Mesnex (Intravenous)

Mesna injection is used to reduce the risk of inflammation and bleeding of the bladder (hemorrhagic cystitis) in patients who are receiving ifosfamide (cancer medicine).

This medicine should only be given by your doctor or under their direct supervision.

It is very important that your doctor closely monitors your progress while you are receiving this medicine to ensure it is working properly. Blood and urine tests will be needed to check for unwanted effects.

This medicine is used along with ifosfamide. Ifosfamide can harm your unborn baby if you are pregnant. It may also cause birth defects if the father is receiving it when his partner becomes pregnant. Use an effective form of birth control during treatment with this medicine in combination with ifosfamide and for 6 months after the last dose. Male patients with female partners should use an effective form of birth control during treatment and for 3 months after the last dose. If you think you may be pregnant while receiving this medicine, tell your doctor immediately.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and needs immediate medical attention. The most severe signs of this reaction are very fast or irregular breathing, gasping for breath, or fainting. Other signs may include changes in facial skin color, very fast but irregular heartbeat or pulse, hive-like swellings on the skin, and puffiness or swelling of the eyelids or around the eyes. If these side effects occur, seek emergency help right away.

Serious skin reactions can happen with this medicine. Contact your doctor immediately if you experience blistering, peeling, or loosening of the skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while receiving this medicine.

This medicine contains benzyl alcohol, which may cause serious reactions in premature or low-birth weight infants. Talk to your doctor if you have concerns about this.

Make sure any doctor or dentist who treats you knows that you are receiving this medicine. It may affect the results of certain medical tests.

In deciding to use a medicine, you need to balance the risks of taking it against the benefits it will provide. This is a choice you will make together with your doctor. For this medicine, consider the following:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also inform your health care professional about any other allergies you have, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies have not been conducted to determine how mesna injection affects children. Its safety and effectiveness in this age group have not been established.

Geriatric

Studies done so far have not found any specific problems in older adults that would limit the use of mesna injection. However, older patients are more likely to have liver, kidney, and heart issues related to aging, which may require caution and a dose adjustment for those receiving mesna injection.

Breast Feeding

Studies indicate that this medicine may affect milk production or its composition. If you are not given an alternative to this medicine, you should watch your baby for any side effects and ensure they are getting enough milk.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines may be used together even if an interaction could happen. In these situations, your doctor may adjust the dose or take other precautions. While you are receiving this medicine, it is very important for your healthcare professional to know if you are taking any of the medicines listed below. The following interactions have been chosen based on their potential importance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines may lead to a higher risk of certain side effects, but using both drugs may be the best option for you. If both medicines are prescribed, your doctor may change the dose or how often you take one or both of them.

• Warfarin

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken around mealtimes or with certain foods due to possible interactions. Using alcohol or tobacco with some medicines may also cause interactions. Talk to your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical issues may affect how you can use this medicine. Be sure to tell your doctor if you have any other medical problems, especially:

• Allergy to thiol compounds (e.g., amifostine), history of—Use with caution. This may increase the risk of having another allergic reaction.

Along with its necessary effects, a medicine may cause some unwanted effects. Not all of these side effects may happen, but if they do, they may need medical attention.

Check with your doctor or nurse right away if any of the following side effects occur:

More common

• Black, tarry stools
• Bleeding gums
• Bloating or swelling of the face, arms, hands, lower legs, or feet
• Blood in the urine or stools
• Chest pain
• Chills
• Cough
• Decreased urination
• Dizziness
• Dry mouth
• Fainting
• Fast, pounding, or irregular heartbeat or pulse
• Fever
• Increased thirst
• Lightheadedness
• Loss of appetite
• Mood changes
• Muscle pain or cramps
• Nausea
• Numbness or tingling in the hands, feet, or lips
• Painful or difficult urination
• Pinpoint red spots on the skin
• Rapid breathing
• Rapid weight gain
• Seizures
• Sore throat
• Sores, ulcers, or white spots on the lips or in the mouth
• Sunken eyes
• Swelling
• Swollen glands
• Tightness in the chest
• Trouble breathing
• Unusual bleeding or bruising
• Unusual tiredness or weakness
• Unusual weight gain or loss
• Vomiting
• Wrinkled skin

Less common

• Blurred vision
• Confusion
• Dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• Sweating

Incidence not known

• Coughing or spitting up blood
• Dark urine
• General tiredness and weakness
• Headache
• Light-colored stools
• Nervousness
• Pounding in the ears
• Slow heartbeat
• Upper right abdominal or stomach pain
• Yellow eyes and skin

Some side effects may happen that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Your healthcare professional may also be able to tell you ways to prevent or reduce some of these side effects. Check with your healthcare professional if any of the following side effects continue or are bothersome, or if you have any questions about them:

More common

• Back pain
• Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
• Diarrhea
• Difficulty having a bowel movement
• Hair loss
• Increased sweating
• Lack or loss of strength
• Sleepiness or unusual drowsiness
• Stomach pain
• Trouble sleeping
• Weight loss

Less common

• Belching
• Feeling of warmth
• Heartburn
• Indigestion
• Redness of the face, neck, arms, and occasionally, upper chest
• Stomach discomfort or upset

Incidence not known

• Change or loss of taste

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Mesnex

Available Dosage Forms:

• Solution

Therapeutic Class: Hemorrhagic Cystitis Inhibitor

A nurse or other trained health professional will give you this medicine in a medical facility. It is given through a needle placed into one of your veins.

This medicine is given on a fixed schedule. It may be given after receiving ifosfamide, 4 hours, and 8 hours after each dose of ifosfamide.

Drink extra fluids (1 to 2 liters per day) so you will pass more urine while you are receiving this medicine. This may help prevent bladder and kidney problems.

Missed Dose

This medicine needs to be given on a fixed schedule. If you miss a dose or forget to use your medicine, call your doctor or pharmacist for instructions.