Mesna (Uromitexan ®)
Mesna is a drug used to protect the bladder from the effects of the chemotherapy drugs ifosfamide (Mitoxana ®) and cyclophosphamide. It 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.
If you are given ifosfamide chemotherapy, you may get blood in your 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 to protect your bladder lining.
Mesna is a clear fluid. It is usually given as a drip (infusion) at the same time as your chemotherapy. The infusion will be given through a fine tube (cannula) inserted into a vein.
Some people are given mesna and chemotherapy 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 is also available as a tablet. 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 know which side effects may be from mesna and which ones may be from the chemotherapy. Side effects from mesna are rare, but may include:
Feeling or being sick
Your doctor can prescribe very effective anti-sickness drugs (anti-emetics) to help prevent or reduce sickness. If you are sick after taking mesna tablets, contact the hospital for advice. It’s important you don’t miss a dose of mesna so that your bladder lining is protected.
You may get a bitter or metallic taste in your mouth or find that food tastes different. This should go away when your treatment finishes. Try using herbs and spices (unless you have a sore mouth or ulcers) or strong-flavoured sauces to give your food more flavour. Sucking boiled sweets can sometimes help get rid of a bitter or metallic taste. Your nurse can give you more advice.
Mesna may cause headaches. If this happens, let your doctor or nurse know. They can give you painkillers.
You may get pain or discomfort in your tummy (abdomen), feel bloated or wind. Your doctor can prescribe drugs to help improve these symptoms. Tell them if the pain doesn’t improve or gets worse.
Your doctor can prescribe drugs to control diarrhoea. Let them know if it is severe or if it doesn’t get better. Make sure you drink at least two litres (three and a half pints) of fluids every day if you have diarrhoea.
Feeling very tired is a common side effect. It’s often worse towards the end of treatment and for some weeks after it’s finished. Try to pace yourself and get as much rest as you need. It helps to balance this with some gentle exercise, such as short walks. If you feel sleepy, don’t drive or operate machinery.
Limb and joint pain
You may get pain in your joints or limbs for a few days after treatment. Tell your doctor if this happens so they can prescribe painkillers. Let them know if the pain does not get better. Try to get plenty of rest. Taking regular warm baths may help.
Mesna may affect your skin. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day. Mesna can cause a rash, which may be itchy. Always tell your doctor or nurse about any skin changes. They can give you advice and may prescribe creams or medicines to help. Any changes to your skin are usually temporary and improve when treatment finishes.
Mood and behaviour changes
Occasionally, mesna can affect your mood. You may feel irritable and have mood swings. Tell your doctor or nurse if you have any of these side effects. They may make some changes to your treatment if the side effects become a problem.
This section has been compiled using information from a number of reliable sources, including:
British National Formulary. 67th edition. 2014. 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 Penny Daynes, Oncology/Haematology Pharmacist, and the people affected by cancer who reviewed this edition.
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