{"id":"mesna","rwe":[{"pmid":"41845894","year":"2026","title":"Conformationally Adaptive SERS Receptors: Reconfiguring Binding Environments via Dynamic Gauche-Trans Transitions for Broad-Spectrum Ion Sensing.","finding":"","journal":"ACS applied materials & interfaces","studyType":"Clinical Study"},{"pmid":"41635361","year":"2026","title":"Primary Renal Synovial Sarcoma: A Report of a Rare Case and Management Approach.","finding":"","journal":"Cureus","studyType":"Clinical Study"},{"pmid":"41608667","year":"2026","title":"Primary Embryonal Rhabdomyosarcoma of the Breast: A Case Report and Literature Review.","finding":"","journal":"Case reports in oncology","studyType":"Clinical Study"},{"pmid":"41578877","year":"2026","title":"Mesna in Otologic Surgery: Efficacy and Safety-A Scoping Review.","finding":"","journal":"The Laryngoscope","studyType":"Clinical Study"},{"pmid":"41561516","year":"2025","title":"An evidence-based approach to pericardial synovial sarcoma: a unique case report.","finding":"","journal":"Ecancermedicalscience","studyType":"Clinical Study"}],"_fda":{"id":"4597547b-01bd-48fd-e063-6294a90afad8","set_id":"1dd69e84-616d-fb77-e063-6394a90af2f4","openfda":{"unii":["NR7O1405Q9"],"route":["INTRAVENOUS"],"rxcui":["204870","899350"],"spl_id":["4597547b-01bd-48fd-e063-6294a90afad8"],"brand_name":["MESNEX"],"spl_set_id":["1dd69e84-616d-fb77-e063-6394a90af2f4"],"package_ndc":["83703-559-01","83703-559-03"],"product_ndc":["83703-559"],"generic_name":["MESNA"],"product_type":["HUMAN PRESCRIPTION DRUG"],"substance_name":["MESNA"],"manufacturer_name":["Bamboo US Bidco LCC"],"application_number":["NDA019884"],"is_original_packager":[true]},"version":"2","pregnancy":["8.1 Pregnancy Risk Summary MESNEX is used in combination with ifosfamide or other cytotoxic agents. Ifosfamide can cause fetal harm when administered to a pregnant woman. Refer to the ifosfamide prescribing information for more information on use during pregnancy. MESNEX injection contains the preservative benzyl alcohol. Because benzyl alcohol is rapidly metabolized by a pregnant woman, benzyl alcohol exposure in the fetus is unlikely [see Warnings and Precautions (5.3) and Use in Specific Populations (8.4)]. The estimated background risk of major birth defects and miscarriage for the indicated populations are unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2-4% and 15-20%, respectively. Data Animal Data MESNEX is used in combination with ifosfamide or other cytotoxic agents. Ifosfamide can cause fetal harm including embryo-fetal lethality. Refer to the ifosfamide prescribing information for more information on use during pregnancy. In embryo-fetal development studies, oral administration of mesna to pregnant rats (500, 1000, 1500, and 2000 mg/kg) and rabbits (500 and 1000 mg/kg) during the period of organogenesis revealed no adverse developmental outcomes at doses approximately 10 times the maximum recommended total daily human equivalent dose based on body surface area."],"overdosage":["10 OVERDOSAGE There is no known antidote for MESNEX. In a clinical trial, 11 patients received intravenous MESNEX 10 mg/kg to 66 mg/kg per day for 3 to 5 days. Patients also received ifosfamide or cyclophosphamide. Adverse reactions included nausea, vomiting, diarrhea and fever. An increased rate of these adverse reactions has also been found in oxazaphosphorine-treated patients receiving ≥80 mg MESNEX per kg per day intravenously compared with patients receiving lower doses or hydration treatment only. Postmarketing, administration of 4.5 g to 6.9 g of MESNEX resulted in hypersensitivity reactions including mild hypotension, shortness of breath, asthma exacerbation, rash, and flushing."],"description":["11 DESCRIPTION MESNEX (mesna) is a detoxifying agent to inhibit the hemorrhagic cystitis induced by ifosfamide. The active ingredient, mesna, is a synthetic sulfhydryl compound designated as sodium-2-mercaptoethane sulfonate with a molecular formula of C 2 H 5 NaO 3 S 2 and a molecular weight of 164.18. Its structural formula is as follows: HS–CH 2 –CH 2 SO 3 –Na + MESNEX injection is a sterile, nonpyrogenic, aqueous solution of clear and colorless appearance in clear glass multidose vials for intravenous administration. MESNEX injection contains 100 mg/mL mesna, 0.25 mg/mL edetate disodium and sodium hydroxide for pH adjustment. MESNEX injection multidose vials also contain 10.4 mg/mL of benzyl alcohol as a preservative. The solution has a pH range of 7.5-8.5. MESNEX tablets are white, oblong, scored biconvex film-coated tablets with the imprint M4. They contain 400 mg mesna. The excipients are calcium phosphate, cornstarch, hydroxypropylmethylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, povidone, simethicone, and titanium dioxide."],"how_supplied":["16 HOW SUPPLIED/STORAGE AND HANDLING MESNEX (mesna) injection 100 mg/mL NDC 0338-1305-01 1 g Multidose Vial, Box of 1 vial of 10 mL NDC 0338-1305-03 1 g Multidose Vial, Box of 10 vials of 10 mL Store at 20°C to 25°C (68°F to 77°F), excursions permitted to 15°C to 30°C (59°F to 86°F) [see USP Controlled Room Temperature] If MESNEX is co-administered with ifosfamide, refer to the ifosfamide prescribing information for safe handling instructions. MESNEX (mesna) tablets NDC 67108-3565-9 400 mg scored tablets packaged in box of 10 tablets Store at 20°C to 25°C (68°F to 77°F), excursions permitted to 15°C to 30°C (59°F to 86°F) [see USP Controlled Room Temperature]"],"geriatric_use":["8.5 Geriatric Use Clinical studies of MESNEX did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. In general, dose selection for an elderly patient should be cautious, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. The ratio of ifosfamide to MESNEX should remain unchanged."],"pediatric_use":["8.4 Pediatric Use MESNEX injection contains the preservative benzyl alcohol which has been associated with serious adverse reactions and death when administered intravenously to premature neonates and low birth weight infants . Avoid use of MESNEX injection in premature neonates and low-birth weight infants [see Warnings and Precautions (5.3) ]."],"effective_time":"20251210","clinical_studies":["14 CLINICAL STUDIES 14.1 Intravenous MESNEX Hemorrhagic cystitis produced by ifosfamide is dose dependent (Table 4). At a dose of 1.2 g/m 2 ifosfamide administered daily for 5 days, 16 to 26% of the patients who received conventional uroprophylaxis (high fluid intake, alkalinization of the urine, and the administration of diuretics) developed hematuria (>50 RBC per hpf or macrohematuria) (Studies 1, 2, and 3). In contrast, none of the patients who received mesna injection together with this dose of ifosfamide developed hematuria (Studies 3 and 4). In two randomized studies, (Studies 5 and 6), higher doses of ifosfamide, from 2 g/m 2 to 4 g/m 2 administered for 3 to 5 days, produced hematuria in 31 to 100% of the patients. When MESNEX was administered together with these doses of ifosfamide, the incidence of hematuria was less than 7%. Table 4. Percent of MESNEX Patients Developing Hematuria (≥50 RBC/hpf or macrohematuria) Study Conventional Uroprophylaxis (number of patients) Standard MESNEX Intravenous Regimen (number of patients) Uncontrolled Studies Ifosfamide dose 1.2 g/m 2 d x 5 Study 1 16% (7/44) - Study 2 26% (11/43) - Study 3 18% (7/38) 0% (0/21) Study 4 - 0% (0/32) Controlled Studies Ifosfamide dose 2 g/m 2 to 4 g/m 2 d x 3 to 5 Study 5 31% (14/46) 6% (3/46) Study 6 100% (7/7) 0% (0/8) 14.2 Oral MESNEX Clinical studies comparing recommended intravenous and oral MESNEX dosing regimens demonstrated incidences of grade 3 to 4 hematuria of <5%. Study 7 was an open label, randomized, two-way crossover study comparing three intravenous doses with an initial intravenous dose followed by two oral doses of MESNEX in patients with cancer treated with ifosfamide at a dose of 1.2 g/m 2 to 2.0 g/m 2 for 3 to 5 days. Study 8 was a randomized, multicenter study in cancer patients receiving ifosfamide at 2.0 g/m 2 for 5 days. In both studies, development of grade 3 or 4 hematuria was the primary efficacy endpoint. The percent of patients developing hematuria in each of these studies is presented in Table 5. Table 5. Percent of MESNEX Patients Developing Grade 3 or 4 Hematuria MESNEX Dosing Regimen Study Standard Intravenous Regimen (number of patients) Intravenous + Oral Regimen (number of patients) Study 7 0% (0/30) 3.6% (1/28) Study 8 3.7% (1/27) 4.3% (1/23)"],"pharmacokinetics":["12.3 Pharmacokinetics Absorption Following oral administration, peak plasma concentrations were reached within 1.5 to 4 hours and 3 to 7 hours for free mesna and total mesna (mesna plus dimesna and mixed disulfides), respectively. Oral bioavailability averaged 58% (range 45 to 71%) for free mesna and 89% (range 74 to 104%) for total mesna based on plasma AUC data from 8 healthy volunteers who received 1200 mg oral or intravenous doses. Food does not affect the urinary availability of orally administered MESNEX. Distribution Mean apparent volume of distribution (V d ) for mesna is 0.652 ± 0.242 L/kg after intravenous administration which suggests distribution to total body water (plasma, extracellular fluid, and intracellular water). Metabolism Analogous to the physiological cysteine-cystine system, mesna is rapidly oxidized to its major metabolite, mesna disulfide (dimesna). Plasma concentrations of mesna exceed those of dimesna after oral or intravenous administration. Excretion Following intravenous administration of a single 800 mg dose, approximately 32% and 33% of the administered dose was eliminated in the urine in 24 hours as mesna and dimesna, respectively. Mean plasma elimination half-lives of mesna and dimesna are 0.36 hours and 1.17 hours, respectively. Mesna has a plasma clearance of 1.23 L/h/kg."],"adverse_reactions":["6 ADVERSE REACTIONS The following are discussed in more detail in other sections of the labeling. Hypersensitivity Reactions [see Warnings and Precautions (5.1) ] Dermatological Toxicity [see Warnings and Precautions (5.2) ] Benzyl Alcohol Toxicity [see Warnings and Precautions (5.3) ] Laboratory Test Interferences [see Warnings and Precautions (5.4) ] Use in Patients with a History of Adverse Reactions to Thiol Compounds [see Warnings and Precautions (5.5) ] The most common adverse reactions (> 10%) when MESNEX is given with ifosfamide are nausea, vomiting, constipation, leukopenia, fatigue, fever, anorexia, thrombocytopenia, anemia, granulocytopenia, diarrhea, asthenia, abdominal pain, headache, alopecia, and somnolence. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Baxter Healthcare at 1-866-888-2472, or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. MESNEX adverse reaction data are available from four Phase 1 studies in which single intravenous doses of 600-1200 mg MESNEX injection without concurrent chemotherapy were administered to a total of 53 healthy volunteers and single oral doses of 600-2400 mg of MESNEX tablets were administered to a total of 82 healthy volunteers. The most frequently reported side effects (observed in two or more healthy volunteers) for healthy volunteers receiving single doses of MESNEX injection alone were headache, injection site reactions, flushing, dizziness, nausea, vomiting, somnolence, diarrhea, anorexia, fever, pharyngitis, hyperesthesia, influenza-like symptoms, and coughing. In two Phase 1 multiple-dose studies where healthy volunteers received MESNEX tablets alone or intravenous MESNEX followed by repeated doses of MESNEX tablets, flatulence and rhinitis were reported. In addition, constipation was reported by healthy volunteers who had received repeated doses of intravenous MESNEX. Additional adverse reactions in healthy volunteers receiving MESNEX alone included injection site reactions, abdominal pain/colic, epigastric pain/burning, mucosal irritation, lightheadedness, back pain, arthralgia, myalgia, conjunctivitis, nasal congestion, rigors, paresthesia, photophobia, fatigue, lymphadenopathy, extremity pain, malaise, chest pain, dysuria, pleuritic pain, dry mouth, dyspnea, and hyperhidrosis. In healthy volunteers, MESNEX was commonly associated with a rapid (within 24 hours) decrease in lymphocyte count, which was generally reversible within one week of administration. Because MESNEX is used in combination with ifosfamide or ifosfamide-containing chemotherapy regimens, it is difficult to distinguish the adverse reactions which may be due to MESNEX from those caused by the concomitantly administered cytotoxic agents. Adverse reactions reasonably associated with MESNEX administered intravenously and orally in four controlled studies in which patients received ifosfamide or ifosfamide-containing regimens are presented in Table 3. Table 3: Adverse Reactions in ≥ 5% of Patients Receiving MESNEX in combination with Ifosfamide-containing Regimens MESNEX Regimen Intravenous-Intravenous-Intravenous Intravenous dosing of ifosfamide and MESNEX followed by either intravenous or oral doses of MESNEX according to the applicable dosage schedule [see Dosage and Administration (2)]. Intravenous-Oral-Oral N exposed 119 (100.0%) 119 (100%) Incidence of AEs 101 (84.9%) 106 (89.1%) Nausea 65 (54.6) 64 (53.8) Vomiting 35 (29.4) 45 (37.8) Constipation 28 (23.5) 21 (17.6) Leukopenia 25 (21.0) 21 (17.6) Fatigue 24 (20.2) 24 (20.2) Fever 24 (20.2) 18 (15.1) Anorexia 21 (17.6) 19 (16.0) Thrombocytopenia 21 (17.6) 16 (13.4) Anemia 20 (16.8) 21 (17.6) Granulocytopenia 16 (13.4) 15 (12.6) Asthenia 15 (12.6) 21 (17.6) Abdominal Pain 14 (11.8) 18 (15.1) Alopecia 12 (10.1) 13 (10.9) Dyspnea 11 (9.2) 11 (9.2) Chest Pain 10 (8.4) 11 (9.2) Hypokalemia 10 (8.4) 11 (9.2) Diarrhea 9 (7.6) 17 (14.3) Dizziness 9 (7.6) 5 (4.2) Headache 9 (7.6) 13 (10.9) Pain 9 (7.6) 10 (8.4) Sweating Increased 9 (7.6) 2 (1.7) Back Pain 8 (6.7) 6 (5.0) Hematuria 8 (6.7) 7 (5.9) Injection Site Reaction 8 (6.7) 10 (8.4) Edema 8 (6.7) 9 (7.6) Edema Peripheral 8 (6.7) 8 (6.7) Somnolence 8 (6.7) 12 (10.1) Anxiety 7 (5.9) 4 (3.4) Confusion 7 (5.9) 6 (5.0) Face Edema 6 (5.0) 5 (4.2) Insomnia 6 (5.0) 11 (9.2) Coughing 5 (4.2) 10 (8.4) Dyspepsia 4 (3.4) 6 (5.0) Hypotension 4 (3.4) 6 (5.0) Pallor 4 (3.4) 6 (5.0) Dehydration 3 (2.5) 7 (5.9) Pneumonia 2 (1.7) 8 (6.7) Tachycardia 1 (0.8) 7 (5.9) Flushing 1 (0.8) 6 (5.0) 6.2 Postmarketing Experience The following adverse reactions have been reported in the postmarketing experience of patients receiving MESNEX in combination with ifosfamide or similar drugs, making it difficult to distinguish the adverse reactions which may be due to MESNEX from those caused by the concomitantly administered cytotoxic agents. Because these reactions are reported from a population of unknown size, precise estimates of frequency cannot be made. Cardiovascular: Hypertension Gastrointestinal: Dysgeusia Hepatobiliary: Hepatitis Nervous System: Convulsion Respiratory: Hemoptysis"],"contraindications":["4 CONTRAINDICATIONS MESNEX is contraindicated in patients known to be hypersensitive to mesna or to any of the excipients [see Warnings and Precautions (5.1) ]. Known hypersensitivity to mesna or to any of the excipients, including benzyl alcohol. ( 4 )"],"drug_interactions":["7 DRUG INTERACTIONS No clinical drug interaction studies have been conducted with MESNEX."],"mechanism_of_action":["12.1 Mechanism of Action Mesna reacts chemically with the urotoxic ifosfamide metabolites, acrolein and 4-hydroxy-ifosfamide, resulting in their detoxification. The first step in the detoxification process is the binding of mesna to 4-hydroxy-ifosfamide forming a non-urotoxic 4-sulfoethylthioifosfamide. Mesna also binds to the double bonds of acrolein and to other urotoxic metabolites and inhibits their effects on the bladder."],"recent_major_changes":["Warnings and Precautions, Benzyl Alcohol Toxicity ( 5.3 ) 12/2018"],"clinical_pharmacology":["12 CLINICAL PHARMACOLOGY 12.1 Mechanism of Action Mesna reacts chemically with the urotoxic ifosfamide metabolites, acrolein and 4-hydroxy-ifosfamide, resulting in their detoxification. The first step in the detoxification process is the binding of mesna to 4-hydroxy-ifosfamide forming a non-urotoxic 4-sulfoethylthioifosfamide. Mesna also binds to the double bonds of acrolein and to other urotoxic metabolites and inhibits their effects on the bladder. 12.3 Pharmacokinetics Absorption Following oral administration, peak plasma concentrations were reached within 1.5 to 4 hours and 3 to 7 hours for free mesna and total mesna (mesna plus dimesna and mixed disulfides), respectively. Oral bioavailability averaged 58% (range 45 to 71%) for free mesna and 89% (range 74 to 104%) for total mesna based on plasma AUC data from 8 healthy volunteers who received 1200 mg oral or intravenous doses. Food does not affect the urinary availability of orally administered MESNEX. Distribution Mean apparent volume of distribution (V d ) for mesna is 0.652 ± 0.242 L/kg after intravenous administration which suggests distribution to total body water (plasma, extracellular fluid, and intracellular water). Metabolism Analogous to the physiological cysteine-cystine system, mesna is rapidly oxidized to its major metabolite, mesna disulfide (dimesna). Plasma concentrations of mesna exceed those of dimesna after oral or intravenous administration. Excretion Following intravenous administration of a single 800 mg dose, approximately 32% and 33% of the administered dose was eliminated in the urine in 24 hours as mesna and dimesna, respectively. Mean plasma elimination half-lives of mesna and dimesna are 0.36 hours and 1.17 hours, respectively. Mesna has a plasma clearance of 1.23 L/h/kg."],"indications_and_usage":["1 INDICATIONS AND USAGE MESNEX is indicated as a prophylactic agent in reducing the incidence of ifosfamide-induced hemorrhagic cystitis. Limitation of Use: MESNEX is not indicated to reduce the risk of hematuria due to other pathological conditions such as thrombocytopenia. MESNEX is a cytoprotective agent indicated as a prophylactic agent in reducing the incidence of ifosfamide-induced hemorrhagic cystitis. ( 1 ) Limitation of Use: MESNEX is not indicated to reduce the risk of hematuria due to other pathological conditions such as thrombocytopenia. ( 1 )"],"warnings_and_cautions":["5 WARNINGS AND PRECAUTIONS Hypersensitivity reactions: Anaphylactic reactions have been reported. Less severe hypersensitivity reactions may also occur. Monitor patients. If a reaction occurs, discontinue MESNEX and provide supportive care. ( 5.1 ) Dermatologic toxicity: Skin rash with eosinophilia and systemic symptoms, Stevens-Johnson syndrome, and toxic epidermal necrolysis have occurred. Skin rash, urticaria, and angioedema have also been seen. Monitor patients. If a reaction occurs, discontinue MESNEX and provide supportive care. ( 5.2 ) Benzyl alcohol toxicity: Serious and fatal adverse reactions can occur in premature neonates and low-birth weight infants treated with benzyl alcohol-preserved drugs, including MESNEX injection. Avoid use in premature neonates and low-birth weight infants. ( 5.3 ) Laboratory test alterations: False positive tests for urinary ketones and interference with enzymatic CPK activity tests have been seen. ( 5.4 ) 5.1 Hypersensitivity Reactions MESNEX may cause systemic hypersensitivity reactions, including anaphylaxis. These reactions may include fever, cardiovascular symptoms (hypotension, tachycardia), acute renal impairment, hypoxia, respiratory distress, urticaria, angioedema, laboratory signs of disseminated intravascular coagulation, hematological abnormalities, increased liver enzymes, nausea, vomiting, arthralgia, and myalgia. These reactions may occur with the first exposure or after several months of exposure. Monitor for signs or symptoms. Discontinue MESNEX and provide supportive care. 5.2 Dermatologic Toxicity Drug rash with eosinophilia and systemic symptoms and bullous and ulcerative skin and mucosal reactions, consistent with Stevens-Johnson syndrome or toxic epidermal necrolysis have occurred. MESNEX may cause skin and mucosal reactions characterized by urticaria, rash, erythema, pruritus, burning sensation, angioedema, periorbital edema, flushing and stomatitis. These reactions may occur with the first exposure or after several months of exposure. Discontinue MESNEX and provide supportive care. 5.3 Benzyl Alcohol Toxicity Serious adverse reactions including fatal reactions and the “gasping syndrome” occurred in premature neonates and low-birth weight infants who received benzyl alcohol dosages of 99 to 234 mg/kg/day (blood levels of benzyl alcohol were 0.61 to 1.378 mmol/L). Symptoms associated with “gasping syndrome” and other potential adverse reactions include gradual neurological deterioration, seizures, intracranial hemorrhage, hematological abnormalities, skin breakdown, hepatic and renal failure, hypotension, bradycardia, and cardiovascular collapse. Premature neonates and low-birth weight infants may be more likely to develop these reactions because they may be less able to metabolize benzyl alcohol. The minimum amount of benzyl alcohol at which toxicity may occur is not known. MESNEX injection contains 10.4 mg/mL of the preservative benzyl alcohol. Avoid use of MESNEX injection in premature neonates and low-birth weight infants. MESNEX tablets do not contain benzyl alcohol [see Use in Specific Populations (8.4) ]. 5.4 Laboratory Test Interferences False-Positive Urine Tests for Ketone Bodies A false positive test for urinary ketones may arise in patients treated with MESNEX when using nitroprusside sodium-based urine tests (including dipstick tests). The addition of glacial acetic acid can be used to differentiate between a false positive result (cherry-red color that fades) and a true positive result (red-violet color that intensifies). False-Negative Tests for Enzymatic CPK Activity MESNEX may interfere with enzymatic creatinine phosphokinase (CPK) activity tests that use a thiol compound (e.g., N-acetylcysteine) for CPK reactiviation. This may result in a falsely low CPK level. False-Positive Tests for Ascorbic Acid MESNEX may cause false-positive reactions in Tillman’s reagent-based urine screening tests for ascorbic acid. 5.5 Use in Patients with a History of Adverse Reactions to Thiol Compounds MESNEX is a thiol compound, i.e., a sulfhydryl (SH) group-containing organic compound. Hypersensitivity reactions to mesna and to amifostine, another thiol compound, have been reported. It is not clear whether patients who experienced an adverse reaction to a thiol compound are at increased risk for a hypersensitivity reaction to MESNEX."],"clinical_studies_table":["<table ID=\"_RefID982DFC7C9E464D46A90459AFF5F9C023\" width=\"100%\"><caption>Table 4. Percent of MESNEX Patients Developing Hematuria (&#x2265;50 RBC/hpf or macrohematuria)</caption><col width=\"28%\"/><col width=\"35%\"/><col width=\"37%\"/><tbody><tr><td styleCode=\"Botrule Lrule Toprule \" valign=\"top\"><paragraph><content styleCode=\"bold\">Study</content></paragraph></td><td align=\"center\" styleCode=\"Botrule Lrule Toprule \" valign=\"top\"><paragraph><content styleCode=\"bold\">Conventional Uroprophylaxis (number of patients)</content></paragraph></td><td align=\"center\" styleCode=\"Rrule Botrule Lrule Toprule \" valign=\"top\"><paragraph><content styleCode=\"bold\">Standard MESNEX Intravenous Regimen (number of patients)</content></paragraph></td></tr><tr><td colspan=\"3\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph><content styleCode=\"bold\">Uncontrolled Studies</content><footnote ID=\"_RefID2E9EFC8C7A7242E98EBCD82B150E97A4\">Ifosfamide dose 1.2 g/m 2 d x 5 </footnote></paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Study 1</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>16% (7/44)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>-</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Study 2</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>26% (11/43)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>-</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Study 3</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>18% (7/38)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>0% (0/21)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Study 4</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>-</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>0% (0/32)</paragraph></td></tr><tr><td colspan=\"3\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph><content styleCode=\"bold\">Controlled Studies</content><footnote ID=\"_RefID7A400A9CC08449F08DA8D0B6A3D921BD\">Ifosfamide dose 2 g/m 2 to 4 g/m 2 d x 3 to 5 </footnote></paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Study 5</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>31% (14/46)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>6% (3/46)</paragraph></td></tr><tr><td styleCode=\"Botrule Lrule \" valign=\"top\"><paragraph>Study 6</paragraph></td><td align=\"center\" styleCode=\"Botrule Lrule \" valign=\"top\"><paragraph>100% (7/7)</paragraph></td><td align=\"center\" styleCode=\"Rrule Botrule Lrule \" valign=\"top\"><paragraph>0% (0/8)</paragraph></td></tr></tbody></table>","<table ID=\"_RefID65DEAEC5A0C841AD8638893B3085F274\" width=\"100%\"><caption>Table 5. Percent of MESNEX Patients Developing Grade 3 or 4 Hematuria</caption><col width=\"28%\"/><col width=\"35%\"/><col width=\"37%\"/><tbody><tr><td styleCode=\"Botrule Lrule Toprule \" valign=\"top\"/><td align=\"center\" colspan=\"2\" styleCode=\"Rrule Botrule Lrule Toprule \" valign=\"top\"><paragraph><content styleCode=\"bold\">MESNEX Dosing Regimen</content></paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph><content styleCode=\"bold\">Study</content></paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph><content styleCode=\"bold\">Standard Intravenous Regimen</content></paragraph><paragraph><content styleCode=\"bold\">(number of patients)</content></paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph><content styleCode=\"bold\">Intravenous + Oral Regimen</content></paragraph><paragraph><content styleCode=\"bold\">(number of patients)</content></paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Study 7</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>0% (0/30)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>3.6% (1/28)</paragraph></td></tr><tr><td styleCode=\"Botrule Lrule \" valign=\"top\"><paragraph>Study 8</paragraph></td><td align=\"center\" styleCode=\"Botrule Lrule \" valign=\"top\"><paragraph>3.7% (1/27)</paragraph></td><td align=\"center\" styleCode=\"Rrule Botrule Lrule \" valign=\"top\"><paragraph>4.3% (1/23)</paragraph></td></tr></tbody></table>"],"nonclinical_toxicology":["13 NONCLINICAL TOXICOLOGY 13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility No long-term studies in animals have been performed to evaluate the carcinogenic potential of mesna. Mesna was not genotoxic in the in vitro Ames bacterial mutagenicity assay, the in vitro mammalian lymphocyte chromosomal aberration assay or the in vivo mouse micronucleus assay. No studies on male or female fertility were conducted. No signs of male or female reproductive organ toxicity were seen in 6-month oral rat studies (≤ 2000 mg/kg/day) or 29-week oral dog studies (520 mg/kg/day) at doses approximately 10-fold higher than the maximum recommended human dose on a body surface area basis."],"adverse_reactions_table":["<table ID=\"_RefIDE6FA9469B0974A7DBE0E91EFA3461940\" width=\"100%\"><caption>Table 3: Adverse Reactions in &#x2265; 5% of Patients Receiving MESNEX in combination with Ifosfamide-containing Regimens</caption><col width=\"25%\"/><col width=\"45%\"/><col width=\"30%\"/><tbody><tr><td styleCode=\"Botrule Lrule Toprule \" valign=\"top\"><paragraph>MESNEX Regimen</paragraph></td><td align=\"center\" styleCode=\"Botrule Lrule Toprule \" valign=\"top\"><paragraph>Intravenous-Intravenous-Intravenous <footnote ID=\"_Ref404254572\">Intravenous dosing of ifosfamide and MESNEX followed by either intravenous or oral doses of MESNEX according to the applicable dosage schedule [see Dosage and Administration (2)]. </footnote></paragraph></td><td align=\"center\" styleCode=\"Rrule Botrule Lrule Toprule \" valign=\"top\"><paragraph>Intravenous-Oral-Oral <footnoteRef IDREF=\"_Ref404254572\"/></paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>N exposed</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>119 (100.0%)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>119 (100%)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Incidence of AEs</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>101 (84.9%)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>106 (89.1%)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Nausea</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>65 (54.6)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>64 (53.8)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Vomiting</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>35 (29.4)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>45 (37.8)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Constipation</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>28 (23.5)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>21 (17.6)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Leukopenia</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>25 (21.0)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>21 (17.6)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Fatigue</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>24 (20.2)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>24 (20.2)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Fever</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>24 (20.2)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>18 (15.1)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Anorexia</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>21 (17.6)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>19 (16.0)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Thrombocytopenia</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>21 (17.6)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>16 (13.4)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Anemia</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>20 (16.8)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>21 (17.6)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Granulocytopenia</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>16 (13.4)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>15 (12.6)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Asthenia</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>15 (12.6)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>21 (17.6)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Abdominal Pain</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>14 (11.8)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>18 (15.1)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Alopecia</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>12 (10.1)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>13 (10.9)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Dyspnea</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>11 (9.2)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>11 (9.2)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Chest Pain</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>10 (8.4)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>11 (9.2)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Hypokalemia</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>10 (8.4)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>11 (9.2)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Diarrhea</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>9 (7.6)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>17 (14.3)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Dizziness</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>9 (7.6)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>5 (4.2)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Headache</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>9 (7.6)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>13 (10.9)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Pain</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>9 (7.6)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>10 (8.4)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Sweating Increased</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>9 (7.6)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>2 (1.7)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Back Pain</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>8 (6.7)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>6 (5.0)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Hematuria</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>8 (6.7)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>7 (5.9)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Injection Site Reaction</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>8 (6.7)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>10 (8.4)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Edema</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>8 (6.7)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>9 (7.6)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Edema Peripheral</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>8 (6.7)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>8 (6.7)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Somnolence</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>8 (6.7)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>12 (10.1)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Anxiety</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>7 (5.9)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>4 (3.4)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Confusion</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>7 (5.9)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>6 (5.0)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Face Edema</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>6 (5.0)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>5 (4.2)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Insomnia</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>6 (5.0)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>11 (9.2)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Coughing</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>5 (4.2)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>10 (8.4)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Dyspepsia</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>4 (3.4)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>6 (5.0)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Hypotension</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>4 (3.4)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>6 (5.0)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Pallor</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>4 (3.4)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>6 (5.0)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Dehydration</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>3 (2.5)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>7 (5.9)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Pneumonia</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>2 (1.7)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>8 (6.7)</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Tachycardia</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>1 (0.8)</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>7 (5.9)</paragraph></td></tr><tr><td styleCode=\"Botrule Lrule \" valign=\"top\"><paragraph>Flushing</paragraph></td><td align=\"center\" styleCode=\"Botrule Lrule \" valign=\"top\"><paragraph>1 (0.8)</paragraph></td><td align=\"center\" styleCode=\"Rrule Botrule Lrule \" valign=\"top\"><paragraph>6 (5.0)</paragraph></td></tr></tbody></table>"],"information_for_patients":["17 PATIENT COUNSELING INFORMATION See FDA-approved patient labeling (Patient Information). Hypersensitivity Advise the patient to discontinue MESNEX and seek immediate medical attention if any signs or symptoms of a hypersensitivity reaction, including systemic anaphylactic reactions occur [see Warnings and Precautions (5.1) ]. Dosing Instructions Advise the patient to take MESNEX at the exact time and in the exact amount as prescribed. Advise the patient to contact their healthcare provider if they vomit within 2 hours of taking oral MESNEX, or if they miss a dose of oral MESNEX [see Dosage and Administration (2.2) ]. Hemorrhagic Cystitis MESNEX does not prevent hemorrhagic cystitis in all patients nor does it prevent or alleviate any of the other adverse reactions or toxicities associated with ifosfamide. Advise the patient to report to their healthcare provider if his/her urine has turned a pink or red color [see Dosage and Administration (2.3) ]. Advise the patient to drink 1 to 2 liters of fluid each day during MESNEX therapy [see Dosage and Administration (2.3) ]. Dermatologic Toxicity Advise the patient that Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug rash with eosinophilia and systemic symptoms and bullous and ulcerative skin and mucosal reactions have occurred with MESNEX. Advise the patient to report to their healthcare provider if signs and symptoms of these syndromes occur [see Warnings and Precautions (5.2) ]. Benzyl Alcohol Toxicity Advise patients that serious adverse reactions are associated with the benzyl alcohol found in MESNEX and other medications in premature neonates and low-birth weight infants [see Warnings and Precautions (5.3) and Use in Specific Populations (8.4) ]. Embryo-Fetal Toxicity MESNEX is used in combination with ifosfamide. Ifosfamide or other cytotoxic agents can cause fetal harm when administered to a pregnant woman. Inform female patients of the risk to a fetus and potential loss of the pregnancy. Advise females to inform their healthcare provider if they are pregnant or become pregnant [see Use in Specific Populations (8.1) ]. Contraception Advise females of reproductive potential to use effective contraception during treatment with MESNEX in combination with ifosamide and for 6 months after the last dose [see Use in Specific Populations (8.3)] . Advise male patients with female partners of reproductive potential to use effective contraception during treatment with MESNEX in combination with ifosamide and for 3 months after the last dose [see Use in Specific Populations (8.3) ]. Lactation Advise lactating women not to breastfeed during treatment with MESNEX or ifosfamide and for 1 week after the last dose [see Use in Specific Populations (8.2) ]."],"spl_unclassified_section":["Baxter Logo MESNEX (mesna) injection manufactured by: MESNEX (mesna) tablets manufactured for: Baxter Healthcare Corporation Deerfield, IL 60015 USA For Product Inquiry 1800 ANA DRUG (1-800-262-3784) Made in Germany Baxter and Mesnex are registered trademarks of Baxter International Inc. Material No. HA-30-01-814"],"dosage_and_administration":["2 DOSAGE AND ADMINISTRATION MESNEX may be given on a fractionated dosing schedule of three bolus intravenous injections or a single bolus injection followed by two oral administrations of MESNEX tablets as outlined below. The dosing schedule should be repeated on each day that ifosfamide is administered. When the dosage of ifosfamide is adjusted, the ratio of MESNEX to ifosfamide should be maintained. ( 2 ) Intravenous Dosing Schedule: 0 Hours 4 Hours 8 Hours Ifosfamide 1.2 g/m 2 -- -- MESNEX injection 240 mg/m 2 240 mg/m 2 240 mg/m 2 Intravenous and Oral Dosing Schedule: 0 Hours 2 Hours 6 Hours Ifosfamide 1.2 g/m 2 -- -- MESNEX injection 240 mg/m 2 -- -- MESNEX tablets -- 480 mg/m 2 480 mg/m 2 Maintain sufficient urinary output, as required for ifosfamide treatment, and monitor urine for the presence of hematuria. ( 2.3 ) 2.1 Intravenous Dosing MESNEX may be given on a fractionated dosing schedule of three bolus intravenous injections as outlined below. MESNEX injection is given as intravenous bolus injections in a dosage equal to 20% of the ifosfamide dosage weight by weight (w/w) at the time of ifosfamide administration and 4 and 8 hours after each dose of ifosfamide. The total daily dose of MESNEX is 60% of the ifosfamide dose. The recommended dosing schedule is outlined below in Table 1. Table 1. Recommended Intravenous Dosing Schedule 0 Hours 4 Hours 8 Hours Ifosfamide 1.2 g/m 2 – – MESNEX injection The dosing schedule should be repeated on each day that ifosfamide is administered. When the dosage of ifosfamide is increased or decreased, the ratio of MESNEX to ifosfamide should be maintained. 240 mg/m 2 240 mg/m 2 240 mg/m 2 2.2 Intravenous and Oral Dosing MESNEX may be given on a fractionated dosing schedule of a single bolus injection followed by two oral administrations of MESNEX tablets as outlined below. MESNEX injection is given as intravenous bolus injections in a dosage equal to 20% of the ifosfamide dosage (w/w) at the time of ifosfamide administration. MESNEX tablets are given orally in a dosage equal to 40% of the ifosfamide dose 2 and 6 hours after each dose of ifosfamide. The total daily dose of MESNEX is 100% of the ifosfamide dose. The recommended dosing schedule is outlined in Table 2. Table 2. Recommended Intravenous and Oral Dosing Schedule 0 Hours 2 Hours 6 Hours Ifosfamide 1.2 g/m 2 – – MESNEX injection The dosing schedule should be repeated on each day that ifosfamide is administered. When the dosage of ifosfamide is increased or decreased, the ratio of MESNEX to ifosfamide should be maintained. 240 mg/m 2 – – MESNEX tablets – 480 mg/m 2 480 mg/m 2 The efficacy and safety of this ratio of intravenous and oral MESNEX has not been established as being effective for daily doses of ifosfamide higher than 2 g/m 2 . Patients who vomit within two hours of taking oral MESNEX should repeat the dose or receive intravenous MESNEX. 2.3 Monitoring for Hematuria Maintain adequate hydration and sufficient urinary output, as required for ifosfamide treatment, and monitor urine for the presence of hematuria. If severe hematuria develops when MESNEX is given according to the recommended dosage schedule, dosage reductions or discontinuation of ifosfamide therapy may be required. 2.4 Preparation for Intravenous Administration and Stability Preparation Determine the volume of MESNEX injection for the intended dose. Dilute the volume of MESNEX injection for the dose in any of the following fluids to obtain a final concentration of 20 mg/mL: 5% Dextrose Injection, USP 5% Dextrose and 0.2% Sodium Chloride Injection, USP 5% Dextrose and 0.33% Sodium Chloride Injection, USP 5% Dextrose and 0.45% Sodium Chloride Injection, USP 0.9% Sodium Chloride Injection, USP Lactated Ringer’s Injection, USP Stability The MESNEX injection multidose vials may be stored and used for up to 8 days after initial puncture. Store diluted solutions at 25°C (77°F). Use diluted solutions within 24 hours. Do not mix MESNEX injection with epirubicin, cyclophosphamide, cisplatin, carboplatin, and nitrogen mustard. The benzyl alcohol contained in MESNEX injection vials can reduce the stability of ifosfamide. Ifosfamide and MESNEX may be mixed in the same bag provided the final concentration of ifosfamide does not exceed 50 mg/mL. Higher concentrations of ifosfamide may not be compatible with MESNEX and may reduce the stability of ifosfamide. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Any solutions which are discolored, hazy, or contain visible particulate matter should not be used."],"spl_product_data_elements":["MESNEX mesna EDETATE DISODIUM SODIUM HYDROXIDE BENZYL ALCOHOL MESNA 2-MERCAPTOETHANESULFONIC ACID"],"dosage_forms_and_strengths":["3 DOSAGE FORMS AND STRENGTHS MESNEX (mesna) injection: 1 g Multidose Vial, 100 mg/mL MESNEX (mesna) tablets: 400 mg film-coated tablets with functional score Injection: 1g (100 mg/mL) Multidose vials ( 3 ) Tablets: 400 mg with functional score ( 3 )"],"use_in_specific_populations":["8 USE IN SPECIFIC POPULATIONS Pregnancy: MESNEX in combination with ifosfamide can cause fetal harm. Advise patients of potential risk to a fetus. (8.1) Lactation: Do not breastfeed. (8.2) Females and Males of Reproductive Potential: Advise patients to use effective contraception. Verify pregnancy status prior to initiation of MESNEX in combination with ifosfamide. (8.3) Pediatric use: In premature neonates and low-birth weight infants, avoid use of benzyl alcohol–containing solutions. (8.4) Geriatric use: Dose selection should be cautious. (8.5) 8.1 Pregnancy Risk Summary MESNEX is used in combination with ifosfamide or other cytotoxic agents. Ifosfamide can cause fetal harm when administered to a pregnant woman. Refer to the ifosfamide prescribing information for more information on use during pregnancy. MESNEX injection contains the preservative benzyl alcohol. Because benzyl alcohol is rapidly metabolized by a pregnant woman, benzyl alcohol exposure in the fetus is unlikely [see Warnings and Precautions (5.3) and Use in Specific Populations (8.4)]. The estimated background risk of major birth defects and miscarriage for the indicated populations are unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2-4% and 15-20%, respectively. Data Animal Data MESNEX is used in combination with ifosfamide or other cytotoxic agents. Ifosfamide can cause fetal harm including embryo-fetal lethality. Refer to the ifosfamide prescribing information for more information on use during pregnancy. In embryo-fetal development studies, oral administration of mesna to pregnant rats (500, 1000, 1500, and 2000 mg/kg) and rabbits (500 and 1000 mg/kg) during the period of organogenesis revealed no adverse developmental outcomes at doses approximately 10 times the maximum recommended total daily human equivalent dose based on body surface area. 8.2 Lactation Risk Summary MESNEX is used in combination with ifosfamide or other cytotoxic agents. Ifosfamide is excreted in breast milk. Refer to the ifosfamide prescribing information for more information on use during lactation. There are no data on the presence of mesna in human or animal milk, the effect on the breastfed child, or the effect on milk production. MESNEX injection contains the preservative benzyl alcohol. Because benzyl alcohol is rapidly metabolized by a lactating woman, benzyl alcohol exposure in the breastfed infant is unlikely. However, adverse reactions have occurred in premature neonates and low birth weight infants who received intravenously administered benzyl alcohol-containing drugs [see Warnings and Precautions (5.3) and Use in Specific Populations (8.4)]. Because of the potential for serious adverse reactions in a breastfed child, advise lactating women not to breastfeed during treatment and for 1 week after the last dose of MESNEX or ifosfamide. 8.3 Females and Males of Reproductive Potential MESNEX is used in combination with ifosfamide or other cytotoxic agents. Ifosfamide can cause fetal harm when administered to a pregnant woman. Refer to the ifosfamide prescribing information for more information on contraception and effects on fertility. Pregnancy Testing Verify the pregnancy status of females of reproductive potential prior to initiation of MESNEX in combination with ifosfamide. Contraception Females Advise females of reproductive potential to use effective contraception during treatment with MESNEX in combination with ifosfamide and for 6 months after the last dose. Males Advise males with female partners of reproductive potential to use effective contraception during treatment with MESNEX in combination with ifosfamide and for 3 months after the last dose. 8.4 Pediatric Use MESNEX injection contains the preservative benzyl alcohol which has been associated with serious adverse reactions and death when administered intravenously to premature neonates and low birth weight infants . Avoid use of MESNEX injection in premature neonates and low-birth weight infants [see Warnings and Precautions (5.3) ]. 8.5 Geriatric Use Clinical studies of MESNEX did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. In general, dose selection for an elderly patient should be cautious, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. The ratio of ifosfamide to MESNEX should remain unchanged. 8.6 Use in Patients with Renal Impairment No clinical studies were conducted to evaluate the effect of renal impairment on the pharmacokinetics of MESNEX. 8.7 Use in Patients with Hepatic Impairment No clinical studies were conducted to evaluate the effect of hepatic impairment on the pharmacokinetics of MESNEX."],"patient_medication_information":["Patient Information MESNEX (MES-nex) (mesna) tablets MESNEX (MES-nex) (mesna) injection What is the most important information I should know about MESNEX? MESNEX can cause serious allergic reactions and skin reactions. These serious reactions can happen the first time you are treated with MESNEX or after several months of treatment with MESNEX. Stop treatment with MESNEX and go to the nearest hospital emergency room right away if you develop any of the symptoms listed below: fever swelling of your face, lips, mouth, or tongue trouble breathing or wheezing itching burning skin rash or hives skin redness or swelling skin blisters or peeling feel lightheaded or faint feel like your heart is racing nausea vomiting joint or muscle aches mouth sores See “ What are the possible side effects of MESNEX? ” for more information about side effects. What is MESNEX? MESNEX is a prescription medicine used to reduce the risk of inflammation and bleeding of the bladder (hemorrhagic cystitis) in people who receive ifosfamide (a medicine used to treat cancer). MESNEX is not for use to reduce the risk of blood in the urine (hematuria) due to other medical conditions. Do not take MESNEX tablets or receive MESNEX by intravenous (IV) infusion if you are allergic to mesna or any of the ingredients in MESNEX. See the end of this leaflet for a complete list of ingredients in MESNEX. Before you take or receive MESNEX, tell your healthcare provider about all of your medical conditions, including if you: are allergic to any medicines are pregnant or plan to become pregnant. Females who are able to become pregnant: Your healthcare provider will verify if you are pregnant or not before you start treatment with MESNEX and ifosfamide. You should use effective birth control (contraception) during treatment with MESNEX and ifosfamide and for 6 months after the last dose. Tell your healthcare provider if you become pregnant during treatment with MESNEX and ifosfamide. Males with female partners who are able to become pregnant should use effective birth control during treatment with MESNEX and ifosfamide and for 3 months after the last dose. You should also read the ifosfamide Prescribing Information for important pregnancy, contraception, and infertility information. are breastfeeding or plan to breastfeed. It is not known if MESNEX passes into your breast milk. Do not breastfeed during treatment and for 1 week after the last dose of MESNEX or ifosfamide. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. How will I receive MESNEX? MESNEX is given on the same day that you receive ifosfamide. MESNEX can be given by an intravenous (IV) infusion into a vein or tablets taken by mouth. You will receive MESNEX in one of two ways: MESNEX intravenous (IV) infusion into a vein at the time you receive ifosfamide and 4 and 8 hours after you receive ifosfamide, OR MESNEX intravenous (IV) infusion into a vein at the time you receive ifosfamide and MESNEX tablets taken by mouth 2 and 6 hours after you receive ifosfamide. Take MESNEX tablets at the exact times and the exact dose your healthcare provider tells you to take it. During treatment with MESNEX intravenous (IV) infusion or MESNEX tablets, you should drink 4 to 8 cups of liquid (1 to 2 liters) each day. Tell your healthcare provider if you: vomit within 2 hours of taking MESNEX tablets by mouth miss a dose of MESNEX tablets have pink or red colored urine What are the possible side effects of MESNEX? MESNEX may cause serious side effects, including: See “What is the most important information I should know about MESNEX?” MESNEX that is given by intravenous (IV) infusion contains the preservative benzyl alcohol. Benzyl alcohol has been shown to cause serious side effects and death in premature newborns and low-birth weight babies. Avoid use of MESNEX injection in premature newborns and low birth weight infants. MESNEX tablets do not contain benzyl alcohol. The most common side effects of MESNEX when given with ifosfamide include: nausea vomiting constipation decreased white blood cell count tiredness fever decreased appetite decreased platelet count decreased red blood cell count diarrhea weakness stomach (abdomen) pain headache hair loss sleepiness These are not all the possible side effects of MESNEX. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. How should I store MESNEX tablets? Store MESNEX tablets at room temperature between 68°F to 77°F (20°C to 25°C). Keep MESNEX and all medicines out of the reach of children. General information about the safe and effective use of MESNEX. Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use MESNEX for a condition for which it was not prescribed. Do not give MESNEX to other people, even if they have the same symptoms that you have. It may harm them. You can ask your pharmacist or healthcare provider for information about MESNEX that is written for health professionals. What are the ingredients in MESNEX? Active ingredient: mesna Inactive ingredients: MESNEX injection: edetate disodium, sodium hydroxide, and benzyl alcohol as a preservative. MESNEX tablets: calcium phosphate, cornstarch, hydroxypropylmethylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, povidone, simethicone, and titanium dioxide. Manufactured by: Baxter Healthcare Corporation, Deerfield, IL 60015 USA Made in Germany Baxter and Mesnex are registered trademarks of Baxter International Inc. For more information, call 1-800-262-3784. This Patient Information has been approved by the U.S. Food and Drug Administration. Revised: 12 2018"],"dosage_and_administration_table":["<table ID=\"_RefID8C8F3C91AB414C2DB88D7BC4D6A06F2C\" width=\"100%\"><caption>Intravenous Dosing Schedule:</caption><col width=\"32%\"/><col width=\"16%\"/><col width=\"16%\"/><col width=\"16%\"/><tbody><tr><td styleCode=\"Botrule Lrule Toprule \" valign=\"top\"/><td align=\"center\" styleCode=\"Botrule Lrule Toprule \" valign=\"top\"><paragraph>0 Hours</paragraph></td><td align=\"center\" styleCode=\"Botrule Lrule Toprule \" valign=\"top\"><paragraph>4 Hours</paragraph></td><td align=\"center\" styleCode=\"Rrule Botrule Lrule Toprule \" valign=\"top\"><paragraph>8 Hours</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Ifosfamide</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>1.2 g/m <sup>2</sup></paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>--</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>--</paragraph></td></tr><tr><td styleCode=\"Botrule Lrule \" valign=\"top\"><paragraph>MESNEX injection</paragraph></td><td align=\"center\" styleCode=\"Botrule Lrule \" valign=\"top\"><paragraph>240 mg/m <sup>2</sup></paragraph></td><td align=\"center\" styleCode=\"Botrule Lrule \" valign=\"top\"><paragraph>240 mg/m <sup>2</sup></paragraph></td><td align=\"center\" styleCode=\"Rrule Botrule Lrule \" valign=\"top\"><paragraph>240 mg/m <sup>2</sup></paragraph></td></tr></tbody></table>","<table ID=\"_RefID82EB34C83D2746279400FC0CFE8BC7B4\" width=\"100%\"><caption>Intravenous and Oral Dosing Schedule:</caption><col width=\"31%\"/><col width=\"17%\"/><col width=\"16%\"/><col width=\"16%\"/><tbody><tr><td styleCode=\"Botrule Lrule Toprule \" valign=\"top\"/><td align=\"center\" styleCode=\"Botrule Lrule Toprule \" valign=\"top\"><paragraph>0 Hours</paragraph></td><td align=\"center\" styleCode=\"Botrule Lrule Toprule \" valign=\"top\"><paragraph>2 Hours</paragraph></td><td align=\"center\" styleCode=\"Rrule Botrule Lrule Toprule \" valign=\"top\"><paragraph>6 Hours</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>Ifosfamide</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>1.2 g/m <sup>2</sup></paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>--</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>--</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>MESNEX injection</paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>240 mg/m <sup>2</sup></paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>--</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>--</paragraph></td></tr><tr><td styleCode=\"Botrule Lrule \" valign=\"top\"><paragraph>MESNEX tablets</paragraph></td><td align=\"center\" styleCode=\"Botrule Lrule \" valign=\"top\"><paragraph>--</paragraph></td><td align=\"center\" styleCode=\"Botrule Lrule \" valign=\"top\"><paragraph>480 mg/m <sup>2</sup></paragraph></td><td align=\"center\" styleCode=\"Rrule Botrule Lrule \" valign=\"top\"><paragraph>480 mg/m <sup>2</sup></paragraph></td></tr></tbody></table>","<table ID=\"_RefID7050513770844753922DF3610D301BE2\" width=\"100%\"><caption>Table 1. Recommended Intravenous Dosing Schedule</caption><col width=\"37%\"/><col width=\"23%\"/><col width=\"21%\"/><col width=\"20%\"/><tbody><tr><td styleCode=\"Botrule Lrule Toprule \" valign=\"top\"><paragraph> </paragraph></td><td align=\"center\" styleCode=\"Botrule Lrule Toprule \" valign=\"top\"><paragraph><content styleCode=\"bold\">0 Hours</content></paragraph></td><td align=\"center\" styleCode=\"Botrule Lrule Toprule \" valign=\"top\"><paragraph><content styleCode=\"bold\">4 Hours</content></paragraph></td><td align=\"center\" styleCode=\"Rrule Botrule Lrule Toprule \" valign=\"top\"><paragraph><content styleCode=\"bold\">8 Hours</content></paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph><content styleCode=\"bold\">Ifosfamide</content></paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>1.2 g/m <sup>2</sup></paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>&#x2013;</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>&#x2013;</paragraph></td></tr><tr><td styleCode=\"Botrule Lrule \" valign=\"top\"><paragraph><content styleCode=\"bold\">MESNEX injection</content><footnote ID=\"_RefID2B17BBA191DF4C9297842EF968166595\">The dosing schedule should be repeated on each day that ifosfamide is administered. When the dosage of ifosfamide is increased or decreased, the ratio of MESNEX to ifosfamide should be maintained.</footnote></paragraph></td><td align=\"center\" styleCode=\"Botrule Lrule \" valign=\"top\"><paragraph>240 mg/m <sup>2</sup></paragraph></td><td align=\"center\" styleCode=\"Botrule Lrule \" valign=\"top\"><paragraph>240 mg/m <sup>2</sup></paragraph></td><td align=\"center\" styleCode=\"Rrule Botrule Lrule \" valign=\"top\"><paragraph>240 mg/m <sup>2</sup></paragraph></td></tr></tbody></table>","<table ID=\"_RefIDDC041E0E5CED4786A6D6AB5B04FE60BD\" width=\"100%\"><caption>Table 2. Recommended Intravenous and Oral Dosing Schedule</caption><col width=\"30%\"/><col width=\"25%\"/><col width=\"23%\"/><col width=\"22%\"/><tbody><tr><td styleCode=\"Botrule Lrule Toprule \" valign=\"top\"><paragraph> </paragraph></td><td align=\"center\" styleCode=\"Botrule Lrule Toprule \" valign=\"top\"><paragraph><content styleCode=\"bold\">0 Hours</content></paragraph></td><td align=\"center\" styleCode=\"Botrule Lrule Toprule \" valign=\"top\"><paragraph><content styleCode=\"bold\">2 Hours</content></paragraph></td><td align=\"center\" styleCode=\"Rrule Botrule Lrule Toprule \" valign=\"top\"><paragraph><content styleCode=\"bold\">6 Hours</content></paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph><content styleCode=\"bold\">Ifosfamide</content></paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>1.2 g/m <sup>2</sup></paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>&#x2013;</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>&#x2013;</paragraph></td></tr><tr><td styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph><content styleCode=\"bold\">MESNEX injection</content><footnote ID=\"_RefID3CF4F66EEBC0424F81CCD7ABDDFDAC20\">The dosing schedule should be repeated on each day that ifosfamide is administered. When the dosage of ifosfamide is increased or decreased, the ratio of MESNEX to ifosfamide should be maintained.</footnote></paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>240 mg/m <sup>2</sup></paragraph></td><td align=\"center\" styleCode=\"Lrule Botrule \" valign=\"top\"><paragraph>&#x2013;</paragraph></td><td align=\"center\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>&#x2013;</paragraph></td></tr><tr><td styleCode=\"Botrule Lrule \" valign=\"top\"><paragraph><content styleCode=\"bold\">MESNEX tablets</content></paragraph></td><td align=\"center\" styleCode=\"Botrule Lrule \" valign=\"top\"><paragraph>&#x2013;</paragraph></td><td align=\"center\" styleCode=\"Botrule Lrule \" valign=\"top\"><paragraph>480 mg/m <sup>2</sup></paragraph></td><td align=\"center\" styleCode=\"Rrule Botrule Lrule \" valign=\"top\"><paragraph>480 mg/m <sup>2</sup></paragraph></td></tr></tbody></table>"],"patient_medication_information_table":["<table width=\"100%\"><col width=\"50%\"/><col width=\"50%\"/><tbody><tr><td align=\"center\" colspan=\"2\" styleCode=\"Rrule Botrule Lrule Toprule \" valign=\"top\"><paragraph><content styleCode=\"bold\">Patient Information   MESNEX (MES-nex)   (mesna)   tablets </content></paragraph><paragraph><content styleCode=\"bold\">MESNEX (MES-nex)   (mesna)   injection </content></paragraph></td></tr><tr><td colspan=\"2\" styleCode=\"Rrule Lrule Toprule \" valign=\"top\"><paragraph><content styleCode=\"bold\">What is the most important information I should know about MESNEX?</content></paragraph><paragraph><content styleCode=\"bold\">MESNEX can cause serious allergic reactions and skin reactions.</content>These serious reactions can happen the first time you are treated with MESNEX or after several months of treatment with MESNEX. Stop treatment with MESNEX and go to the nearest hospital emergency room right away if you develop any of the symptoms listed below: </paragraph></td></tr><tr><td styleCode=\"Lrule \" valign=\"top\"><list listType=\"unordered\"><item>fever</item><item>swelling of your face, lips, mouth, or tongue</item><item>trouble breathing or wheezing</item><item>itching</item><item>burning</item><item>skin rash or hives</item><item>skin redness or swelling</item></list></td><td styleCode=\"Rrule \" valign=\"top\"><list listType=\"unordered\"><item>skin blisters or peeling</item><item>feel lightheaded or faint</item><item>feel like your heart is racing</item><item>nausea</item><item>vomiting</item><item>joint or muscle aches</item><item>mouth sores</item></list></td></tr><tr><td colspan=\"2\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><list listType=\"ordered\"><item>See &#x201C; <content styleCode=\"bold\">What are the possible side effects of MESNEX?</content>&#x201D; for more information about side effects. </item></list></td></tr><tr><td colspan=\"2\" styleCode=\"Rrule Lrule Toprule Botrule \" valign=\"top\"><paragraph><content styleCode=\"bold\">What is MESNEX?</content></paragraph><paragraph>MESNEX is a prescription medicine used to reduce the risk of inflammation and bleeding of the bladder (hemorrhagic cystitis) in people who receive ifosfamide (a medicine used to treat cancer).</paragraph><paragraph>MESNEX is not for use to reduce the risk of blood in the urine (hematuria) due to other medical conditions.</paragraph></td></tr><tr><td colspan=\"2\" styleCode=\"Rrule Lrule Toprule Botrule \" valign=\"top\"><paragraph><content styleCode=\"bold\">Do not take MESNEX tablets or receive MESNEX by intravenous (IV) infusion if</content>you are allergic to mesna or any of the ingredients in MESNEX. See the end of this leaflet for a complete list of ingredients in MESNEX. </paragraph></td></tr><tr><td colspan=\"2\" styleCode=\"Rrule Lrule Toprule Botrule \" valign=\"top\"><paragraph><content styleCode=\"bold\">Before you take or receive MESNEX, tell your healthcare provider about all of your medical conditions, including if you:</content></paragraph><list listType=\"unordered\"><item>are allergic to any medicines</item><item>are pregnant or plan to become pregnant.</item><item><content styleCode=\"bold\">Females who are able to become pregnant:</content></item><item>Your healthcare provider will verify if you are pregnant or not before you start treatment with MESNEX and ifosfamide. <list listType=\"unordered\"><item>You should use effective birth control (contraception) during treatment with MESNEX and ifosfamide and for 6 months after the last dose.</item><item>Tell your healthcare provider if you become pregnant during treatment with MESNEX and ifosfamide.</item></list></item><item><content styleCode=\"bold\">Males</content>with female partners who are able to become pregnant should use effective birth control during treatment with MESNEX and ifosfamide and for 3 months after the last dose. </item><item>You should also read the ifosfamide Prescribing Information for important pregnancy, contraception, and infertility information.</item><item>are breastfeeding or plan to breastfeed. It is not known if MESNEX passes into your breast milk. Do not breastfeed during treatment and for 1 week after the last dose of MESNEX or ifosfamide.</item></list><paragraph><content styleCode=\"bold\">Tell your healthcare provider about all the medicines you take,</content>including prescription and over-the-counter medicines, vitamins, and herbal supplements. </paragraph></td></tr><tr><td colspan=\"2\" styleCode=\"Rrule Lrule Toprule Botrule \" valign=\"top\"><paragraph><content styleCode=\"bold\">How will I receive MESNEX?</content></paragraph><list listType=\"unordered\"><item>MESNEX is given on the same day that you receive ifosfamide.</item><item>MESNEX can be given by an intravenous (IV) infusion into a vein or tablets taken by mouth.</item><item>You will receive MESNEX in one of two ways:</item><item>MESNEX intravenous (IV) infusion into a vein at the time you receive ifosfamide and 4 and 8 hours after you receive ifosfamide, <content styleCode=\"bold\">OR</content></item><item>MESNEX intravenous (IV) infusion into a vein at the time you receive ifosfamide and MESNEX tablets taken by mouth 2 and 6 hours after you receive ifosfamide.</item><item>Take MESNEX tablets at the exact times and the exact dose your healthcare provider tells you to take it.</item><item>During treatment with MESNEX intravenous (IV) infusion or MESNEX tablets, you should drink 4 to 8 cups of liquid (1 to 2 liters) each day.</item><item>Tell your healthcare provider if you:</item><item>vomit within 2 hours of taking MESNEX tablets by mouth</item><item>miss a dose of MESNEX tablets</item><item>have pink or red colored urine</item></list></td></tr><tr><td colspan=\"2\" styleCode=\"Rrule Lrule Toprule \" valign=\"top\"><paragraph><content styleCode=\"bold\">What are the possible side effects of MESNEX?</content></paragraph><paragraph><content styleCode=\"bold\">MESNEX may cause serious side effects, including:</content></paragraph><paragraph>See <content styleCode=\"bold\">&#x201C;What is the most important information I should know about MESNEX?&#x201D;</content></paragraph><list listType=\"unordered\"><item><content styleCode=\"bold\">MESNEX that is given by intravenous (IV) infusion contains the preservative benzyl alcohol.</content>Benzyl alcohol has been shown to cause serious side effects and death in premature newborns and low-birth weight babies. Avoid use of MESNEX injection in premature newborns and low birth weight infants. MESNEX tablets do not contain benzyl alcohol. </item></list><paragraph><content styleCode=\"bold\">The most common side effects of MESNEX when given with ifosfamide include:</content></paragraph></td></tr><tr><td styleCode=\"Lrule \" valign=\"top\"><list listType=\"unordered\"><item>nausea</item><item>vomiting</item><item>constipation</item><item>decreased white blood cell count</item><item>tiredness</item><item>fever</item><item>decreased appetite</item><item>decreased platelet count</item></list></td><td styleCode=\"Rrule \" valign=\"top\"><list listType=\"unordered\"><item>decreased red blood cell count</item><item>diarrhea</item><item>weakness</item><item>stomach (abdomen) pain</item><item>headache</item><item>hair loss</item><item>sleepiness</item></list></td></tr><tr><td colspan=\"2\" styleCode=\"Rrule Lrule Botrule \" valign=\"top\"><paragraph>These are not all the possible side effects of MESNEX.</paragraph><paragraph>Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.</paragraph></td></tr><tr><td colspan=\"2\" styleCode=\"Rrule Lrule Toprule Botrule \" valign=\"top\"><paragraph><content styleCode=\"bold\">How should I store MESNEX tablets?</content></paragraph><list listType=\"unordered\"><item>Store MESNEX tablets at room temperature between 68&#xB0;F to 77&#xB0;F (20&#xB0;C to 25&#xB0;C).</item></list><paragraph><content styleCode=\"bold\">Keep MESNEX and all medicines out of the reach of children.</content></paragraph></td></tr><tr><td colspan=\"2\" styleCode=\"Rrule Lrule Toprule Botrule \" valign=\"top\"><paragraph><content styleCode=\"bold\">General information about the safe and effective use of MESNEX.</content></paragraph><paragraph>Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use MESNEX for a condition for which it was not prescribed. Do not give MESNEX to other people, even if they have the same symptoms that you have. It may harm them. You can ask your pharmacist or healthcare provider for information about MESNEX that is written for health professionals.</paragraph></td></tr><tr><td colspan=\"2\" styleCode=\"Rrule Botrule Lrule Toprule \" valign=\"top\"><paragraph><content styleCode=\"bold\">What are the ingredients in MESNEX?</content></paragraph><paragraph><content styleCode=\"bold\">Active ingredient:</content>mesna </paragraph><paragraph><content styleCode=\"bold\">Inactive ingredients:</content></paragraph><paragraph><content styleCode=\"bold\">MESNEX injection:</content>edetate disodium, sodium hydroxide, and benzyl alcohol as a preservative. </paragraph><paragraph><content styleCode=\"bold\">MESNEX tablets:</content>calcium phosphate, cornstarch, hydroxypropylmethylcellulose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, povidone, simethicone, and titanium dioxide. </paragraph><paragraph>Manufactured by: Baxter Healthcare Corporation, Deerfield, IL 60015 USA   Made in Germany   Baxter and Mesnex are registered trademarks of Baxter International Inc.   For more information, call 1-800-262-3784. </paragraph></td></tr></tbody></table>"],"package_label_principal_display_panel":["PACKAGE LABEL - PRINCIPAL DISPLAY PANEL 1g Multidose Vial 1 Multidose Vial NDC 0338-1305-01 Mesnex (mesna) Injection FOR INTRAVENOUS USE 1g/vial Rx only N (01) 1 03 0338 1305 01 4 Lot Number / Expires: JMXXXA JJJJ - MM Each vial contains 1 gram of mesna in 10 mL water. 1% benzyl alcohol is added as a preservative. See insert for dosing information. Store at 20° - 25°C (68° - 77°F), excursions permitted to 15° - 30°C (59° - 86°F)[see USP Controlled Room Temperature] Manufactured by: Baxter Healthcare Corporation Deerfield, IL 60015 USA USA HA-65-01-568 C 93 1 Multidose Vial NDC 0338-1305-01 MESNEX (mesna) Injection 1g/vial FOR INTRAVENOUS USE Rx only Baxter Logo Manufactured by Baxter Healthcare Corporation Deerfield, IL 60015 USA (01) 00303381305017 (21) XXXXXXXXXXXX (17) JJMMTT (10) JMXXXA Barcode MESNEX mesna Injection 1g/vial Barcode HA-80-02-158 USA Fragile: Handle with care. Store at 20° - 25°C (68°-77°F) excursions permitted to 15° - 30°C (59° - 86°F) [see USP Controlled Room Temperature]. Baxter Logo Manufactured by Baxter Healthcare Corporation Deerfield, IL 60015 USA C 203 1 Multidose Vial NDC 0338-1305-01 MESNEX (mesna) Injection 1g/vial FOR INTRAVENOUS USE Rx only Baxter Logo Manufactured by Baxter Healthcare Corporation Deerfield, IL 60015 USA Lot/Exp: JMXXXA JJJJ - MM 2639B3994 Barcode Folding Box Logo Can Be Recycled Each vial contains 1 g mesna in 10 mL water, Mesnex is a sterile and nonpyrogenic solution containing 10% sodium-2-mercaptoehane sulfonate (mesna) in water for injection with 0.025% edetate disodium and sodium hydroxide to adjust pH to 7.5 to 8.5. 1% benzyl alcohol is added as a preservative. Dosage: See package insert for directions for use. Should not be prescribed without thorough knowledge of dose, indications and toxicology as contained in accompanying literature. Manufactured by: Baxter Healthcare Corporation Deerfield, IL 60015 USA Made in Germany Schwarz P 186 C 10 Multidose Vials NDC 0338-1305-03 1g MESNEX (mesna) Injection Baxter Logo Manufactured by Baxter Healthcare Corporation Deerfield, IL 60015 USA 10 Multidose Vials NDC 0338-1305-03 1g N3 0338130503 1 MESNEX (mesna) Injection Each vial contains 1 g mesna in 10mL water. Mesnex is a sterile and nonpyrogenic solution containing 10% sodium-2-mercaptoehane sulfonate (mesna) in water for injection with 0.025% edetate disodium and sodium hydroxide to adjust pH to 7.5 to 8.5. 1% benzyl alcohol is added as a preservative. Fragile: Handle with care. Store at 20° - 25°C (68°-77°F) see excursions permitted to 15° - 30°C (59° - 86°F) [see USP Controlled Room Temperature] U.S. Patent No 5,696, 172 FOR INTRAVENOUS USE Dosage: See package insert for directions for use. Should not be prescribed without thorough knowledge of dose, indications and toxicology as contained in accompanying literature. Manufactured by: Baxter Healthcare Corporation Deerfield, IL 60015 USA Made in Germany Rx only HA-80-01-627 USA 10 Multidose Vials NDC 0338-1305-03 1g MESNEX (mesna) Injection FOR INTRAVENOUS USE 10 Multidose Vials C 53 10 Multidose Vials NDC 0338-1305-03 1g 2639B3913 Lot: Exp.: MESNEX (mesna) Injection Each vial contains 1 g mesna in 10mL water. Mesnex is a sterile and nonpyrogenic solution containing 10% sodium-2-mercaptoehane sulfonate (mesna) in water for injection with 0.025% edetate disodium and sodium hydroxide to adjust pH to 7.5 to 8.5. 1% benzyl alcohol is added as a preservative. Fragile: Handle with care. Store at 20° - 25°C (68°-77°F) see excursions permitted to 15° - 30°C (59° - 86°F) [see USP Controlled Room Temperature] U.S. Patent No 5,696, 172 FOR INTRAVENOUS USE Dosage: See package insert for directions for use. Should not be prescribed without thorough knowledge of dose, indications and toxicology as contained in accompanying literature. Manufactured by: Baxter Healthcare Corporation Deerfield, IL 60015 USA Made in Germany Rx only Folding Box Logo Can Be Recycled 10 Multidose Vials NDC 0338-1305-03 1g MESNEX (mesna) Injection FOR INTRAVENOUS USE 10 Multidose Vials Representative vial label 1g 0338-1305-01 Representative carton label 1g 0338-1305-01 1 of 4 Representative carton label 1g 0338-1305-01 2 of 4 Representative carton label 1g 0338-1305-01 3 of 4 Representative carton label 1g 0338-1305-01 4 of 4 Representative Box Label 1g panel 1 of 4 Representative Box Label 1g panel 2 of 4 Representative Box Label 1g panel 3 of 4 Representative Box Label 1g panel 4 of 4"],"carcinogenesis_and_mutagenesis_and_impairment_of_fertility":["13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility No long-term studies in animals have been performed to evaluate the carcinogenic potential of mesna. Mesna was not genotoxic in the in vitro Ames bacterial mutagenicity assay, the in vitro mammalian lymphocyte chromosomal aberration assay or the in vivo mouse micronucleus assay. No studies on male or female fertility were conducted. No signs of male or female reproductive organ toxicity were seen in 6-month oral rat studies (≤ 2000 mg/kg/day) or 29-week oral dog studies (520 mg/kg/day) at doses approximately 10-fold higher than the maximum recommended human dose on a body surface area basis."]},"tags":[{"label":"mesna","category":"class"},{"label":"Small Molecule","category":"modality"},{"label":"R05CB05","category":"atc"},{"label":"Oral","category":"route"},{"label":"Intravenous","category":"route"},{"label":"Injection","category":"form"},{"label":"Solution","category":"form"},{"label":"Tablet","category":"form"},{"label":"Off-Patent","category":"patent"},{"label":"Generic Available","category":"availability"},{"label":"Established","category":"status"},{"label":"Prevention of Chemotherapy-Induced Hemorrhagic Cystitis","category":"indication"},{"label":"Testicular Germ Cell Tumor","category":"indication"},{"label":"Baxter Hlthcare","category":"company"},{"label":"Approved 1980s","category":"decade"},{"label":"Protective Agents","category":"pharmacology"}],"phase":"marketed","safety":{"boxedWarnings":[],"safetySignals":[{"date":"","signal":"FEBRILE NEUTROPENIA","source":"FDA FAERS","actionTaken":"1252 reports"},{"date":"","signal":"PYREXIA","source":"FDA FAERS","actionTaken":"676 reports"},{"date":"","signal":"OFF LABEL USE","source":"FDA FAERS","actionTaken":"643 reports"},{"date":"","signal":"NEUTROPENIA","source":"FDA FAERS","actionTaken":"565 reports"},{"date":"","signal":"THROMBOCYTOPENIA","source":"FDA FAERS","actionTaken":"381 reports"},{"date":"","signal":"ANAEMIA","source":"FDA FAERS","actionTaken":"377 reports"},{"date":"","signal":"VOMITING","source":"FDA FAERS","actionTaken":"370 reports"},{"date":"","signal":"NAUSEA","source":"FDA FAERS","actionTaken":"355 reports"},{"date":"","signal":"SEPSIS","source":"FDA FAERS","actionTaken":"354 reports"},{"date":"","signal":"PANCYTOPENIA","source":"FDA FAERS","actionTaken":"343 reports"}],"commonSideEffects":[{"effect":"Nausea","drugRate":"≥ 10%","severity":"common","_validated":true},{"effect":"Vomiting","drugRate":"≥ 10%","severity":"common","_validated":true},{"effect":"Constipation","drugRate":"≥ 10%","severity":"common","_validated":true},{"effect":"Leukopenia","drugRate":"≥ 10%","severity":"common","_validated":true},{"effect":"Fatigue","drugRate":"≥ 10%","severity":"common","_validated":true},{"effect":"Fever","drugRate":"≥ 10%","severity":"common","_validated":true},{"effect":"Anorexia","drugRate":"≥ 10%","severity":"common","_validated":true},{"effect":"Thrombocytopenia","drugRate":"≥ 10%","severity":"common","_validated":true},{"effect":"Anemia","drugRate":"≥ 10%","severity":"common","_validated":true},{"effect":"Granulocytopenia","drugRate":"≥ 10%","severity":"common","_validated":true},{"effect":"Diarrhea","drugRate":"≥ 10%","severity":"common","_validated":true},{"effect":"Asthenia","drugRate":"≥ 10%","severity":"common","_validated":true},{"effect":"Abdominal pain","drugRate":"≥ 10%","severity":"common","_validated":true},{"effect":"Headache","drugRate":"≥ 10%","severity":"common","_validated":true},{"effect":"Alopecia","drugRate":"≥ 10%","severity":"common","_validated":true},{"effect":"Somnolence","drugRate":"6.1%","severity":"common","_validated":true}],"contraindications":["Anemia","Bone Metastases","Bone marrow depression","Breastfeeding (mother)","CNS Toxicity","Cancer Chemotherapy Induced Hemorrhagic Cystitis","Coma","Dehydration","Disease of liver","Fanconi syndrome","Hyperbilirubinemia","Hypokalemia","Impaired cognition","Impaired wound healing","Kidney disease","Kidney excision","Leukopenia","Liver function tests abnormal","Polyneuropathies","Pregnancy, function","Renal tubular acidosis","Severe Bone Marrow Depression","Thrombocytopenic disorder"],"specialPopulations":{"Lactation":"Do not breastfeed. Ifosfamide is excreted in breast milk. Refer to the ifosfamide prescribing information for more information on use during lactation. There are no data on the presence of mesna in human or animal milk, the effect on the breastfed child, or the effect on milk production. Mesna injection contains the preservative benzyl alcohol. Because benzyl alcohol is rapidly metabolized by lactating woman, benzyl alcohol exposure in the breastfed child is unlikely.","Pregnancy":"MESNEX in combination with ifosfamide can cause fetal harm. Advise patients of potential risk to fetus. Ifosfamide can cause fetal harm when administered to pregnant woman. Refer to the ifosfamide prescribing information for more information on use during pregnancy. Mesna injection contains the preservative benzyl alcohol. Because benzyl alcohol is rapidly metabolized by pregnant woman, benzyl alcohol exposure in the fetus is unlikely.","Geriatric use":"Dose selection should be cautious. Clinical studies of mesna injection did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. In general, dose selection for an elderly patient should be cautious, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. The ratio of ifosfamide to mesna should remain unchanged.","Paediatric use":"Avoid use of mesna injection in premature neonates and low-birth weight infants. Mesna injection contains the preservative benzyl alcohol which has been associated with serious adverse reactions and death when administered intravenously to premature neonates and low-birth weight infants."}},"trials":[],"aliases":[],"company":"Baxter","patents":[],"pricing":[],"_sources":{"trials":{"url":"https://clinicaltrials.gov/search?intr=MESNA","method":"api_direct","source":"ClinicalTrials.gov","rawText":"","confidence":1,"sourceType":"ctgov","retrievedAt":"2026-04-20T03:11:26.066552+00:00"},"timeline":{"url":"https://en.wikipedia.org/wiki/Mesna","method":"deterministic","source":"Wikipedia","rawText":"","confidence":0.8,"sourceType":"wikipedia","retrievedAt":"2026-04-20T03:11:35.506747+00:00"},"regulatory.ca":{"url":"","method":"api_direct","source":"Health Canada DPD","rawText":"","confidence":1,"sourceType":"health_canada_dpd","retrievedAt":"2026-04-20T03:11:34.004967+00:00"},"regulatory.us":{"url":"","method":"api_direct","source":"FDA Drugs@FDA","rawText":"","confidence":1,"sourceType":"fda_drugsfda","retrievedAt":"2026-04-20T03:11:24.702896+00:00"},"publicationCount":{"url":"https://pubmed.ncbi.nlm.nih.gov/?term=MESNA","method":"api_direct","source":"PubMed/NCBI","rawText":"","confidence":1,"sourceType":"pubmed","retrievedAt":"2026-04-20T03:11:34.847760+00:00"},"administration.route":{"url":"","method":"deterministic","source":"FDA Label","rawText":"","confidence":1,"sourceType":"fda_label","retrievedAt":"2026-04-20T03:11:23.321583+00:00"},"safety.boxedWarnings":{"url":"","method":"deterministic","source":"FDA Label (no boxed warning)","rawText":"","confidence":1,"sourceType":"fda_label","retrievedAt":"2026-04-20T03:11:23.321631+00:00"},"safety.safetySignals":{"url":"https://api.fda.gov/drug/event.json","method":"api_direct","source":"FDA FAERS","rawText":"","confidence":1,"sourceType":"fda_faers","retrievedAt":"2026-04-20T03:11:36.420060+00:00"},"crossReferences.chemblId":{"url":"https://www.ebi.ac.uk/chembl/compound_report_card/CHEMBL975/","method":"api_direct","source":"ChEMBL (EMBL-EBI)","rawText":"","confidence":1,"sourceType":"chembl","retrievedAt":"2026-04-20T03:11:35.398343+00:00"},"regulatory.fda_application":{"url":"","method":"deterministic","source":"FDA Label","rawText":"NDA019884","confidence":1,"sourceType":"fda_label","retrievedAt":"2026-04-20T03:11:23.321639+00:00"}},"allNames":"mesnex","offLabel":[],"synonyms":["mesna","mercaptoethanesulfonic acid","reduced coenzyme M"],"timeline":[{"date":"1988-01-01","type":"neutral","source":"FDA Orange Book","milestone":"Rights transferred from BAXTER HLTHCARE to Baxter Hlthcare"},{"date":"1988-12-30","type":"positive","source":"DrugCentral","milestone":"FDA approval (Baxter Hlthcare)"},{"date":"2002-03-21","type":"positive","source":"FDA Orange Book","milestone":"Mesnex approved — 400MG"},{"date":"2010-04-13","type":"neutral","source":"FDA Orange Book","milestone":"Generic entry — 4 manufacturers approved"}],"aiSummary":"Mesnex (MESNA) is a small molecule drug developed by Baxter Healthcare, currently owned by the same company. It is used to prevent chemotherapy-induced hemorrhagic cystitis and treat testicular germ cell tumors. Mesnex is an off-patent medication with multiple generic manufacturers. It has a short half-life of 0.36 hours and moderate bioavailability of 62%. As an off-patent medication, it is widely available in the market.","approvals":[{"date":"1988-12-30","orphan":true,"company":"BAXTER HLTHCARE","regulator":"FDA"}],"brandName":"Mesnex","ecosystem":[{"indication":"Prevention of Chemotherapy-Induced Hemorrhagic Cystitis","otherDrugs":[],"globalPrevalence":null},{"indication":"Testicular Germ Cell Tumor","otherDrugs":[{"name":"bleomycin","slug":"bleomycin","company":"Bristol Myers Squibb"},{"name":"cisplatin","slug":"cisplatin","company":"Hq Spclt Pharma"},{"name":"ifosfamide","slug":"ifosfamide","company":"Baxter Hlthcare"}],"globalPrevalence":null}],"mechanism":{"novelty":"Follow-on","modality":"Small Molecule","drugClass":"mesna","explanation":"Mesna reacts chemically with the urotoxic ifosfamide metabolites, acrolein and 4-hydroxy-ifosfamide, resulting in their detoxification. The first step in the detoxification process is the binding of mesna to 4-hydroxy-ifosfamide forming non-urotoxic 4-sulfoethylthioifosfamide. Mesna also binds to the double bonds of acrolein and to other urotoxic metabolites and inhibits their effects on the bladder.","oneSentence":"Mesnex works by binding to and neutralizing acrolein, a toxic byproduct of chemotherapy that causes hemorrhagic cystitis.","technicalDetail":"Mesnex (MESNA) is a sulfhydryl compound that acts as a scavenger of acrolein, a toxic urothelial irritant produced during the metabolism of cyclophosphamide and ifosfamide, thereby preventing hemorrhagic cystitis."},"_wikipedia":{"url":"https://en.wikipedia.org/wiki/Mesna","title":"Mesna","extract":"Mesna, sold under the brand name Mesnex among others, is a medication used in those taking cyclophosphamide or ifosfamide to decrease the risk of bleeding from the bladder. It is used either by mouth or injection into a vein."},"commercial":{"launchDate":"1988","_launchSource":"DrugCentral (FDA 1988-12-30, BAXTER HLTHCARE)"},"references":[{"id":1,"url":"https://drugcentral.org/drugcard/1711","fields":["approvals","synonyms","ATC","PK","indications","contraindications","DDIs","targets","patents","FAERS"],"source":"DrugCentral"},{"id":2,"url":"https://clinicaltrials.gov/search?intr=MESNA","fields":["trials"],"source":"ClinicalTrials.gov"},{"id":3,"url":"https://pubmed.ncbi.nlm.nih.gov/?term=MESNA","fields":["publications"],"source":"PubMed/NCBI"},{"id":4,"url":"https://en.wikipedia.org/wiki/Mesna","fields":["history","overview"],"source":"Wikipedia"},{"id":5,"url":"https://www.fda.gov/drugs/drug-approvals-and-databases/orange-book-data-files","fields":["patents","exclusivity","genericManufacturers"],"source":"FDA Orange Book"}],"_enrichedAt":"2026-03-30T14:20:30.683003","_validation":{"fieldsValidated":0,"lastValidatedAt":"2026-04-20T03:11:42.336140+00:00","fieldsConflicting":0,"overallConfidence":0.95},"biosimilars":[],"competitors":[{"drugName":"acetylcysteine","drugSlug":"acetylcysteine","fdaApproval":"1963-09-14","patentExpiry":"May 8, 2032","patentStatus":"Patent protected","relationship":"same-class"},{"drugName":"dornase alfa","drugSlug":"dornase-alfa","fdaApproval":"1993-12-30","relationship":"same-class"},{"drugName":"mannitol","drugSlug":"mannitol","fdaApproval":"1964-06-08","genericCount":6,"patentStatus":"Off-patent — generic available","relationship":"same-class"}],"genericName":"mesna","indications":{"approved":[{"name":"Prevention of Chemotherapy-Induced Hemorrhagic Cystitis","source":"DrugCentral","snomedId":"","regulator":"FDA","eligibility":{"who can take it":"adults and children with normal kidney function, not indicated for hematuria due to other pathological conditions such as thrombocytopenia"}},{"name":"Testicular Germ Cell Tumor","source":"DrugCentral","snomedId":"","regulator":"FDA","eligibility":null}],"offLabel":[{"name":"Burkitt's lymphoma","source":"DrugCentral","drugName":"MESNA","evidenceCount":7,"evidenceLevel":"emerging"},{"name":"Ewing's sarcoma","source":"DrugCentral","drugName":"MESNA"},{"name":"Malignant tumor of head and/or neck","source":"DrugCentral","drugName":"MESNA","evidenceCount":510879,"evidenceLevel":"strong"},{"name":"Non-small cell lung cancer","source":"DrugCentral","drugName":"MESNA","evidenceCount":123,"evidenceLevel":"strong"},{"name":"Osteosarcoma of bone","source":"DrugCentral","drugName":"MESNA","evidenceCount":47,"evidenceLevel":"moderate"},{"name":"Soft or Connective Tissue Sarcoma","source":"DrugCentral","drugName":"MESNA","evidenceCount":5268,"evidenceLevel":"strong"}],"pipeline":[]},"currentOwner":"Baxter Hlthcare","drugCategory":"established","labelChanges":[],"patentStatus":"Off-patent — no active Orange Book patents","relatedDrugs":[{"drugId":"acetylcysteine","brandName":"acetylcysteine","genericName":"acetylcysteine","approvalYear":"1963","relationship":"same-class"},{"drugId":"dornase-alfa","brandName":"dornase alfa","genericName":"dornase alfa","approvalYear":"1993","relationship":"same-class"},{"drugId":"mannitol","brandName":"mannitol","genericName":"mannitol","approvalYear":"1964","relationship":"same-class"}],"trialDetails":[{"nctId":"NCT02436707","phase":"PHASE2","title":"Novel Combination Therapy in the Treatment of Relapsed and Refractory Aggressive B-Cell Lymphoma","status":"ACTIVE_NOT_RECRUITING","sponsor":"Canadian Cancer Trials Group","startDate":"2015-10-27","conditions":["Lymphoma"],"enrollment":129,"completionDate":"2026-12-31"},{"nctId":"NCT02621021","phase":"PHASE2","title":"A Phase 2 Trial for Metastatic Melanoma Using Adoptive Cell Therapy With Tumor Infiltrating Lymphocytes Plus IL-2 Either Alone or Following the Administration of Pembrolizumab","status":"RECRUITING","sponsor":"National Cancer Institute (NCI)","startDate":"2015-12-04","conditions":["Melanoma"],"enrollment":170,"completionDate":"2029-06-16"},{"nctId":"NCT04530565","phase":"PHASE3","title":"Testing the Use of Steroids and Tyrosine Kinase Inhibitors With Blinatumomab or Chemotherapy for Newly Diagnosed BCR-ABL-Positive Acute Lymphoblastic Leukemia in Adults","status":"RECRUITING","sponsor":"National Cancer Institute (NCI)","startDate":"2021-01-25","conditions":["B Acute Lymphoblastic Leukemia With t(9;22)(q34.1;q11.2); BCR-ABL1"],"enrollment":348,"completionDate":"2028-07-01"},{"nctId":"NCT06834282","phase":"PHASE1","title":"CER-1236 in Patients With Acute Myeloid Leukemia (AML), Myelodysplastic Syndrome (MDS), and Myelofibrosis (MF)","status":"RECRUITING","sponsor":"CERo Therapeutics Holdings, Inc.","startDate":"2025-04-07","conditions":["AML","Acute Myeloid Leukemia","Refractory Acute Myeloid Leukemia"],"enrollment":18,"completionDate":"2029-12-31"},{"nctId":"NCT06847269","phase":"PHASE2","title":"CAR T CELL Therapy for Pediatric, Adolescent and Young Adult Patients With CD19-Positive Leukemia","status":"RECRUITING","sponsor":"St. Jude Children's Research Hospital","startDate":"2025-05-21","conditions":["Acute Lymphoblastic Leukemia","Refractory Acute Lymphoblastic Leukemia"],"enrollment":25,"completionDate":"2031-04"},{"nctId":"NCT04464434","phase":"PHASE4","title":"Upfront Autologous HSCT Versus Immunosuppression in Early Diffuse Cutaneous Systemic Sclerosis","status":"COMPLETED","sponsor":"UMC Utrecht","startDate":"2020-09-17","conditions":["Systemic Sclerosis","Systemic Scleroses, Diffuse","Scleroderma","Scleroderma, Diffuse","Autologous Stem Cell Transplantation","Cyclophosphamide","Mycophenolate Mofetil","Treatment Strategy"],"enrollment":60,"completionDate":"2026-03-19"},{"nctId":"NCT02133196","phase":"PHASE2","title":"T Cell Receptor Immunotherapy for Patients With Metastatic Non-Small Cell Lung Cancer","status":"RECRUITING","sponsor":"National Cancer Institute (NCI)","startDate":"2014-10-23","conditions":["Advanced Non-Small Cell Lung Cancer","Squamous Cell Carcinoma","Advanced NSCLC","Adenosquamous Carcinoma","Adenocarcinoma"],"enrollment":85,"completionDate":"2027-10-23"},{"nctId":"NCT03412877","phase":"PHASE2","title":"Administration of Autologous T-Cells Genetically Engineered to Express T-Cell Receptors Reactive Against Neoantigens in People With Metastatic Cancer","status":"RECRUITING","sponsor":"National Cancer Institute (NCI)","startDate":"2018-09-06","conditions":["Endocrine Tumors","Non-Small Cell Lung Cancer","Ovarian Cancer","Breast Cancer","Gastrointestinal/Genitourinary Cancers","Neuroendocrine Tumors","Multiple Myeloma"],"enrollment":285,"completionDate":"2028-03-23"},{"nctId":"NCT05601817","phase":"NA","title":"Virtual Reality and Computerized Cognitive Intervention for Mild Cognitive Impairment in Heart Failure","status":"ACTIVE_NOT_RECRUITING","sponsor":"Indiana University","startDate":"2023-04-03","conditions":["Heart Failure","Mild Cognitive Impairment"],"enrollment":172,"completionDate":"2027-03-31"},{"nctId":"NCT00338377","phase":"PHASE2","title":"Lymphodepletion Plus Adoptive Cell Transfer With or Without Dendritic Cell Immunization in Patients With Metastatic Melanoma","status":"ACTIVE_NOT_RECRUITING","sponsor":"M.D. Anderson Cancer Center","startDate":"2006-02-01","conditions":["Melanoma"],"enrollment":1230,"completionDate":"2030-02-28"},{"nctId":"NCT05436418","phase":"PHASE1,PHASE2","title":"The Lowest Effective Dose of Post-Transplantation Cyclophosphamide in Combination With Sirolimus and Mycophenolate Mofetil as Graft-Versus-Host Disease Prophylaxis After Reduced Intensity Conditioning and Peripheral Blood Stem Cell Transplantation","status":"RECRUITING","sponsor":"National Cancer Institute (NCI)","startDate":"2022-11-18","conditions":["Peripheral Blood Stem Cell Transplantation","Hematopoietic Stem Cell Transplantation"],"enrollment":260,"completionDate":"2028-06-25"},{"nctId":"NCT03745326","phase":"PHASE1,PHASE2","title":"Administering Peripheral Blood Lymphocytes Transduced With a Murine T-Cell Receptor Recognizing the G12D Variant of Mutated RAS in HLA-A*11:01 Patients","status":"COMPLETED","sponsor":"National Cancer Institute (NCI)","startDate":"2019-05-16","conditions":["Gastrointestinal Cancer","Pancreatic Cancer","Gastric Cancer","Colon Cancer","Rectal Cancer"],"enrollment":5,"completionDate":"2022-08-22"},{"nctId":"NCT04904588","phase":"PHASE2","title":"HLA-Mismatched Unrelated Donor Hematopoietic Cell Transplantation With Post-Transplantation Cyclophosphamide","status":"ACTIVE_NOT_RECRUITING","sponsor":"Center for International Blood and Marrow Transplant Research","startDate":"2021-09-30","conditions":["Acute Lymphoblastic Leukemia","Acute Myelogenous Leukemia","Mixed Phenotype Acute Leukemia","Acute Leukemia","Myelodysplastic Syndromes","Chronic Myelogenous Leukemia","Chronic Lymphocytic Leukemia","Lymphoma"],"enrollment":300,"completionDate":"2026-12"},{"nctId":"NCT05813327","phase":"PHASE1","title":"Neoadjuvant ADI-PEG 20 + Ifosfamide + Radiotherapy in Soft Tissue Sarcoma","status":"ACTIVE_NOT_RECRUITING","sponsor":"Washington University School of Medicine","startDate":"2024-03-14","conditions":["Soft Tissue Sarcoma","Sts","Sarcoma,Soft Tissue"],"enrollment":6,"completionDate":"2028-05-31"},{"nctId":"NCT03663933","phase":"PHASE2","title":"Allogeneic Hematopoietic Cell Transplantation for Disorders of T-cell Proliferation and/or Dysregulation","status":"ACTIVE_NOT_RECRUITING","sponsor":"National Cancer Institute (NCI)","startDate":"2018-09-04","conditions":["Lymphoproliferative Disorders","Autoimmune Lymphoproliferative","Primary T-cell Immunodeficiency Disorders","Immune System Diseases","Common Variable Immunodeficiency"],"enrollment":71,"completionDate":"2030-04-03"},{"nctId":"NCT06859424","phase":"PHASE2","title":"A Platform Protocol to Investigate Post-Transplant Cyclophosphamide-Based Graft-Versus-Host Disease Prophylaxis in Patients With Hematologic Malignancies Undergoing Mismatched Unrelated Donor Peripheral Blood Stem Cell Transplantation","status":"RECRUITING","sponsor":"Center for International Blood and Marrow Transplant Research","startDate":"2025-07-25","conditions":["AML (Acute Myelogenous Leukemia)","Acute Lymphoid Leukemia (ALL)","Acute Leukemia (Category)","MDS (Myelodysplastic Syndrome)","CML (Chronic Myelogenous Leukemia)","CLL (Chronic Lymphocytic Leukemia)","Prolymphocyctic Leukemia","Chronic Myelomonocytic Leukemia (CMML)","Myeloproliferative Neoplasm (MPN)","Lymphoma","Myelofibrosis"],"enrollment":358,"completionDate":"2028-06"},{"nctId":"NCT06872333","phase":"PHASE2","title":"Allo HSCT for High Risk Hemoglobinopathies","status":"RECRUITING","sponsor":"Masonic Cancer Center, University of Minnesota","startDate":"2024-11-19","conditions":["Graft Failure","Sickle Cell Disease","Hemoglobinopathies"],"enrollment":62,"completionDate":"2032-06-01"},{"nctId":"NCT06345495","phase":"PHASE2","title":"High Dose Ruxolitinib and Allogeneic Stem Cell Transplantation in Myelofibrosis Patients With Splenomegaly","status":"RECRUITING","sponsor":"M.D. Anderson Cancer Center","startDate":"2024-10-01","conditions":["Splenomegaly","Myelofibrosis"],"enrollment":30,"completionDate":"2029-01-01"},{"nctId":"NCT07257419","phase":"PHASE1","title":"CD45RA-depleted CD19-CAR T Cell Consolidation After TCRαβ+/CD19 B Cell-depleted Haploidentical Hematopoietic Cell Transplantation for Relapsed/Refractory CD19+ ALL and Lymphoma","status":"RECRUITING","sponsor":"St. Jude Children's Research Hospital","startDate":"2026-03-03","conditions":["Relapsed Pediatric ALL","Hematopoietic Cell Transplantation","Hematologic Malignancy"],"enrollment":60,"completionDate":"2035-12"},{"nctId":"NCT05581030","phase":"PHASE1","title":"CalPeg for Newly Diagnosed Acute Lymphoblastic Leukemia (ALL)","status":"RECRUITING","sponsor":"H. Lee Moffitt Cancer Center and Research Institute","startDate":"2023-05-01","conditions":["Acute Lymphoblastic Leukemia"],"enrollment":7,"completionDate":"2026-10"},{"nctId":"NCT03849651","phase":"PHASE2","title":"TCRαβ-depleted Progenitor Cell Graft With Additional Memory T-cell DLI, Plus Selected Use of Blinatumomab, in Naive T-cell Depleted Haploidentical Donor Hematopoietc Cell Transplantation for Hematologic Malignancies","status":"ACTIVE_NOT_RECRUITING","sponsor":"St. Jude Children's Research Hospital","startDate":"2019-01-31","conditions":["Acute Lymphoblastic Leukemia (ALL)","Acute Myeloid Leukemia (AML)","Myelodysplastic Syndromes (MDS)","NK-Cell Leukemia","Hodgkin Lymphoma","Non Hodgkin Lymphoma (NHL)","Juvenile Myelomonocytic Leukemia (JMML)","Chronic Myeloid Leukemia (CML)"],"enrollment":69,"completionDate":"2026-06-07"},{"nctId":"NCT01174121","phase":"PHASE2","title":"Immunotherapy Using Tumor Infiltrating Lymphocytes for Patients With Metastatic Cancer","status":"RECRUITING","sponsor":"National Cancer Institute (NCI)","startDate":"2010-08-26","conditions":["Metastatic Colorectal Cancer","Metastatic Pancreatic Cancer","Metastatic Ovarian Cancer","Metastatic Breast Carcinoma","Metastatic Endocrine Tumors/ Neuroendocrine Tumors"],"enrollment":332,"completionDate":"2029-12-27"},{"nctId":"NCT04486391","phase":"PHASE3","title":"Tislelizumab Monotherapy Versus Salvage Chemotherapy for Relapsed/Refractory Classical Hodgkin Lymphoma","status":"TERMINATED","sponsor":"BeiGene","startDate":"2020-12-14","conditions":["Classical Hodgkin Lymphoma"],"enrollment":3,"completionDate":"2025-10-13"},{"nctId":"NCT06078696","phase":"PHASE1,PHASE2","title":"Siplizumab for Sickle Cell Disease Transplant","status":"TERMINATED","sponsor":"Columbia University","startDate":"2023-09-28","conditions":["Anemia, Sickle Cell"],"enrollment":1,"completionDate":"2025-12-11"},{"nctId":"NCT06942039","phase":"EARLY_PHASE1","title":"Pilot Study of IT Topotecan and Maintenance Chemotherapy for HR-EBTs in Children < 6 Years, Post Consolidation","status":"RECRUITING","sponsor":"C17 Council","startDate":"2025-09-23","conditions":["CNS Embryonal Tumor","CNS, Medulloblastoma","Atypical Teratoid Rhabdoid Tumor","Medulloblastoma, Childhood","Medulloblastoma, Group 3","Medulloblastoma, Group 4","Pineoblastoma","Neuroblastoma","Embryonal Tumor With Multilayered Rosettes","Embryonal Tumor With Abundant Neuropil and True Rosettes","Ependymoblastoma","Medulloepithelioma","CNS Embryonal Tumor With Rhabdoid Features","CNS Embryonal Tumor, Nos"],"enrollment":15,"completionDate":"2032-12-31"},{"nctId":"NCT05470491","phase":"PHASE1,PHASE2","title":"Trial of Allogeneic Reduced-Intensity, HLA-Haploidentical Allogeneic Hematopoietic Cell Bone Marrow Transplantation Followed by Graft-versus-Host-Disease (GVHD) Prophylaxis With Cyclophosphamide, Bortezomib and Maraviroc for Hematologic Malignancies ...","status":"RECRUITING","sponsor":"National Cancer Institute (NCI)","startDate":"2023-01-26","conditions":["HIV","Hematologic Malignancies"],"enrollment":265,"completionDate":"2027-07-30"},{"nctId":"NCT04684368","phase":"PHASE2","title":"A Study of a New Way to Treat Children and Young Adults With a Brain Tumor Called NGGCT","status":"RECRUITING","sponsor":"Children's Oncology Group","startDate":"2021-07-13","conditions":["Central Nervous System Nongerminomatous Germ Cell Tumor","Choriocarcinoma","Embryonal Carcinoma","Immature Teratoma","Malignant Teratoma","Mixed Germ Cell Tumor","Pineal Region Germ Cell Tumor","Pineal Region Immature Teratoma","Pineal Region Yolk Sac Tumor","Suprasellar Germ Cell Tumor"],"enrollment":160,"completionDate":"2029-12-21"},{"nctId":"NCT05589896","phase":"PHASE1,PHASE2","title":"A First-in-Human Study of HLA-Partially to Fully Matched Allogenic Cryopreserved Deceased Donor Bone Marrow Transplantation for Patients With Hematologic Malignancies","status":"RECRUITING","sponsor":"Ossium Health, Inc.","startDate":"2024-08-16","conditions":["Acute Leukemia","Acute Lymphoblastic Leukemia","Acute Myeloid Leukemia","Acute Biphenotypic Leukemia","Acute Undifferentiated Leukemia","CLL (Chronic Lymphocytic Leukemia)","Chronic Myeloid Leukemia (CML)","MDS (Myelodysplastic Syndrome)","Non-Hodgkin Lymphomas","Hodgkins Lymphoma","Cutaneous T Cell Lymphomas (CTCL)"],"enrollment":12,"completionDate":"2027-03-31"},{"nctId":"NCT07428993","phase":"PHASE2","title":"Evaluating Efficacy of B7-H3-CAR T Cells Administered at the End of Upfront Map Chemotherapy in Patients With Newly Diagnosed High-Risk Osteosarcoma","status":"NOT_YET_RECRUITING","sponsor":"St. Jude Children's Research Hospital","startDate":"2026-02","conditions":["Pediatric Osteosarcoma"],"enrollment":41,"completionDate":"2035-12"},{"nctId":"NCT05170828","phase":"PHASE1","title":"Cryopreserved MMUD BM With PTCy for Hematologic Malignancies","status":"WITHDRAWN","sponsor":"Ossium Health, Inc.","startDate":"2022-09","conditions":["Acute Leukemia","Myelodysplastic Syndromes","T-lymphoblastic Lymphoma","Acute Lymphocytic Leukemia","Acute Myeloid Leukemia","Acute Biphenotypic Leukemia","Acute Undifferentiated Leukemia"],"enrollment":0,"completionDate":"2024-11"},{"nctId":"NCT04426669","phase":"PHASE1,PHASE2","title":"A Study of Metastatic Gastrointestinal Cancers Treated With Tumor Infiltrating Lymphocytes in Which the Gene Encoding the Intracellular Immune Checkpoint CISH Is Inhibited Using CRISPR Genetic Engineering","status":"COMPLETED","sponsor":"Intima Bioscience, Inc.","startDate":"2020-05-15","conditions":["Gastrointestinal Epithelial Cancer","Gastrointestinal Neoplasms","Cancer of Gastrointestinal Tract","Cancer, Gastrointestinal","Gastrointestinal Cancer","Colo-rectal Cancer","Pancreatic Cancer","Gall Bladder Cancer","Colon Cancer","Esophageal Cancer","Stomach Cancer"],"enrollment":23,"completionDate":"2026-01-22"},{"nctId":"NCT05566223","phase":"PHASE1,PHASE2","title":"CISH Inactivated TILs in the Treatment of NSCLC","status":"WITHDRAWN","sponsor":"Intima Bioscience, Inc.","startDate":"2023-02","conditions":["Carcinoma, Non-Small-Cell Lung","Metastatic Non Small Cell Lung Cancer","Stage IV Non-small Cell Lung Cancer","Squamous Cell Lung Cancer","Adenocarcinoma of Lung","Large Cell Lung Cancer"],"enrollment":0,"completionDate":"2027-11"},{"nctId":"NCT00003042","phase":"PHASE2","title":"Chemotherapy and Stem Cell Transplantation in Treating Patients With Stage IIIB Breast Cancer","status":"COMPLETED","sponsor":"City of Hope Medical Center","startDate":"1997-05-30","conditions":["Breast Cancer"],"enrollment":41,"completionDate":"2025-11-06"},{"nctId":"NCT04224558","phase":"PHASE1,PHASE2","title":"Stem Cell Transplantation in Crohn's Disease","status":"RECRUITING","sponsor":"Cedars-Sinai Medical Center","startDate":"2019-11-15","conditions":["Crohn Disease"],"enrollment":15,"completionDate":"2027-09-30"},{"nctId":"NCT02724579","phase":"PHASE2","title":"Reduced Craniospinal Radiation Therapy and Chemotherapy in Treating Younger Patients With Newly Diagnosed WNT-Driven Medulloblastoma","status":"ACTIVE_NOT_RECRUITING","sponsor":"Children's Oncology Group","startDate":"2017-11-17","conditions":["Medulloblastoma"],"enrollment":45,"completionDate":"2028-03-31"},{"nctId":"NCT06253520","phase":"PHASE1","title":"Autologous T-cells Genetically Engineered to Express Receptors Reactive Against KRAS Mutations in Conjunction With a Vaccine Directed Against These Antigens in Participants With Metastatic Cancer","status":"RECRUITING","sponsor":"National Cancer Institute (NCI)","startDate":"2024-05-16","conditions":["Metastatic Solid Cancers","Colorectal Cancer","Breast Cancer","Non-Small Cell Lung Cancer","Gastrointestinal Cancer","Ovarian Cancer","Genitourinary Cancer"],"enrollment":210,"completionDate":"2033-06-15"},{"nctId":"NCT02875314","phase":"PHASE4","title":"HeadStart4: Newly Diagnosed Children (<10 y/o) With Medulloblastoma and Other CNS Embryonal Tumors","status":"ACTIVE_NOT_RECRUITING","sponsor":"Parth Patel","startDate":"2015-09","conditions":["Medulloblastoma","Central Nervous System Embryonal Tumors"],"enrollment":250,"completionDate":"2030-12"},{"nctId":"NCT06001385","phase":"PHASE2","title":"HLA-Mismatched Unrelated Donor Peripheral Blood Stem Cell Transplantation With Reduced Dose Post Transplantation Cyclophosphamide GvHD Prophylaxis","status":"ACTIVE_NOT_RECRUITING","sponsor":"Center for International Blood and Marrow Transplant Research","startDate":"2023-12-08","conditions":["Acute Lymphoblastic Leukemia","Acute Myeloid Leukemia","Acute Leukemia","Myelodysplastic Syndromes","Chronic Myeloid Leukemia","Chronic Lymphocytic Leukemia","Myeloproliferative Neoplasm","Lymphoma","Chronic Myelomonocytic Leukemia","Pro-Lymphocytic Leukemia","Myelofibrosis"],"enrollment":313,"completionDate":"2026-06-30"},{"nctId":"NCT07389356","phase":"NA","title":"Modified R-MINE Regimen vs. R-GemOx Regimens on the Treatment of Late Relapsed DLBCL","status":"NOT_YET_RECRUITING","sponsor":"The First Affiliated Hospital with Nanjing Medical University","startDate":"2026-02-25","conditions":["DLBCL - Diffuse Large B Cell Lymphoma"],"enrollment":70,"completionDate":"2029-12-30"},{"nctId":"NCT00902044","phase":"PHASE1","title":"Her2 Chimeric Antigen Receptor Expressing T Cells in Advanced Sarcoma","status":"ACTIVE_NOT_RECRUITING","sponsor":"Baylor College of Medicine","startDate":"2010-02-11","conditions":["Sarcoma"],"enrollment":36,"completionDate":"2032-07"},{"nctId":"NCT01953900","phase":"PHASE1","title":"iC9-GD2-CAR-VZV-CTLs/Refractory or Metastatic GD2-positive Sarcoma and Neuroblastoma","status":"ACTIVE_NOT_RECRUITING","sponsor":"Baylor College of Medicine","startDate":"2014-04","conditions":["Osteosarcoma","Neuroblastoma"],"enrollment":26,"completionDate":"2034-10-31"},{"nctId":"NCT06326463","phase":"PHASE1","title":"CAR T-cell Therapy Directed to CD70 for Pediatric Patients With Hematological Malignancies","status":"RECRUITING","sponsor":"St. Jude Children's Research Hospital","startDate":"2024-10-16","conditions":["Hematologic Malignancy","ALL, Childhood","AML, Childhood","Lymphoma","MDS"],"enrollment":18,"completionDate":"2031-07-01"},{"nctId":"NCT04959175","phase":"PHASE1,PHASE2","title":"Phase I/II Study to Reduce Post-transplantation Cyclophosphamide Dosing for Older or Unfit Patients Undergoing Bone Marrow Transplantation for Hematologic Malignancies","status":"RECRUITING","sponsor":"National Cancer Institute (NCI)","startDate":"2021-09-23","conditions":["Hematologic Neoplasms"],"enrollment":320,"completionDate":"2027-04-30"},{"nctId":"NCT01652092","phase":"NA","title":"Allogeneic Hematopoietic Stem Cell Transplant for Patients With Primary Immune Deficiencies","status":"ACTIVE_NOT_RECRUITING","sponsor":"Masonic Cancer Center, University of Minnesota","startDate":"2012-09-04","conditions":["SCID","Omenn's Syndrome","Reticular Dysgenesis","Wiskott-Aldrich Syndrome","Bare Lymphocyte Syndrome","Common Variable Immunodeficiency","Chronic Granulomatous Disease","CD40 Ligand Deficiency","Hyper IgM Syndrome","X-linked Lymphoproliferative Disease","Hemophagocytic Lymphohistiocytosis","Griscelli Syndrome","Chediak-Higashi Syndrome","Langerhan's Cell Histiocytosis"],"enrollment":57,"completionDate":"2026-12"},{"nctId":"NCT04187105","phase":"PHASE2","title":"BMT-06: Study of Intensity Modulated Total Marrow Irradiation (IM-TMI)","status":"RECRUITING","sponsor":"University of Illinois at Chicago","startDate":"2020-01-27","conditions":["Acute Leukemia","MDS"],"enrollment":27,"completionDate":"2026-12"},{"nctId":"NCT02106988","phase":"PHASE2","title":"Concurrent Chemotherapy and Radiation Therapy for Newly Diagnosed Nasal NK Cell Lymphoma","status":"RECRUITING","sponsor":"M.D. Anderson Cancer Center","startDate":"2015-01-16","conditions":["Lymphoma"],"enrollment":40,"completionDate":"2034-01-31"},{"nctId":"NCT05628883","phase":"PHASE1","title":"Proof of Concept of TBio-4101, Lymphodepleting Chemo, IL-2 for Relapsed/Refractory Melanoma","status":"ACTIVE_NOT_RECRUITING","sponsor":"H. Lee Moffitt Cancer Center and Research Institute","startDate":"2022-11-22","conditions":["Metastatic Melanoma","Unresectable Melanoma","Acral Melanoma","Mucosal Melanoma","Cutaneous Melanoma","Ocular Melanoma","Uveal Melanoma","Iris Melanoma","Conjunctival Melanoma","Non-Cutaneous Melanoma"],"enrollment":17,"completionDate":"2026-12-31"},{"nctId":"NCT04047628","phase":"PHASE3","title":"Best Available Therapy Versus Autologous Hematopoietic Stem Cell Transplant for Multiple Sclerosis (BEAT-MS)","status":"RECRUITING","sponsor":"National Institute of Allergy and Infectious Diseases (NIAID)","startDate":"2019-12-19","conditions":["Relapsing Multiple Sclerosis","Relapsing Remitting Multiple Sclerosis","Secondary Progressive Multiple Sclerosis"],"enrollment":156,"completionDate":"2029-10"},{"nctId":"NCT04425070","phase":"PHASE1,PHASE2","title":"A Study of Evaluating the Safety and Efficacy of ATG-010 Combined With Chemotherapy Sequential With ATG-010 Monotherapy Maintenance in Peripheral T- and NK/T-cell Lymphoma","status":"TERMINATED","sponsor":"Antengene Corporation","startDate":"2020-08-18","conditions":["Peripheral T-cell Lymphoma","NK/T-cell Lymphoma"],"enrollment":56,"completionDate":"2025-12-30"},{"nctId":"NCT07052370","phase":"PHASE1","title":"TCRαβ-depleted Progenitor Cell Graft With Early Memory T-cell DLI, Plus Selected Use of Blinatumomab, in naïve T-cell Depleted Haploidentical Donor Hematopoietic Cell Transplantation for Hematologic Malignancies","status":"RECRUITING","sponsor":"St. Jude Children's Research Hospital","startDate":"2025-09-25","conditions":["Hematologic Malignancy"],"enrollment":30,"completionDate":"2030-12"},{"nctId":"NCT04224337","phase":"PHASE2","title":"Phase II Study of Durvalumab ,Doxorubicin, and Ifosfamide in Pulmonary Sarcomatoid Carcinoma","status":"COMPLETED","sponsor":"Seoul National University Hospital","startDate":"2020-06-11","conditions":["Carcinoma, Non-Small-Cell Lung"],"enrollment":16,"completionDate":"2025-05-07"},{"nctId":"NCT04881240","phase":"PHASE1","title":"Study of CD19-directed Allogeneic Memory T-cell Therapy for Relapsed/Refractory CD19+ Leukemia","status":"RECRUITING","sponsor":"St. Jude Children's Research Hospital","startDate":"2024-02-14","conditions":["Acute Lymphoblastic Leukemia, in Relapse","Acute Lymphoblastic Leukemia, Refractory","Pediatric ALL"],"enrollment":60,"completionDate":"2028-07-01"},{"nctId":"NCT01319565","phase":"PHASE2","title":"Prospective Randomized Study of Cell Transfer Therapy for Metastatic Melanoma Using Tumor Infiltrating Lymphocytes Plus IL-2 Following Non-Myeloablative Lymphocyte Depleting Chemo Regimen Alone or in Conjunction With 12Gy Total Body Irradiation (TBI...","status":"COMPLETED","sponsor":"National Cancer Institute (NCI)","startDate":"2011-03-24","conditions":["Metastatic Melanoma","Skin Cancer"],"enrollment":102,"completionDate":"2024-09-10"},{"nctId":"NCT05115630","phase":"PHASE2","title":"Off-the-shelf NK Cells + SCT for Myeloid Malignancies","status":"COMPLETED","sponsor":"M.D. Anderson Cancer Center","startDate":"2022-04-08","conditions":["Myeloid Malignancies","Acute Myeloid Leukemia","Myelodysplastic Syndrome","Chronic Myeloid Leukemia"],"enrollment":24,"completionDate":"2025-05-15"},{"nctId":"NCT01005745","phase":"NA","title":"Lymphodepletion Plus Adoptive Cell Transfer With High Dose IL-2 in Patients With Metastatic Melanoma","status":"COMPLETED","sponsor":"H. Lee Moffitt Cancer Center and Research Institute","startDate":"2009-10-20","conditions":["Metastatic Melanoma"],"enrollment":19,"completionDate":"2025-08-18"},{"nctId":"NCT01871766","phase":"PHASE2","title":"Risk-Adapted Focal Proton Beam Radiation and/or Surgery in Patients With Low, Intermediate and High Risk Rhabdomyosarcoma Receiving Standard or Intensified Chemotherapy","status":"ACTIVE_NOT_RECRUITING","sponsor":"St. Jude Children's Research Hospital","startDate":"2013-12-04","conditions":["Rhabdomyosarcoma"],"enrollment":115,"completionDate":"2030-06"},{"nctId":"NCT00692939","phase":"PHASE1,PHASE2","title":"Autologous Stem Cell Transplantation for Crohn's Disease","status":"RECRUITING","sponsor":"Paul Szabolcs","startDate":"2012-06-26","conditions":["Crohn's Disease"],"enrollment":20,"completionDate":"2027-12"},{"nctId":"NCT07255664","phase":"PHASE1,PHASE2","title":"A FIH, Phase I/IIa, Trial Assessing Feasibility of Administrations of TIL-based Immunotherapy in Patients With Metastatic CRC and PC","status":"RECRUITING","sponsor":"Curacell Holding AB","startDate":"2025-11-13","conditions":["Metastatic Colorectal Cancer","Prostate Cancer Metastatic","Prostate Cancer Locally Advanced"],"enrollment":12,"completionDate":"2029-04"},{"nctId":"NCT06777979","phase":"PHASE1","title":"CD19-CD22-Bispecific Chimeric Antigen Receptor (CAR) T Cell Therapy for Pediatric Patients With Acute Lymphoblastic Leukemia","status":"RECRUITING","sponsor":"St. Jude Children's Research Hospital","startDate":"2025-04-28","conditions":["Acute Lymphoblastic Leukemia","Recurrent Acute Lymphoblastic Leukemia","Recurrent B Acute Lymphoblastic Leukemia"],"enrollment":30,"completionDate":"2031-01"},{"nctId":"NCT03190941","phase":"PHASE1,PHASE2","title":"Administering Peripheral Blood Lymphocytes Transduced With a Murine T-Cell Receptor Recognizing the G12V Variant of Mutated RAS in HLA-A*11:01 Patients","status":"RECRUITING","sponsor":"National Cancer Institute (NCI)","startDate":"2017-09-21","conditions":["Pancreatic Cancer","Gastric Cancer","Gastrointestinal Cancer","Colon Cancer","Rectal Cancer"],"enrollment":110,"completionDate":"2028-06-29"},{"nctId":"NCT03391466","phase":"PHASE3","title":"Study of Effectiveness of Axicabtagene Ciloleucel Compared to Standard of Care Therapy in Patients With Relapsed/Refractory Diffuse Large B Cell Lymphoma","status":"COMPLETED","sponsor":"Kite, A Gilead Company","startDate":"2018-01-25","conditions":["Relapsed/Refractory Diffuse Large B-Cell Lymphoma (DLBCL)"],"enrollment":359,"completionDate":"2024-11-25"},{"nctId":"NCT02810743","phase":"PHASE3","title":"Substantially Improving the Cure Rate of High-risk BRCA1-like Breast Cancer","status":"ACTIVE_NOT_RECRUITING","sponsor":"The Netherlands Cancer Institute","startDate":"2017-01-25","conditions":["Breast Cancer"],"enrollment":174,"completionDate":"2033-12-01"},{"nctId":"NCT05030155","phase":"PHASE3","title":"Study of Mepolizumab-based Regimen Compared to Conventional Therapeutic Strategy in Patients With Eosinophilic Granulomatosis With Polyangiitis (E-merge)","status":"ACTIVE_NOT_RECRUITING","sponsor":"Assistance Publique - Hôpitaux de Paris","startDate":"2022-05-30","conditions":["Eosinophilic Granulomatosis With Polyangiitis"],"enrollment":100,"completionDate":"2025-11"},{"nctId":"NCT03573700","phase":"PHASE1,PHASE2","title":"Evaluation of CD19-Specific CAR Engineered Autologous T-Cells for Treatment of Relapsed/Refractory CD19+ Acute Lymphoblastic Leukemia","status":"ACTIVE_NOT_RECRUITING","sponsor":"St. Jude Children's Research Hospital","startDate":"2018-07-24","conditions":["Acute Lymphoblastic Leukemia, in Relapse","Acute Lymphoblastic Leukemia, Refractory"],"enrollment":24,"completionDate":"2026-07-01"},{"nctId":"NCT01857934","phase":"PHASE2","title":"Therapy for Children With Advanced Stage Neuroblastoma","status":"ACTIVE_NOT_RECRUITING","sponsor":"St. Jude Children's Research Hospital","startDate":"2013-07-05","conditions":["Neuroblastoma"],"enrollment":153,"completionDate":"2025-12"},{"nctId":"NCT01864109","phase":"PHASE2","title":"Irinotecan and Temozolomide in Combination With Existing High Dose Alkylator Based Chemotherapy for Treatment of Patients With Newly Diagnosed Ewing Sarcoma","status":"ACTIVE_NOT_RECRUITING","sponsor":"Memorial Sloan Kettering Cancer Center","startDate":"2013-05","conditions":["Newly Diagnosed Ewing Sarcoma"],"enrollment":83,"completionDate":"2027-05"},{"nctId":"NCT01096368","phase":"PHASE3","title":"Maintenance Chemotherapy or Observation Following Induction Chemotherapy and Radiation Therapy in Treating Patients With Newly Diagnosed Ependymoma","status":"ACTIVE_NOT_RECRUITING","sponsor":"Children's Oncology Group","startDate":"2010-05-07","conditions":["Anaplastic Ependymoma","Brain Ependymoma","Cellular Ependymoma","Clear Cell Ependymoma","Ependymoma","Papillary Ependymoma"],"enrollment":479,"completionDate":"2026-03-31"},{"nctId":"NCT04897321","phase":"PHASE1","title":"B7-H3-Specific Chimeric Antigen Receptor Autologous T-Cell Therapy for Pediatric Patients With Solid Tumors (3CAR)","status":"RECRUITING","sponsor":"St. Jude Children's Research Hospital","startDate":"2022-07-06","conditions":["Pediatric Solid Tumor","Osteosarcoma","Rhabdomyosarcoma","Neuroblastoma","Ewing Sarcoma","Wilms Tumor","Adrenocortical Cancer","Desmoplastic Small Round Cell Tumor","Germ Cell Cancer","Rhabdoid Tumor","Clear Cell Sarcoma","Hepatoblastoma","Melanoma","Carcinoma","Malignant Peripheral Nerve Sheath Tumors","Soft Tissue Sarcoma"],"enrollment":32,"completionDate":"2027-03-01"},{"nctId":"NCT04318678","phase":"PHASE1","title":"CD123-Directed T-Cell Therapy for Acute Myelogenous Leukemia (CATCHAML)","status":"RECRUITING","sponsor":"St. Jude Children's Research Hospital","startDate":"2020-07-29","conditions":["AML/MDS","B-ALL","T-ALL","BPDCN"],"enrollment":108,"completionDate":"2030-07-29"},{"nctId":"NCT04678401","phase":"PHASE1","title":"IS-free Treg HaploHCT","status":"RECRUITING","sponsor":"Dana-Farber Cancer Institute","startDate":"2021-01-12","conditions":["Stem Cell Transplant Complications","Graft Vs Host Disease","Myeloid Leukemia, Acute","Myeloid Leukemia in Relapse (Disorder)","Myelodysplastic Syndromes"],"enrollment":30,"completionDate":"2029-08-31"},{"nctId":"NCT05470283","phase":"PHASE1","title":"Phase I, Open-Label, Study of Tumor Infiltrating Lymphocytes Engineered With Membrane Bound IL15 Plus Acetazolamide in Adult Patients With Metastatic Melanoma","status":"ACTIVE_NOT_RECRUITING","sponsor":"M.D. Anderson Cancer Center","startDate":"2022-09-07","conditions":["Tumor","Metastatic Melanoma","Melanoma"],"enrollment":21,"completionDate":"2027-04-01"},{"nctId":"NCT03856216","phase":"PHASE2","title":"Inotuzumab Ozogamicin and Chemotherapy in Treating Patients With Leukemia or Lymphoma Undergoing Stem Cell Transplantation","status":"TERMINATED","sponsor":"M.D. Anderson Cancer Center","startDate":"2019-10-28","conditions":["Acute Lymphoblastic Leukemia","B Acute Lymphoblastic Leukemia","Lymphocytic Neoplasm","Lymphoma"],"enrollment":15,"completionDate":"2025-10-13"},{"nctId":"NCT03630211","phase":"PHASE2","title":"Autologous Stem Cell Transplantation in Patients With Systemic Sclerosis","status":"RECRUITING","sponsor":"Paul Szabolcs","startDate":"2018-07-31","conditions":["Systemic Sclerosis","Diffuse Sclerosis Systemic","Interstitial Lung Disease","Pulmonary Hypertension"],"enrollment":8,"completionDate":"2026-08-01"},{"nctId":"NCT03016806","phase":"","title":"Umbilical Cord Blood Transplantation From Unrelated Donors","status":"RECRUITING","sponsor":"University of Rochester","startDate":"2015-06","conditions":["Acute Leukemia","Immune Deficiency Disorder","Congenital Hematological Disorder","Metabolism Disorder","Aplastic Anemia","Myelodysplastic Syndromes","Chronic Leukemia","Lymphoma","Multiple Myeloma","Solid Tumor"],"enrollment":30,"completionDate":"2027-06"},{"nctId":"NCT03805022","phase":"PHASE3","title":"Benefit of Intensified Peri-operative Chemotherapy Within High-risk CINSARC Patients With Resectable Soft-tissue Sarcomas","status":"RECRUITING","sponsor":"Institut Bergonié","startDate":"2019-02-14","conditions":["Non-metastatic Soft-tissue Sarcoma","Resectable"],"enrollment":351,"completionDate":"2028-12"},{"nctId":"NCT05579769","phase":"PHASE2","title":"Pediatric Study of GVHD Ppx w/o Calcineurin Inhibitors After Day60 Post First Allo HSCT for Hematological Malignancies.","status":"TERMINATED","sponsor":"St. Jude Children's Research Hospital","startDate":"2023-03-14","conditions":["Hematologic Malignancy","Myeloid Malignancy"],"enrollment":3,"completionDate":"2024-05-08"},{"nctId":"NCT02356159","phase":"PHASE1,PHASE2","title":"Study of Palifermin (Kepivance) in Persons Undergoing Unrelated Donor Allogeneic Hematopoietic Cell Transplantation","status":"COMPLETED","sponsor":"National Cancer Institute (NCI)","startDate":"2015-09-24","conditions":["Myelodysplastic Syndromes","Hodgkin's Lymphoma","Non-Hodgkin's Lymphoma","Acute Leukemia","Multiple Myeloma"],"enrollment":34,"completionDate":"2025-03-25"},{"nctId":"NCT07187960","phase":"PHASE3","title":"Evaluation of the Efficacy and Safety of TQB2825 Injection Compared to Immunotherapy in the Treatment of Recurrent/Refractory Follicular Lymphoma","status":"NOT_YET_RECRUITING","sponsor":"Shanghai Chia Tai Tianqing Pharmaceutical Technology Development Co., Ltd.","startDate":"2025-11","conditions":["Follicular Lymphoma"],"enrollment":228,"completionDate":"2029-02"},{"nctId":"NCT06341998","phase":"PHASE2,PHASE3","title":"Clinical Study of Chemotherapy in the Treatment of Recurrent/Refractory Yolk Sac Tumor in Children","status":"COMPLETED","sponsor":"Shandong First Medical University","startDate":"2020-06-01","conditions":["Germ Cell Tumor","Yolk Sac Tumor"],"enrollment":32,"completionDate":"2024-02-01"},{"nctId":"NCT06690281","phase":"PHASE2","title":"A Phase II Study of Adjuvant Immunotherapy Targeting KRAS G12D, KRAS G12V, or TP53 R175H for Participants With Advanced Gastrointestinal Malignancies","status":"WITHDRAWN","sponsor":"National Cancer Institute (NCI)","startDate":"2025-09-09","conditions":["Gastrointestinal Carcinoma","Pancreatic Cancer","Hepatocellular Cancer","Cholangiocarcinoma","Duodenal Cancer","Colorectal Cancer","Small Bowel Cancer","Metastatic Cancers"],"enrollment":0,"completionDate":"2025-09-09"},{"nctId":"NCT05438667","phase":"EARLY_PHASE1","title":"TCR-T Cell Therapy on Advanced Solid Tumors","status":"RECRUITING","sponsor":"Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University","startDate":"2023-06-01","conditions":["Pancreatic Cancer"],"enrollment":18,"completionDate":"2028-06-30"},{"nctId":"NCT00186888","phase":"PHASE3","title":"Study of Treatment for Patients With Cancer of the Eye -Retinoblastoma","status":"COMPLETED","sponsor":"St. Jude Children's Research Hospital","startDate":"2005-04-07","conditions":["Retinoblastoma","Retinal Neoplasm"],"enrollment":107,"completionDate":"2024-11-12"},{"nctId":"NCT06027957","phase":"PHASE1","title":"CD19 CAR T-Cell Therapy for R/R Non-Hodgkin Lymphoma and Acute Lymphoblastic Leukemia","status":"COMPLETED","sponsor":"Vinmec Research Institute of Stem Cell and Gene Technology","startDate":"2023-08-02","conditions":["B-Cell Non Hodgkin Lymphoma","B-Cell Acute Lymphoblastic Leukemia"],"enrollment":18,"completionDate":"2025-07-31"},{"nctId":"NCT06023641","phase":"PHASE2","title":"Treatment of Newly Diagnosed Rhabdomyosarcoma Using Molecular Risk Stratification and Liposomal Irinotecan Based Therapy in Children With Intermediate and High Risk Disease","status":"RECRUITING","sponsor":"St. Jude Children's Research Hospital","startDate":"2024-03-13","conditions":["Rhabdomyosarcoma"],"enrollment":135,"completionDate":"2037-10"},{"nctId":"NCT02790515","phase":"PHASE2","title":"Provision of TCRγδ T Cells and Memory T Cells Plus Selected Use of Blinatumomab in Naïve T-cell Depleted Haploidentical Donor Hematopoietic Cell Transplantation for Hematologic Malignancies Relapsed or Refractory Despite Prior Transplantation","status":"ACTIVE_NOT_RECRUITING","sponsor":"St. Jude Children's Research Hospital","startDate":"2016-07-14","conditions":["Acute Lymphoblastic Leukemia (ALL)","Acute Myeloid Leukemia (AML)","Myeloid Sarcoma","Chronic Myeloid Leukemia (CML)","Juvenile Myelomonocytic Leukemia (JMML)","Myelodysplastic Syndrome (MDS)","Non-Hodgkin Lymphoma (NHL)"],"enrollment":170,"completionDate":"2026-07-01"},{"nctId":"NCT05032183","phase":"PHASE1,PHASE2","title":"Tagraxofusp and Low-Intensity Chemotherapy for the Treatment of CD123 Positive Relapsed or Refractory Acute Lymphoblastic Leukemia or Lymphoblastic Lymphoma","status":"TERMINATED","sponsor":"M.D. Anderson Cancer Center","startDate":"2022-02-17","conditions":["Recurrent Adult Lymphoblastic Lymphoma","Recurrent B Acute Lymphoblastic Leukemia","Recurrent T Acute Lymphoblastic Leukemia","Refractory B Acute Lymphoblastic Leukemia","Refractory Lymphoblastic Lymphoma","Refractory T Acute Lymphoblastic Leukemia"],"enrollment":4,"completionDate":"2024-07-31"},{"nctId":"NCT02793544","phase":"PHASE2","title":"HLA-Mismatched Unrelated Donor Bone Marrow Transplantation With Post-Transplantation Cyclophosphamide","status":"COMPLETED","sponsor":"Center for International Blood and Marrow Transplant Research","startDate":"2016-12","conditions":["Myelodysplastic Syndrome (MDS)","Chronic Lymphocytic Leukemia (CLL)","Chemotherapy-sensitive Lymphoma","Acute Lymphoblastic Leukemia (ALL)/T Lymphoblastic Lymphoma","Acute Myelogenous Leukemia (AML)","Acute Biphenotypic Leukemia (ABL)","Acute Undifferentiated Leukemia (AUL)"],"enrollment":80,"completionDate":"2020-03"},{"nctId":"NCT04947501","phase":"EARLY_PHASE1","title":"A Study of N9 Chemotherapy in Children With Neuroblastoma","status":"ACTIVE_NOT_RECRUITING","sponsor":"Memorial Sloan Kettering Cancer Center","startDate":"2021-06-22","conditions":["Neuroblastoma","Pediatric Cancer"],"enrollment":26,"completionDate":"2026-06-22"},{"nctId":"NCT05882604","phase":"NA","title":"MESNA Injection for TMJ Internal Derangement","status":"COMPLETED","sponsor":"Tanta University","startDate":"2023-03-01","conditions":["TMJ Disorder"],"enrollment":60,"completionDate":"2024-03-10"},{"nctId":"NCT00878254","phase":"PHASE2","title":"Rituximab and Combination Chemotherapy in Treating Patients With Previously Untreated Mantle Cell Lymphoma","status":"COMPLETED","sponsor":"University of Miami","startDate":"2009-03-25","conditions":["Mantle-Cell Lymphoma"],"enrollment":25,"completionDate":"2025-05-30"},{"nctId":"NCT06220097","phase":"PHASE2","title":"Mitoxantrone Hydrochloride Liposome Injection-containing Bridging Regimen and CD19-targeting CAR-T Therapies","status":"ACTIVE_NOT_RECRUITING","sponsor":"Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","startDate":"2022-02-01","conditions":["B-cell Acute Lymphoblastic Leukemia","B-cell Lymphoma Refractory"],"enrollment":28,"completionDate":"2025-12-30"},{"nctId":"NCT04558736","phase":"PHASE2","title":"Haploidentical HCT for Severe Aplastic Anemia","status":"RECRUITING","sponsor":"St. Jude Children's Research Hospital","startDate":"2021-01-21","conditions":["Aplastic Anemia","Bone Marrow Failure Syndrome"],"enrollment":21,"completionDate":"2030-07-01"},{"nctId":"NCT01873326","phase":"PHASE2","title":"Paclitaxel, Ifosfamide and Cisplatin (TIP) Versus Bleomycin, Etoposide and Cisplatin (BEP) for Patients With Previously Untreated Intermediate- and Poor-risk Germ Cell Tumors","status":"ACTIVE_NOT_RECRUITING","sponsor":"Memorial Sloan Kettering Cancer Center","startDate":"2013-06","conditions":["Germ Cell Tumors"],"enrollment":92,"completionDate":"2026-06"},{"nctId":"NCT06412497","phase":"PHASE2","title":"MT2023-20: Hematopoietic Cell Transplant With Reduced Intensity Conditioning and Post-transplant Cyclophosphamide for Severe Aplastic Anemia and Other Forms of Acquired Bone Marrow Failure.","status":"RECRUITING","sponsor":"Masonic Cancer Center, University of Minnesota","startDate":"2024-06-05","conditions":["Severe Aplastic Anemia","Acquired Amegakaryocytic Thrombocytopenia","Acquired Pure Red Cell Aplasia","Paroxysmal Nocturnal Hemoglobinuria"],"enrollment":60,"completionDate":"2036-05-01"},{"nctId":"NCT06190249","phase":"PHASE1","title":"Efficacy & Safety for LN144 With Pembrolizumab With High Risk Stage IIIb-dResectable Melanoma","status":"WITHDRAWN","sponsor":"James Isaacs, MD","startDate":"2024-12-02","conditions":["Stage IIIB Melanoma","Stage IIIC Melanoma","Stage IIID Melanoma"],"enrollment":0,"completionDate":"2028-07"},{"nctId":"NCT06119685","phase":"PHASE1,PHASE2","title":"IDP-023 as a Single Agent and in Combination With Antibody Therapies in Patients With Advanced Hematologic Cancers","status":"RECRUITING","sponsor":"Indapta Therapeutics, INC.","startDate":"2023-10-25","conditions":["NHL","Multiple Myeloma","Blood Cancer","Refractory Non-Hodgkin Lymphoma","Relapsed Non-Hodgkin Lymphoma","Refractory Multiple Myeloma","Relapsed Multiple Myeloma"],"enrollment":128,"completionDate":"2029-12-31"},{"nctId":"NCT04752163","phase":"PHASE1,PHASE2","title":"DS-1594b With or Without Azacitidine, Venetoclax, or Mini-HCVD for the Treatment of Relapsed or Refractory Acute Myeloid Leukemia or Acute Lymphoblastic Leukemia","status":"TERMINATED","sponsor":"M.D. Anderson Cancer Center","startDate":"2021-03-25","conditions":["Hematopoietic and Lymphoid Cell Neoplasm","Recurrent Acute Lymphoblastic Leukemia","Recurrent Acute Myeloid Leukemia","Recurrent Chronic Myelomonocytic Leukemia","Recurrent Myelodysplastic Syndrome","Refractory Acute Lymphoblastic Leukemia","Refractory Acute Myeloid Leukemia","Refractory Chronic Myelomonocytic Leukemia","Refractory Myelodysplastic Syndrome"],"enrollment":17,"completionDate":"2023-11-08"},{"nctId":"NCT05705687","phase":"NA","title":"Validation of a Treatment Algorithm for Poor-Risk NSGCTnon Seminomatous Germ-cell Tumors","status":"RECRUITING","sponsor":"Gustave Roussy, Cancer Campus, Grand Paris","startDate":"2023-05-05","conditions":["Non-Seminomatous Germ Cell Tumor"],"enrollment":150,"completionDate":"2037-02"},{"nctId":"NCT06677710","phase":"PHASE1","title":"IDP-023 g-NK Cells Plus Ocrelizumab in Patients With Progressive Multiple Sclerosis","status":"SUSPENDED","sponsor":"Indapta Therapeutics, INC.","startDate":"2026-06-30","conditions":["Multiple Sclerosis","Primary Progressive Multiple Sclerosis (PPMS)","Secondary Progressive Multiple Sclerosis (SPMS)","Non-Active Secondary Progressive Multiple Sclerosis","Non-Active SPMS","Autoimmune Diseases of the Nervous System","Nervous System Diseases","Autoimmune Diseases","Demyelinating Diseases","Immune System Diseases","Demyelinating Autoimmune Diseases, Central Nervous System (CNS)"],"enrollment":34,"completionDate":"2028-12-31"},{"nctId":"NCT03263559","phase":"PHASE2","title":"Haploidentical Bone Marrow Transplantation in Sickle Cell Patients (BMTCTN1507)","status":"COMPLETED","sponsor":"Medical College of Wisconsin","startDate":"2017-10-03","conditions":["Sickle Cell Disease"],"enrollment":95,"completionDate":"2025-01-29"}],"genericFilers":[],"latestUpdates":[],"manufacturing":[],"administration":{"route":"Intravenous","formulation":"Injection, Solution, Tablet","formulations":[{"form":"INJECTION, SOLUTION","route":"INTRAVENOUS","productName":"Mesna"},{"form":"INJECTION, SOLUTION","route":"INTRAVENOUS","productName":"mesna"},{"form":"INJECTION, SOLUTION","route":"INTRAVENOUS","productName":"MESNA"},{"form":"INJECTION, SOLUTION","route":"INTRAVENOUS","productName":"MESNEX"},{"form":"SOLUTION","route":"INTRAVENOUS","productName":"Mesna"},{"form":"TABLET, FILM COATED","route":"ORAL","productName":"MESNEX"}]},"_patentsChecked":true,"crossReferences":{"NUI":"N0000147597","MMSL":"41498","NDDF":"002678","UNII":"NR7O1405Q9","VUID":"4019477","CHEBI":"CHEBI:62955","VANDF":"4019477","INN_ID":"2813","RXNORM":"1546354","UMLSCUI":"C0000294","chemblId":"CHEMBL975","ChEMBL_ID":"CHEMBL1098319","KEGG_DRUG":"D01459","DRUGBANK_ID":"DB09110","PDB_CHEM_ID":"COM","PUBCHEM_CID":"23662354","SNOMEDCT_US":"108821000","SECONDARY_CAS_RN":"19767-45-4","MESH_DESCRIPTOR_UI":"D015080"},"formularyStatus":[],"originalProduct":{"form":"INJECTION, SOLUTION","route":"INTRAVENOUS","company":"Baxter Healthcare Corporation","brandName":"MESNEX","isOriginal":true,"marketingStatus":"NDA"},"_enricherVersion":"v2","_offLabelChecked":true,"developmentCodes":[],"ownershipHistory":[{"period":"1988-","companyName":"Baxter Hlthcare","relationship":"Original Developer"}],"pharmacokinetics":{"source":"DrugCentral","halfLife":"0.36 hours","clearance":"20.5 mL/min/kg","bioavailability":"62%","volumeOfDistribution":"0.65 L/kg"},"publicationCount":1445,"therapeuticAreas":["Oncology"],"atcClassification":{"source":"DrugCentral","atcCode":"R05CB05","allCodes":["R05CB05","V03AF01"]},"biosimilarFilings":[],"originalDeveloper":"Baxter Hlthcare","recentPublications":[{"date":"2026 Mar 17","pmid":"41845894","title":"Conformationally Adaptive SERS Receptors: Reconfiguring Binding Environments via Dynamic Gauche-Trans Transitions for Broad-Spectrum Ion Sensing.","journal":"ACS applied materials & interfaces"},{"date":"2026 Jan","pmid":"41635361","title":"Primary Renal Synovial Sarcoma: A Report of a Rare Case and Management Approach.","journal":"Cureus"},{"date":"2026 Jan-Dec","pmid":"41608667","title":"Primary Embryonal Rhabdomyosarcoma of the Breast: A Case Report and Literature Review.","journal":"Case reports in oncology"},{"date":"2026 Jan 24","pmid":"41578877","title":"Mesna in Otologic Surgery: Efficacy and Safety-A Scoping Review.","journal":"The Laryngoscope"},{"date":"2025","pmid":"41561516","title":"An evidence-based approach to pericardial synovial sarcoma: a unique case report.","journal":"Ecancermedicalscience"}],"companionDiagnostics":[],"genericManufacturers":9,"_genericFilersChecked":true,"genericManufacturerList":["Eugia Pharma","Fresenius Kabi Usa","Gland","Hikma","Ingenus Pharms Llc","Mylan Institutional","Rising","Sagent Pharms Inc","Teva Pharms Usa"],"status":"approved","companyName":"Baxter Hlthcare","companyId":"baxter","modality":"Small molecule","firstApprovalDate":"1988","enrichmentLevel":4,"visitCount":0,"regulatoryByCountry":[{"country_code":"US","regulator":"FDA","status":"approved","approval_date":"1988-12-30T00:00:00.000Z","mah":"BAXTER HLTHCARE","brand_name_local":null,"application_number":""},{"country_code":"US","regulator":"FDA","status":"approved","approval_date":"2000-07-26T00:00:00.000Z","mah":"BAXTER HLTHCARE","brand_name_local":null,"application_number":"NDA019884"},{"country_code":"US","regulator":"FDA","status":"approved","approval_date":"2015-08-21T00:00:00.000Z","mah":"SAGENT PHARMS INC","brand_name_local":null,"application_number":"ANDA090913"},{"country_code":"US","regulator":"FDA","status":"approved","approval_date":"2015-11-18T00:00:00.000Z","mah":"FRESENIUS KABI USA","brand_name_local":null,"application_number":"ANDA075811"},{"country_code":"US","regulator":"FDA","status":"approved","approval_date":"2019-09-06T00:00:00.000Z","mah":"GLAND","brand_name_local":null,"application_number":"ANDA206992"},{"country_code":"US","regulator":"FDA","status":"approved","approval_date":"2024-07-17T00:00:00.000Z","mah":"HIKMA","brand_name_local":null,"application_number":"ANDA075739"},{"country_code":"IL","regulator":"MOH","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"IL","regulator":"MOH","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"SG","regulator":"HSA","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"SG","regulator":"HSA","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"SG","regulator":"HSA","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"SG","regulator":"HSA","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"SG","regulator":"HSA","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"SG","regulator":"HSA","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"AE","regulator":"MOH","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"AE","regulator":"MOH","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"AE","regulator":"MOH","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"AE","regulator":"MOH","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"AE","regulator":"MOH","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"AE","regulator":"MOH","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"KR","regulator":"MFDS","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"KR","regulator":"MFDS","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"KR","regulator":"MFDS","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"KR","regulator":"MFDS","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"KR","regulator":"MFDS","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"KR","regulator":"MFDS","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"AU","regulator":"TGA","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"AU","regulator":"TGA","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"AU","regulator":"TGA","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"AU","regulator":"TGA","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"AU","regulator":"TGA","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"AU","regulator":"TGA","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"GB","regulator":"MHRA","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"GB","regulator":"MHRA","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"GB","regulator":"MHRA","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"GB","regulator":"MHRA","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"GB","regulator":"MHRA","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"GB","regulator":"MHRA","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"CA","regulator":"Health Canada","status":"approved","approval_date":null,"mah":"","brand_name_local":"","application_number":""},{"country_code":"IL","regulator":"MOH","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"IL","regulator":"MOH","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"IL","regulator":"MOH","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null},{"country_code":"IL","regulator":"MOH","status":"likely_approved","approval_date":null,"mah":null,"brand_name_local":null,"application_number":null}],"trialStats":{"total":30,"withResults":10},"validation":{"fieldsValidated":0,"lastValidatedAt":"2026-04-20T03:11:42.336140+00:00","fieldsConflicting":0,"overallConfidence":0.95},"verificationStatus":"verified","dataCompleteness":{"mechanism":true,"indications":true,"safety":true,"trials":true,"score":4}}