Mesna

The chemotherapy drugs ifosfamide and cyclophosphamide can sometimes irritate the lining of the bladder. This can cause bleeding from the bladder and may show up as blood in your urine (pee). This is called haematuria. Mesna helps protect your bladder to prevent irritation and bleeding.

People being treated with ifosfamide will always have mesna. 

Cyclophosphamide only causes bleeding from the bladder when it is given in high doses. Most people who have treatment with cyclophosphamide do not have it as a high dose. They will not need mesna. Your doctor can tell you if you are having a high dose of cyclophosphamide. 

While you are having mesna, your urine (pee) is tested for signs of blood. If you have blood in your urine, you will be given extra mesna. 

Doing these things can help protect your bladder during treatment:

• Drinking plenty of water – at least 2 litres (3½ pints) daily. Your nurse can tell you how much you should drink.
• Emptying your bladder often during the treatment.

This information is correct at time of publishing. But sometimes the types of cancer this treatment is used for, or treatment side effects, may change between revision dates.

You can talk to your cancer team if you want more detailed information about this treatment. Or visit the electronic Medicines Compendium (eMC) website, which has patient information leaflets (PIL) for individual drugs.

We explain the most common side effects of this treatment here. We also include some less common side effects.

You may get some of the side effects we mention, but you are unlikely to get all of them. It is often difficult to know which side effects may be caused by mesna and which ones may be caused by the chemotherapy. Always tell your doctor or nurse about the side effects you have.

Your doctor can give you drugs to help control some side effects. It is important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work for you. Your nurse will give you advice about managing your side effects. After your treatment is over, most side effects start to improve.

Your doctor, nurse or pharmacist will give you 24-hour contact numbers for the hospital. If you feel unwell or need advice, you can call at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.

Some cancer treatments can cause serious side effects. Sometimes, these may be life-threatening. Your doctor, nurse or pharmacist can explain the risk of these side effects to you.

You may feel sick. Your doctor will give you anti-sickness drugs to help prevent or control sickness. Take the drugs exactly as your nurse or pharmacist tells you. It is easier to prevent sickness than to treat it after it has started.

If you are sick after taking mesna by mouth, contact the hospital for advice. It is important you do not miss a dose of mesna so that your bladder lining is protected.

This treatment may cause headaches. If you have headaches, tell your doctor, nurse or pharmacist. They can give you advice about painkillers that may help. Tell them if the headache does not get better, or gets worse.

You may get pain or discomfort in your tummy (abdomen), feel bloated or have wind. Your doctor can give you drugs to help improve these symptoms. Tell them if the pain does not improve or if it gets worse.

This treatment may cause diarrhoea. Diarrhoea means passing more stools (poo) than is normal for you, or having watery or loose stools. You may also have stomach cramps. If you have a stoma, it may be more active than usual. 

If you are passing loose stools 3 or more times a day and this is not normal for you, contact the hospital as soon as possible on the 24-hour number. Follow the advice they give you about:

• taking anti-diarrhoea medicines 
• drinking enough fluids to keep you hydrated and to replace lost salts and minerals
• any changes to your diet that might help. 

They might also ask you for a specimen of your stool to check for infection.

Feeling tired is a common side effect of this treatment. It is often worse towards the end of treatment and for some weeks after it ends. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can help you feel less tired. 

If you feel sleepy, do not drive or use machinery.

You may get pain in your muscles or joints for a few days after treatment. If this happens, tell your doctor, nurse or pharmacist. They can give you painkillers and advice. They can also tell you if any of the painkillers you usually take are suitable. 

Tell them if the pain does not get better. Having warm baths and resting regularly may help. 

This treatment may affect your skin. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day. This treatment can cause a rash, which may be itchy.

Always tell your doctor or nurse about any skin changes. They can give you advice and may give you creams or medicines to help. Any changes to your skin are usually temporary and improve when treatment finishes.

Mesna can cause difficulty sleeping, nightmares and a low attention span. Tell your doctor or nurse if you have any of these side effects. They may make some changes to your treatment if the side effects become a problem.

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

• use plain English
• explain medical words
• use short sentences
• use illustrations to explain text
• structure the information clearly
• make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.