Uromes Special Precautions

The elderly.
Allergic reactions to Mesna ranging from mild hypersensitivity to systemic anaphylactic reactions have been reported.
Patients with autoimmune disorders who were treated with cyclophosphamide and Mesna appeared to have a higher incidence of allergic reactions.
Mesna has been developed as an agent to prevent ifosfamide-induced urinary toxicity. It will not prevent or alleviate any of the other adverse reactions or toxicities associated with ifosfamide therapy.
Mesna does not prevent hemorrhagic cystitis in all patients. Up to 6% of patients treated with Mesna have developed hematuria (＞50 RBC/HPF or WHO grade 2 and above). As a result, a morning specimen of urine should be examined for the presence of hematuria (red blood cells) each day prior to ifosfamide therapy. If hematuria develops when Mesna is given with ifosfamide according to the recommended dosage schedule, depending on the severity of the hematuria, dosage reductions or discontinuation of ifosfamide therapy may be initiated.
Use in Children: Safety and effectiveness in pediatric patients have not been established.
Use in Elderly: In general, dose selection for an elderly patient should be cautious, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. According to decrease administration of ifosfamide, Mesna administration decreases in quantity (A dosage; 20% of ifosfamide in 1 day).