Mesna is used therapeutically to reduce the incidence of haemorrhagic cystitis and haematuria when a patient receives ifosfamide or cyclophosphamide for cancer chemotherapy. These two anticancer agents, in vivo, may be converted to urotoxic metabolites, such as acrolein.
Mesna assists to detoxify these metabolites by reaction of its sulfhydryl group with the vinyl group. It also increases urinary excretion of cysteine.
There is oral mesna available now. FDA approved oral mesna, but oral doses must be double the intravenous (IV) mesna dose due to bioavailability issues. This allows patients to leave the hospital sooner, instead of staying four to five days for all the mesna infusions. The IV mesna infusions would be given with IV ifosfamide, while oral mesna would be given with oral cyclophosphamide.