Mesna

This program discusses mesna (sodium 2-mercapto-ethane sulfonate), a detoxifying agent employed to avert hemorrhagic cystitis in patients undergoing chemotherapy with high-dose cyclophosphamide or ifosfamide. The discussion centers on mesna's distinctive mechanism of action wherein it undergoes initial inactivation to dimesna (mensa disulfide) within the bloodstream. Once filtered through the kidneys and subsequently excreted into the bladder, mesna undergoes reactivation. In the bladder, the reactivated mesna detoxifies acrolein, a urotoxic byproduct of ifosfamide and cyclophosphamide, thereby mitigating the risk of hemorrhagic cystitis.