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Mesna is the antidote to acrolein, a metabolite of anticancer agents from the group oksazafosforinov (ifosfamide, cyclophosphamide), which is irritating to the mucous membrane of the urinary bladder. Protective properties mesna caused by interaction with the double bond of acrolein molecules, resulting in the formation of stable thioether. By reducing effects urotoksicheskie oksazafosforinov, mesna does not impair their antitumor action.  After intravenous (i / v) administration, the active substance is rapidly oxidized to disulfide (dimesny). The epithelium of the renal tubules dimesna reduced to dianabol stack the free thiol compound that binds irreversibly to oksazafosforinov metabolites to form stable nontoxic thioethers.Communication with the plasma proteins is 69-75%. Systemic clearance of 1.23 l / h / kg /. After the on / in the application at 800 mg mesna and half-lives in the blood constitute dimesny 0.36 h and 1.17 h, respectively. Approximately 32% and 33% of the administered dose excreted by the kidneys within 24 hours, respectively, in the form of mesna and dimesny. Most of the recovered dose is excreted by the kidneys for 4 hours.

Indications
Local urotoksicheskih detoxification effects of cytostatic drugs – derivatives oksazafosforinov, including in the following cases:

  • when administered ifosfamide;
  • oksazafosforinov when administered in high doses (greater than 10 mg / kg);
  • at-risk patients – conducted before radiation therapy to the pelvic area, the development of cystitis during previous therapy oksazafosforinov, diseases of the urinary system in history.

Contraindications
: Hypersensitivity to impurity, to any other component of the drug, or thiol compounds.
Pregnancy and lactation.

Dosing and Administration
The is usually administered intravenously (slowly). Single dose for adults is 20% of a single dose oksazafosforinov. The first introduction is carried out simultaneously with the first introduction oksazafosforinov, second and third injections -. 4 hours and 8 hours after administration oksazafosforinov
In children a single dose of the drug Mesna-LENS ® is 60% of the dose of cytostatic agent, the introduction of the drug continue every 3 hours.
During continuous infusion (24 h) ifosfamide or cyclophosphamide drug should be administered in a dose of 20% of the dose of the cytostatic agent at the beginning of the infusion, then – in a dose of 100% of the dose of the cytostatic agent as a 24-hour infusion and after the administration of cytostatic administering  is continued for 6-12 hours at the same dose. In the case of oksazafosforinov in very high doses, for example, prior to bone marrow transplantation, the total dose of  can be increased to 120-160% of the dose oksazafosforinov. After the introduction of 20% of  at the beginning of the introduction of cytostatic rest of the calculated dose is recommended to be administered intravenously for a long time within 24 hours as an alternative to possible fractional bolus injection:. Adult 3 × 40% (time 0, 4, 8 hours), or 4 × 40% (time 0, 3, 6, 9 hours). Instead bolus injections suitable for short infusion lasting 15 minutes.

Side effects
Adverse reactions are more common than in isolated cases are listed according to the following grading: very common (> 10%); frequent (> 1%, <10%); sometimes (> 0.1%, <1%); rarely (> 0.01%, <0.1%);very rare (<0.01%). On the part of the digestive system: often – nausea, vomiting, diarrhea, constipation, abdominal pain, flatulence, anorexia, From the side of hematopoiesis: rarely – thrombocytopenia. Also observed granulocytopenia, leukopenia, anemia. The causal relationship of these events to the use of mesna has not been established, it could be due to concomitant cytotoxic therapy. On the part of the central nervous system: often – dizziness, drowsiness, headache, irritability, depression. Since the cardiovascular system: often – “surge” blood to the face. On the part of the immune system: very rarely – hypersensitivity reactions (skin rash, itching, Lyell’s syndrome, Stevens-Johnson syndrome, urticaria, conjunctivitis, anaphylactoid reactions, blood pressure, increased blood pressure, tachycardia, tachypnea, dianabol stack myalgia, and also increase activity of some liver function tests (eg transaminase). The respiratory system: often – cough. Local reactions: seldom – phlebitis at the injection site pain and redness.Other: often – arthralgia, back pain, fever, chills, flu-like symptoms, sore throat, very rarely – pain in the extremities, fatigue, weakness, pneumonia is also frequently observed, alopecia. The causal relationship of these events to the use of mesna has not been established, it could be due to concomitant cytotoxic therapy.

The interaction with other drugs
Mesna compatible with cyclophosphamide and ifosfamide, therefore, can be administered to them in the same solution, with the antitumor activity of the latter is not changed.
Pharmaceutically drug is incompatible with cisplatin (binding and inactivation of the latter), in connection with which mesna not should be mixed in a solution with cisplatin.
Mesna has no effect on the therapeutic efficacy of doxorubicin, carmustine, cisplatin, methotrexate, vincristine, as well as the activity of the cardiac glycosides.

Overdose
A specific antidote for mesna is not known. Possible overdose symptoms include nausea, bloating, diarrhea, headache, fatigue, pain in the limbs and joints, malaise, fatigue, depression, irritability, skin rashes, blood pressure, tachycardia. Treatment is symptomatic.

Cautions
Mesna has a protective effect only in the urinary system, and does not eliminate the other side effects of cytostatics, so the treatment group oksazafosforinov preparations necessary to use the full range of supportive and symptomatic therapy.
Mesna does not prevent the development of hemorrhagic cystitis in all patients. It is therefore necessary to analyze the daily morning portion of urine for the presence of hematuria. In the case of hematuria during treatment with mesna oksazafosforinov according to the recommended dosage regimen may require dose reduction or discontinuation of therapy oksazafosforinov. Because dianabol stack of the possibility of anaphylactic reactions is necessary to ensure the availability of suitable medicines for emergency care. Patients with autoimmune diseases treated with cyclophosphamide and impurity, hypersensitivity reactions are detected at a higher frequency. In these patients, urinary tract protection with mesna should be done only after a thorough analysis of the risk – benefit and under close medical supervision.During treatment marked false positive reactions for the presence of ketone bodies in urine (in case of the color reaction on ketones may reddish-violet color of urine, which is unstable and immediately disappears into the urine by adding glacial acetic acid).

Product form
solution for intravenous administration of 200mg / 2ml and 400mg / 4ml (100 mg / ml) vials. Each vial with instructions for use in a stack of cardboard, or 3, 5 or 10 vials together with instructions for use in the package with partitions or special pockets made of cardboard. At 50, 85, 100 bottles with instructions for use, at the rate of one instruction on ten vials in a box of cardboard (for hospitals). supplements like steroids dianabol capsules buy steroid needles