Mesna (Uromitexan ®)
This information is about a drug called mesna, which is used to protect the bladder from the effects of the chemotherapy drugs ifosfamide (Mitoxana®) and cyclophosphamide. Mesna is not a chemotherapy drug.
This information describes mesna, how it’s given and some of its possible side effects. It should ideally be read with our information about ifosfamide or cyclophosphamide.
If you have any further questions, you can ask your doctor, nurse or pharmacist at the hospital where you are having your treatment.
Some people who are given ifosfamide chemotherapy may get blood in their urine (haematuria). This can also happen with higher doses of cyclophosphamide chemotherapy.
Both drugs can cause irritation and bleeding in the lining of the bladder. Mesna helps prevent this by protecting your bladder lining.
Mesna is always given with ifosfamide and is normally given with higher doses of cyclophosphamide. While you're having this treatment, your urine is closely monitored and tested for any signs of blood. If you have blood in your urine, you’ll be given extra mesna. Drinking plenty of water and emptying your bladder often during the treatment will also help protect your bladder lining.
Mesna is a clear fluid. It is also available as a tablet.
Mesna is usually given in a drip (infusion) of sterile saline (salt water) in combination with your chemotherapy. The infusion will be given through a fine tube (cannula)inserted into a vein.
Some people have mesna and chemotherapy given through a fine, plastic tube that is inserted under the skin and into a vein near the collarbone (a central line). It may also be passed through a vein in their arm (a PICC line). Your doctor or nurse will explain more about this to you.
Mesna can also be given as tablets. If you’re given tablets, it's important to take them as directed by your doctor.
Possible side effects of mesna
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It is often difficult to distinguish the side effects that may be due to the mesna from those that may be due to the chemotherapy. Side effects from mesna are rare, but may include:
Feeling or being sick (nausea and vomiting)
Your doctor can prescribe very effective anti-sickness drugs (anti-emetics) to prevent or reduce this. These are normally given both in the drip with the treatment and as tablets.
If you are sick after taking mesna tablets, contact the hospital for advice. It’s important you don’t miss a dose of mesna for your bladder to be protected.
This is common. You may notice that food tastes different. Normal taste comes back after your treatment has finished.
Your doctor or nurse can give you tablets to help relieve this.
Diarrhoea or soft stools that may cause discomfort or colic (wind)
Diarrhoea can normally be easily controlled with medicine, but let your doctor know if it is severe or continues. Try to drink 2-3 litres of fluid a day to replace the fluid you are losing.
Tiredness and a general feeling of weakness
Tiredness is also a common side effect of chemotherapy. It's important to allow yourself plenty of time to rest.
Limb and joint pain
Your doctor can give you painkillers to help relieve this pain.
Mesna can cause a rash, which may be itchy. Your doctor can give you medicine to help with this.
Irritability and mood changes
Occasionally, mesna can cause you to feel irritable and to have mood swings. Let your doctor know if there are any changes in your behaviour that concern you.
This section has been compiled using information from a number of reliable sources, including:
British National Formulary. 64th edition. 2012. British Medical Association and Royal Pharmaceutical Society of Great Britain.
Perry MC. The Chemotherapy Source Book. 5th edition. 2012. Lippincott Williams & Wilkins.
Sweetman, et al. Martindale: The Complete Drug Reference. 37th edition. 2012. Pharmaceutical Press.
Thanks to Dermot Ball, Cancer Network Pharmacist, and all of the people affected by cancer who reviewed this edition.
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