Markman M, Kennedy A, Webster K, Kulp B, Peterson G, Belinson J
Department of Gynecology, The Cleveland Clinic Foundation, Cleveland 44195, USA.
Semin Oncol. 1996 Jun;23(3 Suppl 6):97-8.
Hemorrhagic cystitis is a major potential toxicity of ifosfamide that can be prevented by administering mesna along with the cytotoxic agent. Mesna is generally administered by the intravenous route, although experience with oral delivery of the drug has increased. The continuous subcutaneous administration of mesna has the advantage of not requiring intravenous access. In addition, subcutaneous delivery of the neutralizing agent will not be associated with the risk of inadequate urinary mesna concentrations, such as in a patient taking oral mesna who experiences severe ifosfamide-induced emesis and is unable to absorb the drug. Limited clinical experience with continuous subcutaneous mesna administration suggests it is a safe, practical, and economic method of drug delivery that permits ifosfamide to be administered successfully in the outpatient setting.
出血性膀胱炎是异环磷酰胺的一种主要潜在毒性反应，可通过在给予细胞毒性药物的同时给予美司钠来预防。美司钠一般通过静脉途径给药，不过口服该药的经验也有所增加。持续皮下给予美司钠具有无需静脉通路的优点。此外，中和剂的皮下给药不会出现尿中美司钠浓度不足的风险，比如口服美司钠的患者发生严重的异环磷酰胺诱导的呕吐且无法吸收药物时。持续皮下给予美司钠的有限临床经验表明，这是一种安全、实用且经济的给药方法，能使异环磷酰胺在门诊环境中成功给药。
