Department of Medical Oncology Chemotherapy Protocols

Mesna Dose Guidelines (RKG/OF/MK – December 05)

IV Ifosfamide administered over 4 hours, day 1 only, single dose

• 20% of total ifosfamide dose @ t-15min prior to bolus, given as a bolus

• 20% of total ifosfamide dose given as a bolus @ 4hours and @ 8 hours post
ifosfamide treatment.

• or preferably Oral Mesna post-ifosfamide infusion (see below)

Ifosfamide Infusion >4 hours, e.g. R-ICE

• Equivalent of 20% total Ifosfamide dose given as IV bolus pre-ifosfamide ifusion

• Equivalence of 100% total Ifosfamide dose given as IV infusion over 24 hours

(concurrently with Ifosfamide)

• Equivalence of 60% total Ifosfamide dose given as IV infusion over 12 hours

• Total Mesna dose = 180% of total Ifosfamide dose

Ifosfamide given as a long term infusion, e.g. CIV over 24 hours for 3 days or
Given over 4 hours for more than 1 day.

• Equivalence of 20% total Ifosfamide dose IV bolus pre Ifosfamide infusion

• Equivalence of 100% total Ifosfamide dose IV concurrent with Ifosfamide

• Equivalence of 60% total Ifosfamide dose over 12 hours after final 24 hour infusion

• Total Mesna dose = 180% of total Ifosfamide dose

Alternatively Oral Mesna post-ifosfamide infusion

• 40% oral when Ifosfamide infusion has stopped
• 40% after 2 hours
• 40% after 6 hours
• Total mesna dose = 120% po (= 60% IV)

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