Last reviewed 2026-04-20 · How we verify

Mesnex (MESNA)

Mesnex works by binding to and neutralizing acrolein, a toxic byproduct of chemotherapy that causes hemorrhagic cystitis.

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.

At a glance

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 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.

Approved indications

• Prevention of Chemotherapy-Induced Hemorrhagic Cystitis
• Testicular Germ Cell Tumor

Common side effects

• Nausea
• Vomiting
• Constipation
• Leukopenia
• Fatigue
• Fever
• Anorexia
• Thrombocytopenia
• Anemia
• Granulocytopenia
• Diarrhea
• Asthenia

Key clinical trials

• Novel Combination Therapy in the Treatment of Relapsed and Refractory Aggressive B-Cell Lymphoma (PHASE2)
• 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 (PHASE2)
• Testing the Use of Steroids and Tyrosine Kinase Inhibitors With Blinatumomab or Chemotherapy for Newly Diagnosed BCR-ABL-Positive Acute Lymphoblastic Leukemia in Adults (PHASE3)
• CER-1236 in Patients With Acute Myeloid Leukemia (AML), Myelodysplastic Syndrome (MDS), and Myelofibrosis (MF) (PHASE1)
• CAR T CELL Therapy for Pediatric, Adolescent and Young Adult Patients With CD19-Positive Leukemia (PHASE2)
• Upfront Autologous HSCT Versus Immunosuppression in Early Diffuse Cutaneous Systemic Sclerosis (PHASE4)
• T Cell Receptor Immunotherapy for Patients With Metastatic Non-Small Cell Lung Cancer (PHASE2)
• Administration of Autologous T-Cells Genetically Engineered to Express T-Cell Receptors Reactive Against Neoantigens in People With Metastatic Cancer (PHASE2)

Primary sources

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