Mercaptoethanesulphonic acid

Generic name
Mercaptoethanesulphonic acid
Brand name
ATC Code
V03AF01
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Mercaptoethanesulphonic acid

Dosages
Side effects in children
Warnings & precautions in children
Contra-indications in children

Interactions
PK
Renal impairment
References

Pharmacokinetics in children

The bioavailability of the tablets is 50%

dose recommendation of formulary compared to licensed use (on-label versus off-label)

No information is present at this moment.

Available formulations

No information is present at this moment.

Dosages

Prophylaxis for haemorrhagic cystitis
  • Oral
    • 1 month up to 18 years
      [1] [2] [3] [4] [5] [6]

      • 120% orally of the total daily dosage of oxazaphosphorine preparation dosed by bodyweight divided over three equal doses (3x 40%), usually 2 hours before the oxazaphosphorine preparation and 2 hours and 6 hours after administration. If administered intravenously in the first instance, the first oral administration can lapse. This then becomes 20% of the oxazaphosphorine preparation intravenously at Hour 0, followed by 40% orally at Hour 2 and 40% orally at Hour 6. Tablet numbers should be rounded down to whole tablets.

        For long-term infusions of ifosfamide and mercaptoethanesulphonic acid, at the time the combined infusion is stopped and 2 and 6 hours after stopping, give an oral dose corresponding to 40% of the last total 24-hour infusion of ifosfamide rounded down to whole tablets.

        It may be necessary in individual cases to shorten the interval between 2 doses and/or to increase the number of doses. This protects children, who generally have increased urine production.

  • Intravenous
    • 1 month up to 18 years
      [1] [2] [3] [4] [5] [6]

      • 60% intravenously of the total daily dosage of oxazaphosphorine preparation dosed by bodyweight divided over three equal doses (3x 20%). This is usually 0, 4 and 8 hours after administration of the oxazaphosphorine preparation.

        In the case of continuous ifosfamide infusion (24 hours), an initial dose of 20% of the ifosfamide bolus should be given intravenously, followed by infusion (together with ifosfamide) of 100% of the ifosfamide dose. Continue treatment for 6-12 hours after ending the ifosfamide infusion.

        It may be necessary in individual cases to shorten the interval between 2 doses and/or to increase the number of doses. This protects children, who generally have increased urine production.

Renal impaiment in children > 3 months

GFR ≥10 ml/min/1.73m2: Dose adjustment not required.

GFR <10 ml/min/1.73m2: A general recommendation on dose adjustment cannot be provided.

The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here

Side effects

No information is present at this moment.

The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here

Contra-indications

No information available on specific contra indications in children.

The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here

Warnings & precautions in children

When dosing mesna at > 80 mg/kg each time, gastrointestinal side effects may occur. Watch out for hypersensitivity reactions.

Interactions

The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here

ALL OTHER THERAPEUTIC PRODUCTS

This pages provides a list of drugs from the same ATC class for comparison. This does not necessarily mean that these drugs are interchangeable.

Antidotes
V03AB15
V03AB14
Iron chelating agents
V03AC03
V03AC02
V03AC01
Detoxifying agents for antineoplastic treatment
V03AF03
V03AF07
Drugs for treatment of hypoglycemia
V03AH01
DETOXIFYING AGENTS FOR ANTINEOPLASTIC TREATMENT
V03AF03
V03AF07

References

  1. Anderson P, Continuously improving ifosfamide/mesna: a winning combination, Pediatr Blood Cancer, 2010, Oct;55(4), 599-600
  2. Kamps WA et al, Werkboek ondersteundende behandeling kinderoncologie, VU Uitgeverij, 2005
  3. Dorris K, et al , Severe allergic reactions to thiol-based cytoprotective agents mesna and amifostine in a child with a supratentorial primitive neuroectodermal tumor, J Pediatr Hematol Oncol, 2011, Aug;33(6), e250-2
  4. Goren MP, et al, Urine mesna excretion after intravenous and oral dosing in ifosfamide-treated children, Cancer Chemother Pharmacol, 2004, Sep;54(3), 237-40
  5. Kangarloo SB, et al, Influence of mesna on the pharmacokinetics of cisplatin and carboplatin in pediatric cancer patients, Med Oncol, 2004, 21(1), 9-20
  6. Khaw SL, et al, Adverse hypersensitivity reactions to mesna as adjunctive therapy for cyclophosphamide, Pediatr Blood Cancer, 2007, Sep;49(3), 341-3
  7. Baxter BV, SPC Uromitexan (RVG 08461), www.cbg-meb.nl, Geraadpleegd 02 mei 2012, http://db.cbg-meb.nl/IB-teksten/h08461.pdf

Changes

Therapeutic Drug Monitoring


Overdose