Mesnex
Mesnex (mesna) is a detoxifying agent used as a protectant to inhibit hemorrhagic cystitis induced by ifosfamide chemotherapy. It reacts chemically in the kidney with the urotoxic ifosfamide metabolites (such as acrolein) to detoxify them and protect the bladder.
Dosage by Body Weight
Mesnex is administered either intravenously or as a combination of intravenous and oral doses. The dosage is calculated directly as a percentage of the ifosfamide chemotherapy dose (typically 20% of the ifosfamide dose per IV injection given at 0, 4, and 8 hours, or 20% IV at hour 0 followed by 40% orally at 2 and 6 hours).
- Body Weight
- Below 5 kg
- Dose
- Calculated based on ifosfamide dose
- Frequency
- At 0, 4, and 8 hours relative to chemotherapy
- Tracking Notes
- Mesna is not dosed by body weight alone; it is strictly calculated as a percentage (typically 20% to 60%) of the corresponding ifosfamide chemotherapy dose.
- Body Weight
- 5-7 kg
- Dose
- Calculated based on ifosfamide dose
- Frequency
- At 0, 4, and 8 hours relative to chemotherapy
- Tracking Notes
- Must be precisely tailored to the chemotherapy protocol. Administered under strict oncologist supervision.
- Body Weight
- 8-10 kg
- Dose
- Calculated based on ifosfamide dose
- Frequency
- At 0, 4, and 8 hours relative to chemotherapy
- Tracking Notes
- Dose is adjusted dynamically based on ifosfamide infusion schedule and bladder tolerance.
- Body Weight
- 11-15 kg
- Dose
- Calculated based on ifosfamide dose
- Frequency
- At 0, 4, and 8 hours relative to chemotherapy
- Tracking Notes
- Requires maintaining adequate oral or intravenous hydration to ensure active urination.
- Body Weight
- 16-20 kg
- Dose
- Calculated based on ifosfamide dose
- Frequency
- At 0, 4, and 8 hours relative to chemotherapy
- Tracking Notes
- May be administered orally if the child is old enough to reliably swallow and retain tablets or oral solution.
| Body Weight | Dose | Frequency | Tracking Notes |
|---|---|---|---|
| Below 5 kg | Calculated based on ifosfamide dose | At 0, 4, and 8 hours relative to chemotherapy | Mesna is not dosed by body weight alone; it is strictly calculated as a percentage (typically 20% to 60%) of the corresponding ifosfamide chemotherapy dose. |
| 5-7 kg | Calculated based on ifosfamide dose | At 0, 4, and 8 hours relative to chemotherapy | Must be precisely tailored to the chemotherapy protocol. Administered under strict oncologist supervision. |
| 8-10 kg | Calculated based on ifosfamide dose | At 0, 4, and 8 hours relative to chemotherapy | Dose is adjusted dynamically based on ifosfamide infusion schedule and bladder tolerance. |
| 11-15 kg | Calculated based on ifosfamide dose | At 0, 4, and 8 hours relative to chemotherapy | Requires maintaining adequate oral or intravenous hydration to ensure active urination. |
| 16-20 kg | Calculated based on ifosfamide dose | At 0, 4, and 8 hours relative to chemotherapy | May be administered orally if the child is old enough to reliably swallow and retain tablets or oral solution. |