Indications & Dose: IFOSFAMIDE-INDUCED HEMORRHAGIC CYSTITIS IV Adult Short Inf standard-dose ifosfamide (<2.5g/m2/day): Mesna dose is equal to 60% of the ifosfamide dose given in 3 divided doses (0, 4, & 8h after the start of ifosfamide), Continuous Inf standard-dose ifosfamide (<2.5 g/m2/day): Mesna dose (as an IV bolus) is equal to 20% of the ifosfamide dose, followed by a continuous Inf of mesna at 40% of the ifosfamide dose, continue mesna Inf for 12-24h after completion of ifosfamide infusion, High-dose ifosfamide (>2.5g/m2/day): Evidence for use is inadequate, more frequent & prolonged mesna administration regimens may be required, IV followed by oral (for ifosfamide doses <2 g/m2/day): Mesna dose is equal to 100% of the ifosfamide dose, given as 20% of the ifosfamide dose IV at hour 0, followed by 40% of the ifosfamide dose given orally 2- & 6h after start of ifosfamide (Mesna dosing schedule should repeat each day ifosfamide is received) Child Same as adult dose | MUCOLYTIC NSL General Nebuliser: 0.6-1.2g/day (may also be given by direct endotracheal instillation)

Precautions: Autoimmune disorders, IV formulation contains benzyl alcohol causes gasping syndrome in neonates

ADR: Serious: flushing, conjunctivitis, flu-like syndrome, Others: cough, pharyngitis, rhinitis, dizziness, fever, headache, hyperesthesia, somnolence, rash, anorexia, constipation, diarrhea, flatulence, nausea, vomiting, Inj site reactions, arthralgia, back pain, rigors

DDI: Serious Warfarin effects increases

Monitor: Urinalysis