Mesna, sold under the brand name Mesnex among others, is a medication used in those taking cyclophosphamide or ifosfamide to decrease the risk of bleeding from the bladder.[ It is used either by mouth or intravenous.][
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Common side effects include headache, vomiting, sleepiness, loss of appetite, cough, rash, and joint pain.[ Serious side effects include allergic reactions.][ Use during pregnancy appears to be safe for the baby but this use has not been well studied.][
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Mesna was approved for medical use in the United States in 1988.
Medical uses
Chemotherapy adjuvant
Mesna is used therapeutically to reduce the incidence of haemorrhagic cystitis and hematuria when a patient receives ifosfamide or cyclophosphamide for cancer chemotherapy. These two anticancer agents, in vivo, may be converted to urotoxic metabolites, such as acrolein.
Mesna assists to detoxify these metabolites by reaction of its sulfhydryl group with α,β-unsaturated carbonyl containing compounds such as acrolein.
Other
Outside North America, mesna is also used as a mucolytic agent, working in the same way as acetylcysteine; it is sold for this indication as Mistabron
Administration
It is administered intravenously or orally (through the mouth).
Mechanism of action
Mesna reduces the toxicity of urotoxic compounds that may form after chemotherapy administration. Mesna is a water-soluble compound with antioxidant properties, and is given concomitantly with the chemotherapeutic agents cyclophosphamide and ifosfamide. Mesna concentrates in the bladder where acrolein accumulates after administration of chemotherapy and through a Michael addition, forms a conjugate with acrolein and other urotoxic metabolites.
Names
It is marketed by Baxter as Uromitexan and Mesnex. The name of the substance is an acronym for 2- mercapto ethane sulfonate Na ( Na being the chemical symbol for sodium).
See also
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Coenzyme M—a coenzyme with the same structure used by methanogenic bacteria
External links
