Care During Chemotherapy and Beyond


Generic name: Mesna uses generic names in all descriptions of drugs. Mesnex is the trade name for Mesna. In some cases, health care professionals may use the trade name Mesnex when referring to the generic drug name Mesna.

Drug type:  Mesnex is a drug used to reduce the undesired side effects of certain chemotherapy drugs.  Mesnex is referred to as a "chemoprotectant." (For more detail, see "How this drug works" section below).

What This Drug Is Used For:

  • Prevention of ifosfamide-induced hemorrhagic cystitis (syndrome of bleeding and irritation of the bladder).
  • Prevention of high-dose cyclophosphamide-induced hemorrhagic cystitis.
    Note:  If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How This Drug Is Given:

  • As an injection or infusion through the vein (intravenous, IV).  This is given with or after the chemotherapy drug has been given.
  • As a pill by mouth.  Comes in 400mg tablet size.  Recommended that it is taken with strong tasting liquid to mask the taste.  If not taken as tablet, solution is made using carbonated beverage, juice or milk.
  • The amount of mesna that you will receive depends on many factors, including your height and weight, and dose of chemotherapy given.  Your doctor will determine your dose, schedule, and how it is taken.

Side Effects:

Important things to remember about the side effects of mesna:

  • Most people do not experience all of the side effects listed.
  • Side effects are often predictable in terms of their onset and duration. 
  • Side effects are almost always reversible and will go away after treatment is complete.
  • There are many options to help minimize or prevent side effects.
  • There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
  • The side effects seen with treatment of mesna are likely attributable to the other chemotherapy medications being given in combination with mesna.

The following side effects are common (occurring in greater than 30%) for patients taking Mesnex:

  • Bad taste when taken by mouth. (Recommend taking with strong tasting liquid to mask the taste, such as grape juice).
  • Vomiting, caused by the bad taste of the drug when taken by mouth.

A very uncommon side effect of Mesnex is allergic reaction.  Usually it is mild in the form of a skin rash or itching.  Rarely this reaction has been severe.

Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here.  However, you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Seek emergency help immediately and notify your health care provider, it you experience the following symptoms:

  • Shortness of breath, wheezing, difficulty breathing, closing up of the throat, swelling of facial features, hives (possible allergic reaction).

The following symptoms require medical attention, but are not an emergency.  Contact your health care provider within 24 hours of noticing any of the following:

  • Nausea (interferes with ability to eat and unrelieved with prescribed medication)
  • Vomiting (vomiting more than 4-5 times in a 24 hour period)
  • Diarrhea (4-6 episodes in a 24-hour period)
  • Blood in the urine
  • Pain or burning with urination

Always inform your health care provider if you experience any unusual symptoms.


  • Before starting mesna treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).   Do not take aspirin, or products containing aspirin unless your doctor specifically permits this.
  • If you are on warfarin (Coumadin®) as a blood-thinner, adjustments may need to be made to your dose based on blood work.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment.  Pregnancy category B controlled studies in animals do not show evidence of impaired fertility or harm to the fetus.  However, similar studies have not been performed in humans.  Because animal studies are not entirely predictive of human response, the drug should be used during pregnancy only if clearly indicated.
  • Because mesna will be given as part of a protocol using drugs where there is clear evidence of risk in pregnancy, for both men and women: Do not conceive a child (get pregnant) while taking mesna. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
  • Do not breast feed while taking this medication.

Self-Care Tips:

  • If taken by mouth recommend taking with strong tasting liquid, carbonated beverage, juice or milk.
  • Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
  • It is important to void (empty your bladder) frequently especially in the first 24 hours after taking chemotherapy.  Report any pain or burning on urination to your health care provider.
  • To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals. 
  • Get plenty of rest. 
  • Maintain good nutrition.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team.  They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing:

You will be checked regularly by your health care professional while you are taking mesna, to monitor side effects and check your response to therapy.  Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor. 

Your urine may be checked prior to starting treatment and periodically during treatment to check for microscopic blood in the urine.  

How This Drug Works:

Mesna is classified as a chemoprotective agent.  Chemoprotective agents are drugs that are used with certain types of chemotherapy to protect the body from or minimize the side effects of the chemotherapy.  These medications do not eliminate side effects in general.  Rather, they protect the body from some of the potentially serious side effects.  These drugs also have side effects of their own so they are used only with specific types of chemotherapy or when the benefit clearly is greater than the risk.

Mesna is converted to an inactive form in the blood, then as it is circulated through the kidneys it is reactivated.  The reactivated mesna works by interacting with metabolites (substances produced by breakdown of a drug in the body).   Two specific chemotherapies, ifosfomide and cyclophosphamide (given in high doses) when broken down produce a metabolite acrolein.   This metabolite is toxic to the bladder.  Mesna binds to and inactivates acrolein thereby preventing or reducing bladder problems.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice. is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit