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Last reviewed on RxList: 1/4/2019
Mesnex Side Effects Center

Last reviewed on RxList 01/04/2019

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:

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.


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Mesnex Consumer Information

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Get emergency medical help if you have signs of an allergic reaction or severe skin reaction:

  • fever, nausea, vomiting, joint or muscle pain;
  • hives, rash or redness, skin pain or swelling, blisters or peeling;
  • feeling light-headed, trouble breathing;
  • racing heartbeats; or
  • mouth sores, or swelling in your face or throat.

Call your doctor at once if you have:

  • chest pain, trouble breathing;
  • easy bruising or bleeding (nosebleeds, bleeding gums);
  • low red blood cells (anemia)--pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet; or
  • low potassium level--leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling.

Common side effects may include:

  • nausea, vomiting, stomach pain, loss of appetite;
  • diarrhea, constipation;
  • weakness, tiredness, drowsiness;
  • headache;
  • hair loss; or
  • fever, flu-like symptoms.

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.

Read the entire detailed patient monograph for Mesnex (Mesna)

Mesnex Professional Information


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

MESNEX Regimen Intravenous-Intravenous-Intravenous1 Intravenous-Oral-Oral1
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].

Postmarketing Experience

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.

Cardiovascular: Hypertension

Gastrointestinal: Dysgeusia

Hepatobiliary: Hepatitis

Nervous System: Convulsion

Respiratory: Hemoptysis

Read the entire FDA prescribing information for Mesnex (Mesna)

Related Resources for Mesnex

Read the Mesnex User Reviews »

© 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.


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