Uromes Dosage/Direction for Use

For IV administration, the contents of an ampule should be diluted with an appropriate volume of a compatible IV solution (i.e., 5% dextrose; 5% dextrose and 0.2, 0.33, or 0.45% sodium chloride; 0.9% sodium chloride; lactated Ringer's) to obtain a solution containing 20 mg/mL. The diluted solution may then be given by direct IV injection or infused IV over a period of 15-30 minutes.
IV administration with Oxazaphosphorine injection: If ifosfamide or cyclophosphamide is given as an intravenous bolus, Mesna as 20% of the dose of the antineoplastic on a weight for weight basis is given intravenously on 3 occasions over 15 to 30 minutes at 4-hourly intervals beginning at the same time as the antineoplastic injection.
This regimen is repeated for each dose of the antineoplastic. The dose of Mesna may be increased to 40% of the dose of the antineoplastic and given 4 times at 3-hourly intervals for patients at high risk of urotoxicity.
IV administration with Oxazaphosphorine infusion: If the antineoplastic is given as by intravenous infusion over 24 hours, Mesna as 20% of the total antineoplastic dose is given by intravenous injection, followed by 100% of the total dose by intravenous infusion over 24 hours, then followed by 60% by infusion over a further 12 hours.
The final 12-hour infusion may be replaced by 3 injections each of 20% of the antineoplastic dose at 4-hourly intervals. Urinary output should be maintained and the urine monitored for haematuria and proteinuria throughout the treatment period. However, frequent emptying of the bladder should be avoided.
When Mesna is exposed to oxygen, it is oxidized. Therefore, unused portions of the injection should be discarded.
Diluted solutions for drip infusion should be used within 24 hours after preparation.