
|Fever||24 (20.2)||18 (15.1)|
|Anorexia||21 (17.6)||19 (16.0)|
|Thrombocytop eni a||21 (17.6)||16 (13.4)|
|Anemia||20 (16.8)||21 (17.6)|
|Granul ocytopenia||16 (13.4)||15 (12.6)|
|Asthenia||15 (12.6)||21 (17.6)|
|Abdominal Pain||14 (11.8)||18 (15.1)|
|Alopecia||12 (10.1)||13 (10.9)|
|Dyspnea||11 (9.2)||11 (9.2)|
|Chest Pain||10 (8.4)||11 (9.2)|
|Hypokalemia||10 (8.4)||11 (9.2)|
|Diarrhea||9 (7.6)||17 (14.3)|
|Dizziness||9 (7.6)||5 (4.2)|
|Headache||9 (7.6)||13 (10.9)|
|Pain||9 (7.6)||10 (8.4)|
|Sweating Increased||9 (7.6)||2 (1.7)|
|Back Pain||8 (6.7)||6 (5.0)|
|Hematuria||8 (6.7)||7 (5.9)|
|Injection Site Reaction||8 (6.7)||10 (8.4)|
|Edema||8 (6.7)||9 (7.6)|
|Edema Peripheral||8 (6.7)||8 (6.7)|
|Somnolence||8 (6.7)||12 (10.1)|
|Anxiety||7 (5.9)||4 (3.4)|
|Confusion||7 (5.9)||6 (5.0)|
|Face Edema||6 (5.0)||5 (4.2)|
|Insomnia||6 (5.0)||11 (9.2)|
|Coughing||5 (4.2)||10 (8.4)|
|Dyspepsia||4 (3.4)||6 (5.0)|
|Hypotension||4 (3.4)||6 (5.0)|
|Pallor||4 (3.4)||6 (5.0)|
|Dehydration||3 (2.5)||7 (5.9)|
|Pneumonia||2 (1.7)||8 (6.7)|
|Tachycardia||1 (0.8)||7 (5.9)|
|Flushing||1 (0.8)||6 (5.0)|
|1Intravenous dosing of ifosfamide and MESNEX followed by either intravenous or oral doses of MESNEX according to the applicable dosage schedule. [see DOSAGE AND ADMINISTRATION].|
The following adverse reactions have been reported in the postmarketing experience of patients receiving MESNEX in combination with ifosfamide or similar drugs, making it difficult to distinguish the adverse reactions which may be due to MESNEX from those caused by the concomitantly administered cytotoxic agents. Because these reactions are reported from a population of unknown size, precise estimates of frequency cannot be made.
Nervous System: Convulsion
Read the entire FDA prescribing information for Mesnex (Mesna)
© Mesnex Patient Information is supplied by Cerner Multum, Inc. and Mesnex Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.