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RX BIN: 015558
Group ID: DDN6600
Card Holder ID: DDN6600

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2018 Price of Mesnex



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Mesna volume of distribution

Vd = 0.652 0.242 L/Kg after intravenous administration of mesna.

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What is Mesna

Mesna is a synthetic sulfhydryl (thiol) compound and is used for prophylaxis of Ifosfamide and cyclophosphamide induced hemorrhagic cystitis. (2)

Mesna mechanism of action

A metabolite called arolein is produced when ifosfamide and cyclophosphamide are metabolized. (1) This metabolite concentrates in the bladder and causes cell death via upregulation of reactive oxygen species (ROS), and activates inducible nitric oxide synthase (iNOS) which leads to production of nitric oxide (NO). (1) Both ROS and NO produce products which are detrimental to lipids, proteins and DNA strands. (1) Furthermore, ROS stimulate gene expression of pro-inflammatory cytokines such as TNF- AND IL-1 . (1) Acrolein may also lead to ulceration of the bladder urothelium. (1) Mesna protects against cyclophosphamide and ifosfamide induced hemorrhagic cystitis by binding to their toxic metabolites. (1) Mesna is metabolized to dimesna and excreted by the kidneys. (1) Glutathione dihydrogenase acts on the reabsorbed portion and produces free sulfhydryl groups. (1) These free sulfhydryl groups bind acrolein in the bladder, allowing effective excretion and prevention of toxic effects. (1) In addition, Mesna binds to and detoxifies a urotoxic ifosfamide metabolite called 4-hydroxy-ifosfamide.

Dosage forms of Mesna

Prescription Generics


International Brands



2-mercaptoethane sulfonate Na


Fresenius Kabi USA, LLC

CAS number






Affected organisms

Indication of Mesna

Mesna is a uroprotective agent and is used prophylactically to reduce ifosfamide and cyclophosphamide induced hemorrhagic cystitis. (2)

Toxicity of Mesna

The following adverse events were most common (10%) when mesna was administered with ifosfamide: nausea, vomiting, fatigue, fever, abdominal pain, constipation, diarrhea, leukopenia, anorexia, thrombocytopenia, anemia, granulocytopenia, asthenia, headache, alopecia, and somnolence. Hypersensitivity reactions and dermatologic toxicity may occur in patients taking mesna; therefore, if either reaction occurs, mesna should be discontinued and patient should be provided with supportive care.

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