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This information is about a drug called mesna, which is used to protect the bladder and kidneys from the effects of the chemotherapy drugs ifosfamide (Mitoxana®) and cyclophosphamide. Mesna is not a chemotherapy drug. This information describes mesna, how it is given, and some of its possible side effects.
If you have any further questions you can ask your doctor or nurse at the hospital where you are having your treatment, or speak to one of our cancer support service nurses.
Some people who are given ifosfamide chemotherapy may get blood in their urine (haematuria). This can also happen with higher doses of cyclophosphamide chemotherapy, but is less common. Both drugs can cause irritation and bleeding from the lining of the bladder and the kidneys. Mesna helps to protect your bladder and kidneys, to prevent this.
Mesna is always given with ifosfamide, and normally only given with higher doses of cyclophosphamide. While you are having this treatment, your urine is closely monitored and tested for any signs of blood. If you have blood in your urine, you will be given extra mesna. Drinking as much water as possible can help to flush through the chemotherapy.
Mesna is a clear fluid. It is also available as a tablet.
Mesna is usually given through a small tube (cannula) inserted into a vein. You may find this uncomfortable, or a little painful, but it should not take long. It is given in a drip (infusion) of sterile, salty water (saline) in combination with your chemotherapy.
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), or 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 are given tablets, it is important to take them as directed by your doctor.
Because mesna is usually given with chemotherapy, 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) There are now very effective anti-sickness drugs (anti-emetics) to prevent or reduce nausea and vomiting. These are normally given both in the drip with the treatment, and as tablets. If the sickness is not controlled, or continues, tell your doctor. They can give you other anti‑sickness drugs which may be more effective. Some anti‑sickness drugs may cause constipation. Let your doctor or nurse know if this is a problem.
Taste changes This is common. You may notice that your food tastes different. Normal taste will come back after your treatment has finished.
Headache 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 as much as 2–3 litres of fluid a day, to replace the fluid you are losing.
Tiredness and a general feeling of weakness Fatigue is also a common side effect of chemotherapy. It is important to allow yourself plenty of time to rest.
Limb and joint pain Your doctor can give you painkillers to help relieve this pain.
Skin changes 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 make you feel irritable and to have mood swings. Let your doctor know if there are any changes in your behaviour that concern you.
This section is based on our Mesna factsheet which has been compiled using information from a number of reliable sources, including:
For further references, please see general bibliography.
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