Mesna is used to reduce the risk of hemorrhagic cystitis (a condition that causes inflammation of the bladder and can result in serious bleeding) in people who receive ifosfamide (a medication used for the treatment of cancer). Mesna is in a class of medications called cytoprotectants. It works by protecting the bladder against some of the harmful effects of certain chemotherapy medications.

Mesna comes as a tablet to take by mouth. The first dose of mesna is usually given as an injection into your vein at the same time as you receive your chemotherapy treatment. After that, your doctor may choose to continue your treatment with mesna tablets. It is usually given 2 and 6 hours after your chemotherapy treatment. Take mesna exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

If you vomit less than 2 hours after you take a dose of mesna tablets, call your doctor right away.

Drink at least 1 quart (4 cups; about 1 liter) of liquid daily while you are taking mesna tablets.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Before taking mesna,

• tell your doctor and pharmacist if you are allergic to mesna, any other medications, or any of the ingredients in mesna tablets. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.
• tell your doctor if you have or have ever had an autoimmune disorder (conditions in which the immune system attacks healthy parts of the body and causes pain, swelling, and damage) such as rheumatoid arthritis, systemic lupus erythematosus, or nephritis (a type of kidney problem).
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding.

Take the missed dose as soon as you remember it. Call your doctor right away for more instructions. Do not take a double dose to make up for a missed one.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unless your doctor tells you otherwise, continue your normal diet.

Mesna may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• vomiting
• constipation
• loss of appetite or weight
• diarrhea
• abdominal pain
• headache
• tiredness
• dizziness
• hair loss
• loss of strength and energy
• fever
• sore throat
• cough
• flushing
• sensitivity of the skin to touch

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

• pink or red colored urine
• blood in urine
• swelling of the face, arms, or legs
• hives
• rash
• itching
• difficulty breathing or swallowing
• chest pain
• fast, irregular, or pounding heartbeat
• unusual bleeding or bruising

Mesna may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Mesna is also sometimes used to reduce the risk of hemorrhagic cystitis in people who receive the chemotherapy drug cyclophosphamide. Talk to your doctor about the risks of using this medication for your condition.

Keep all appointments with your doctor and the laboratory.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking mesna.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

• Mesnex®