This medication is used to reduce the risk of bleeding in the bladder (hemorrhagic cystitis), which is a very serious side effect of treatment with a cancer chemotherapy drug called ifosfamide. Mesna helps to protect the lining of the bladder against damage from ifosfamide. The body breaks down ifosfamide to form a product that can harm the bladder, and mesna works by making this product less harmful. However, mesna does not change ifosfamide's anti-cancer effects.

This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This drug may also be used to reduce the risk of bleeding in the bladder caused by another cancer chemotherapy drug called cyclophosphamide.

Read the Patient Information Leaflet if available from your pharmacist before you start using mesna and with each treatment cycle. If you have any questions, ask your doctor or pharmacist.

This medication is given by injection into a vein by a health care professional. The dosage is based on your body size and your dose of ifosfamide (or cyclophosphamide).

While using this medication, drink at least a quart (4 cups or 1 liter) of liquid each day unless directed otherwise by your doctor. Doing so will also help to reduce the bladder side effects from the chemotherapy drug.

Mesna is very effective in reducing the risk of hemorrhagic cystitis in most patients. However, it may not work in a small number of patients. Tell your doctor right away if you notice that your urine is pink, red, or bloody.

Headache, redness/pain/swelling at the injection site, flushing, dizziness, drowsiness, nausea, vomiting, loss of appetite, diarrhea, constipation, sensitive skin, or flu-like symptoms (such as sore throat, cough, body aches) may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including:

• fast heartbeat
• swelling ankles/feet
• muscle weakness

Get medical help right away if you have any very serious side effects, including:

• chest pain

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

• fever
• swollen lymph nodes
• rash
• itching/swelling (especially of the face/tongue/throat)
• severe dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before using mesna, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as benzyl alcohol found in some brands), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history.

This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Tell your doctor if you are pregnant or plan to become pregnant. Since mesna is used with a chemotherapy drug, you should not become pregnant during treatment because the chemotherapy drug may harm an unborn baby. Ask about reliable forms of birth control while using this medication and chemotherapy. If you become pregnant, talk to your doctor right away about the risks and benefits of mesna and the chemotherapy drug.

It is unknown if mesna passes into breast milk. Since mesna is given with a chemotherapy drug, breastfeeding is not recommended while using this medication and for 1 week after the last dose of mesna or the chemotherapy drug. Consult your doctor before breastfeeding.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

This medication may interfere with certain lab tests (such as urine ketone test), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669.

This medication does not protect you from other side effects of ifosfamide. Consult your doctor or pharmacist for more information on how to manage other side effects.

Small amounts of blood in the urine cannot be seen without a microscope. A lab test to check for blood in your urine should be done before each dose of ifosfamide. Keep all medical and lab appointments. Consult your doctor for more details.

It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule.

Consult the product instructions and your pharmacist for storage details. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.