A colorless transparent liquid.
MESNEX is indicated as a prophylactic agent in reducing the incidence of ifosfamide-induced hemorrhagic cystitis.
Limitation of Use
MESNEX is not indicated to reduce the risk of hematuria due to other pathological conditions such as thrombocytopenia.
Dosage and administration
MESNEX may be given on a fractionated dosing schedule of three bolus intravenous injections as outlined below.
MESNEX injection is given as intravenous bolus injections in a dosage equal to 20% of the ifosfamide dosage weight by weight (w/w) at the time of ifosfamide administration and 4 and 8 hours after each dose of ifosfamide. The total daily dose of MESNEX is 60% of the ifosfamide dose. The recommended dosing schedule is outlined below in Table 1.
Table 1: Recommended Intravenous Dosing Schedule
0 HOURS 4 HOURS 8 HOURS
Ifosfamide 1.2 g/m² - -
MESNEX Injection1 240 mg/m² 240 mg/m² 240 mg/m²
1The dosing schedule should be repeated on each day that ifosfamide is administered. When the dosage of ifosfamide is increased or decreased, the ratio of MESNEX to ifosfamide should be maintained.
The following are discussed in more detail in other sections of the labeling.
Benzyl Alcohol Toxicity
Laboratory Test Interferences
Use in Patients with a History of Adverse Reactions to Thiol Compounds
MESNEX may cause systemic hypersensitivity reactions, includinganaphylaxis. These reactions may include fever, cardiovascular symptoms (hypotension, tachycardia), acute renal impairment, hypoxia, respiratory distress, urticaria, angioedema, laboratory signs of disseminated intravascular coagulation, hematological abnormalities, increased liver enzymes, nausea, vomiting, arthralgia, and myalgia. These reactions may occur with the first exposure or after several months of exposure. Monitor for signs or symptoms. Discontinue MESNEX and provide supportive care.
Drug rash with eosinophilia and systemic symptoms and bullous and ulcerative skin and mucosal reactions, consistent with Stevens-Johnson syndrome or toxic epidermal necrolysis have occurred. MESNEX may cause skin and mucosal reactions characterized by urticaria, rash, erythema,pruritus, burning sensation, angioedema, periorbital edema, flushing and stomatitis. These reactions may occur with the first exposure or after several months of exposure. Discontinue MESNEX and provide supportive care.