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Mesna Coupon - Mesna 400mg tablet

mesna

Generic Mesnex
Used for Chemotherapy Side Effects
Used for Chemotherapy Side Effects

Mesna (Mesnex) is used to prevent hemorrhagic cystitis (bleeding in the bladder) in people receiving a chemotherapy medication called ifosfamide (Ifex). It's sometimes used off-label in people receiving cyclophosphamide. Mesna (Mesnex) is given as three separate doses, about 2 to 4 hours apart, on the same day as the chemotherapy. People can either receive it as three injections, or one injection and two oral doses. The most common side effects with mesna (Mesnex) are nausea and vomiting. This medication is available as both brand name and generic.

Reviewed by:
reviewer
Ally Tsai, PharmD
reviewer
Kristianne Hannemann, PharmD
Last reviewed on October 9, 2024
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostContraindicationsImagesReferencesPricesMedicare
basics-icon

What is Mesna (Mesnex)?

What is Mesna (Mesnex) used for?

How Mesna (Mesnex) works

Mesna (Mesnex) is a chemoprotectant, meaning it protects against chemotherapy side effects. It's given with ifosfamide (Ifex) to this chemotherapy from damaging your bladder.

After you receive ifosfamide (Ifex), your body breaks it down into different chemicals. Some of these chemicals are toxic and can cause your bladder to swell up and bleed. Mesna (Mesnex) works by attaching to these toxic chemicals and preventing them from damaging your bladder.

Drug Facts

Common BrandsMesnex
Drug ClassChemoprotectant
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
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$457.53(save 30.25%)
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$319.11
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What are the side effects of Mesna (Mesnex)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Nausea (54-55%)
  • Vomiting (29-38%)
  • Constipation (18-24%)
  • Lower blood cell counts (up to 21%)
  • Feeling tired (20%)
  • Fever (15-20%)
  • Loss of appetite (16-18%)
  • Feeling weak (13-18%)
  • Belly pain (12-15%)
  • Diarrhea (8-14%)
Note: Some side effects listed above might not be from mesna (Mesnex) alone, since studies included people receiving mesna (Mesnex) with ifosfamide (Ifex) and other anticancer medications.

Other Side Effects

  • Hair loss
  • Headache
  • Drowsiness
  • Dizziness
  • Chest pain
  • Low potassium levels
  • More sweating
  • Blood in urine
  • Anxiety
  • Injection site reactions
  • Feeling confused
  • Trouble sleeping
  • Coughing
  • Heartburn
  • Pain

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Serious allergic reaction: fast heartbeat, hives, trouble breathing, swelling, joint or muscle pain
  • Serious skin reactions: fever, sore throat, cough, tiredness, rash with blisters, itchy skin, hives, skin pain, puffy eyes, swelling, skin peeling, skin or mouth sores, flushed skin

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

Black, tarry stools

bleeding gums

bloating or swelling of the face, arms, hands, lower legs, or feet

blood in the urine or stools

chest pain

chills

cough

decreased urination

dizziness

dry mouth

fainting

fast, pounding, or irregular heartbeat or pulse

fever

increased thirst

lightheadedness

loss of appetite

mood changes

muscle pain or cramps

nausea

numbness or tingling in the hands, feet, or lips

painful or difficult urination

pinpoint red spots on the skin

rapid breathing

rapid weight gain

seizures

sore throat

sores, ulcers, or white spots on the lips or in the mouth

sunken eyes

swelling

swollen glands

tightness in the chest

trouble breathing

unusual bleeding or bruising

unusual tiredness or weakness

unusual weight gain or loss

vomiting

wrinkled skin

Less common

Blurred vision

confusion

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

sweating

Incidence not known

Coughing or spitting up blood

dark urine

general tiredness and weakness

headache

light-colored stools

nervousness

pounding in the ears

slow heartbeat

upper right abdominal or stomach pain

yellow eyes and skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Back pain

bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site

diarrhea

difficulty having a bowel movement

hair loss

increased sweating

lack or loss of strength

sleepiness or unusual drowsiness

stomach pain

trouble sleeping

weight loss

Less common

Belching

feeling of warmth

heartburn

indigestion

redness of the face, neck, arms, and occasionally, upper chest

stomach discomfort or upset

Incidence not known

Change or loss of taste

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Mesna (Mesnex)

thumbs-up

Pros

Available as both IV and oral forms

Only need to receive on the day of chemotherapy treatment

thumbs-down

Cons

Can cause nausea and vomiting

Oral tablet smells like sulfur, can be hard to swallow

pharmacist-tips

Pharmacist tips for Mesna (Mesnex)

pharmacist

  • Be sure to plan for some extra time for your appointment. Most commonly, you'll receive your first dose of mesna (Mesnex) with your chemotherapy medication. Depending on whether your next two doses are oral or injectable, you might be receiving the remaining medications at an infusion center or at home.

    • Talk to your oncologist right away if you throw up within 2 hours of taking mesna (Mesnex) by mouth, or if you miss your dose. You might need to repeat the dose by mouth or through your vein.

      • If you're taking mesna (Mesnex) by mouth at home, consider setting an alarm to remind yourself to take your doses at the scheduled time.

        • Talk with your oncologist if you have any questions about when it's safe for you to start breastfeeding after receiving mesna (Mesnex). Breastfeeding isn't recommended while you're taking mesna (Mesnex) because it's used along with other anticancer medications that can get in your breast milk and cause harm to your baby.

          • Tell your oncologist if you experience any changes in weight during the period of time you're receiving anticancer medications with mesna (Mesnex) because your dose of these medications might need to be changed. Let your oncologist know if you have nausea, vomiting, or diarrhea that won’t go away since this can also be a cause of weight loss.

            • Mesna (Mesnex) might not prevent inflamed bladder in everyone who uses chemotherapy. Check your urine during treatment and tell your oncologist right away if your urine is pink, red, or brown. Your oncologist might need to adjust your dose of ifosfamide (Ifex) and mesna (Mesnex) or ask you to stop these medications temporarily.

              faqs

              Frequently asked questions about Mesna (Mesnex)

              Is mesna (Mesnex) chemotherapy?
              Mesna (Mesnex) isn't a chemotherapy medication. It's a chemoprotectant that's given along with a chemotherapy medication called ifosfamide (Ifex) to prevent a side effect known as hemorrhagic cystitis (bleeding in the bladder).
              Is mesna (Mesnex) hazardous?
              Mesna (Mesnex) isn't considered a hazardous medication. According to the National Institute for Occupational Safety and Health (NIOSH), a medication is hazardous when it can cause problems, such as cancer, birth defects or developmental problems in babies, and damage to organs. While mesna (Mesnex) isn't hazardous, it's given to protect against ifosfamide (Ifex), a chemotherapy medication that can cause serious bladder damage. Talk with your healthcare team if you have questions about safety of mesna (Mesnex).
              Does mesna (Mesnex) smell bad?
              Yes, mesna (Mesnex) oral tablets can have a bad smell. This is because the medication is sulfur-based. If you have trouble taking mesna (Mesnex) because of the smell, try taking the tablets with flavored liquid, like grape juice. You can also consider crushing the tablets and mixing them with apple sauce.
              Does mesna (Mesnex) cause nausea and vomiting?
              People commonly report nausea and vomiting after receiving mesna (Mesnex). These side effects can also be caused by the chemotherapy medication you're receiving as well. To relieve these symptoms, make sure to stay hydrated during treatment. Eating smaller meals more often throughout the day and avoiding spicy or fatty food might also help. If appropriate, your oncology team can prescribe anti-nausea medications as well, such as ondansetron (Zofran). If you vomit within 2 hours of taking mesna (Mesnex) by mouth, call your healthcare team since you might need to repeat your dose. Talk with your healthcare team if your nausea or vomiting don't get better over time.
              Which chemotherapy medication does mesna (Mesnex) protect against?
              Mesna (Mesnex) is only FDA-approved to prevent bleeding in the bladder in people who are receiving ifosfamide (Ifex). Some studies suggest that mesna (Mesnex) might also work well in preventing this side effect in people who are taking cyclophosphamide (Cytoxan), another chemotherapy medication. The American Society of Clinical Oncology (ASCO) recommends using mesna (Mesnex) with high dose cyclophosphamide (Cytoxan) in the setting of bone marrow transplant. Discuss with your healthcare team to see whether mesna (Mesnex) is the best option for you.
              Can I receive mesna (Mesnex) if I am pregnant?
              No, you shouldn't receive mesna (Mesnex) if you're pregnant. Mesna (Mesnex) is given with ifosfamide (Ifex), which is a medication known to cause serious harm in unborn babies. If you're able to become pregnant, your oncology team might ask you to take a pregnancy test before starting treatment. Make sure to use birth control, like condoms, while receiving this combination and for 6 months (females) or 3 months (males) after the last dose. If you’re pregnant or planning on becoming pregnant, talk to your healthcare team so you can discuss the risks of using this medication.
              Can I receive mesna (Mesnex) if I am breastfeeding?
              It's not clear whether mesna (Mesnex) is safe to use in breastfeeding. But ifosfamide (Ifex), a medication used along with mesna (Mesnex), can pass into breast milk and cause harm to nursing babies. Talk with your healthcare team about when it's safe for you to start breastfeeding after receiving mesna (Mesnex) and ifosfamide (Ifex).
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              What are the risks and warnings for Mesna (Mesnex)?

              Mesna (Mesnex) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

              risk-warning

              Serious allergic reaction

              • Risk factors: Allergy to benzyl alcohol, other inactive ingredients in mesna (Mesnex), or amifostine (Ethyol)

                In some rare cases, mesna (Mesnex) can cause allergic reactions, which can be life-threatening. These reactions can happen even if you’ve received this medication before. Get emergency medical help right away if you have symptoms such as fever, dizziness, fast heartbeat, shortness of breath, hives, swelling, nausea, vomiting, and joint or muscle pain.

                If you're allergic to a medication called amifostine (Ethyol), you might also develop an allergy to mesna (Mesnex). Talk with your healthcare team so you can discuss the benefits and risks of taking mesna (Mesnex).

                risk-warning

                Serious skin reactions

                Mesna (Mesnex) can sometimes cause serious rash and other severe skin reactions, such as Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome or Stevens-Johnson syndrome (SJS). These reactions can happen even if you've received this medication before. If you have a rash with blisters, itchy skin, hives, skin pain, puffy eyes, swelling, skin peeling, skin or mouth sores, or flushed skin, get medical help right away and stop using mesna (Mesnex).

                risk-warning

                Incorrect lab results

                Mesna (Mesnex) can temporarily interfere with different lab tests. It can interfere with certain urinary tests, causing false positive ketone or vitamin C readings. This medication can also cause false negative results on blood tests that look for muscle breakdown or kidney problems. Talk with your healthcare team about your medication history before getting any testing done.

                dosage

                Mesna (Mesnex) dosage forms

                The average cost for 6 tablets of 400mg of Mesna (Mesnex) is $319.11 with a free GoodRx coupon. This is 30.25% off the average retail price of $457.53.
                tablet
                Tablet
                DosageQuantityPrice as low asPrice per unit
                400mg4 tablets$319.11$79.78

                Typical dosing for Mesna (Mesnex)

                Your healthcare team will determine your dose of mesna (Mesnex) based on your dose of ifosfamide (Ifex) and your body surface area (BSA), which takes into account your weight and height.

                You'll receive 3 doses of mesna (Mesnex) each day you receive ifosfamide (Ifex). Mesna (Mesnex) can be given either as injections, or as a combination of injection and oral doses.

                • Mesna (Mesnex) IV injection: The typical dose is 240 mg/m2 injected into the veins every 4 hours for a total of 3 doses.

                • Mesna (Mesnex) tablet: The typical dose is 240 mg/m2 injected into the veins once. Two hours after the injection, you'll continue with 480 mg/m2 taken by mouth every 4 hours for a total of 2 oral doses.

                interactions

                Interactions between Mesna (Mesnex) and other drugs

                Mesna (Mesnex) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Mesna (Mesnex). Please note that only the generic name of each medication is listed below.

                Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

                Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

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                How much does Mesna (Mesnex) cost?

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                Mesnex (brand)
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                $319.11

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                contraindications-icon

                Mesna (Mesnex) contraindications

                Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Mesna (Mesnex) will not be safe for you to take.

                • Allergic reaction to mesna (Mesnex) or any of its inactive ingredients, including benzyl alcohol

                images

                Mesna (Mesnex) images

                White Oblong I354 - Mesna 400mg Tablet
                This medicine is White, Oblong, Scored Tablet Imprinted With "I354".White Oblong I354 - Mesna 400mg Tablet

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                References

                Best studies we found

                American Cancer Society. (n.d.). Chemotherapy.

                Bamboo US Bidco LLC. (2024). Mesnex- mesna injection, solution [package insert]. DailyMed.

                Baxter Healthcare Corporation. (2019). Mesnex- mesna tablet, film coated [package insert]. DailyMed.

                View All References (8)

                Hensley, M. L., et al. (2009). American Society of Clinical Oncology 2008 clinical practice guideline update: Use of chemotherapy and radiation therapy protectants. Journal of Clinical Oncology.

                Hikma Pharmaceuticals USA Inc. (2024). Ifosfamide injection [package insert]. DailyMed.

                Manikandan, R., et al. (2010). Hemorrhagic cystitis: A challenge to the urologist. Indian Journal of Urology.

                National Cancer Institute. (n.d.). Hemorrhagic cystitis.

                Reddy, V., et al. (2024). Mesna. StatPearls.

                Sagent Pharmaceuticals. (2021). Mesna- mesna injection, solution [package insert]. DailyMed.

                Shepherd, J. D., et al. (1991). Mesna versus hyperhydration for the prevention of cyclophosphamide-induced hemorrhagic cystitis in bone marrow transplantation. Journal of Clinical Oncology.

                U.S. Pharmacopeia. (n.d.). USP General Chapter <800>.

                GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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