Prevention of the toxic effects of oxazophosphorins (ifosfamide, cyclophosphamide, trophosphamide) on the urinary tract, in particular in patients at high risk – after radiotherapy of the pelvic organs, with cystitis after pre-treatment with oxazophosphorins or by disorders.
Composition and form of release
Main active ingredient: mesna (2-mercaptoethanesulfonic acid, in the form of sodium salt).
Excipients: sodium edetate, sodium hydroxide, water for injection.
It is produced in the form of an injection solution, in ampoules of 4 ml. 1 ml of the drug contains 100 mg of mesna.
This drug belongs to the group of drugs used in the complex treatment of oncological diseases as an adjunct to prevent excessive intoxication.
The main active component of the drug is mesna, which is used as a sodium salt, which is two-mercaptoethanesulfonic acid.
It has the ability to reduce nephrotoxicity, as well as the urotoxic activity of drugs that produce an alkylating effect.
Uroprotector, which is able to inactivate the urotoxic effects from the use of drugs such as cyclophosphamides and ifosfamides.
Mesna is capable of rapidly oxidizing, turning into a metabolite of Dimesna. Mesna disulfide is able to remain in the vascular bed, entering the kidneys, where it again becomes a free thiol compound – local. Then this substance, as a result of metabolic and chemical processes, detoxifies urotoxic decay products – metabolites.
Thus, the drug produces a strong cytotoxic effect.
This drug can be recommended and used as a cytotoxic drug, in particular:
- in the prevention of the urotoxic effect of oxazaphosphorins during cytostatic therapy;
- in the treatment of cyclophosphamide in high doses (more than 10 mg / kg) of patients at risk, in particular, in a state after radiation therapy of the pelvic organs, cystitis during previous treatment with oxazaphosphorines, a history of urinary tract diseases.
The drug in question is contraindicated for use in cases where the patient has severe hypersensitivity (allergy) to the main or to one of the auxiliary components, bee products.
It is permissible to use this drug in conjunction with antibiotics, except for amine glycosides, which reduce its effectiveness. Incompatible with cisplatin and carboplatin.
Application during pregnancy and lactation
This drug is not used in the treatment of pregnant women and women during lactation.
Method of administration and dosage
The dosage, regimens and duration of treatment are determined by the attending physician individually, depending on the nature and course of the disease.
It is usually used intravenously, in a dosage equal to 20% of the received dose of oxazaphosphorines, which are administered together with the drug, then after 4, and then after 8 hours.
It is possible to increase the dosage up to 40% of the administered dose of oxazaphosphorins.
With 24-hour administration of ifosfamide, competitive intravenous injection of the drug is possible. The initial dosage is 20%, then the dose is increased to 60%.
Mesna can be mixed in the same container with ifosfamide.
The transition to the oral form of the mesna is possible.
Overdose can increase side effects, in particular:
- shortness of breath.
There is no specific antidote.
Means must be provided to respond to a possible anaphylactic reaction.
In general, the use of this drug can cause adverse reactions, such as:
- arterial hypotension;
- leukopenia, thrombocytopenia, anemia;
- nausea, vomiting, diarrhea, increased transaminase activity;
- weakness, headache;
- rash, exanthema;
- allergies – itching, urticaria, anaphylactoid reactions;
- phlebitis at the injection site, pain in the limbs.
Storage conditions and periods
Expiration date – 5 years from the production date indicated on the package.
The storage temperature should not exceed 30 ° C.