Posology : מינונים

4.2    Posology and method of administration
Unless otherwise prescribed, MESNA-cell® is usually administered in adults intravenously at time 0 (time of oxazaphosphorine administration), after 4 hours and after 8 hours, with each dose being 20% of the oxazaphosphorine dose.

Example of MESNA-cell® administration in oxazaphosphorine injection: 
Hours                                           0                 4                  8 (Time)                                       (8 a.m.)         (12 a.m.)           (4 p.m.) Oxazaphosphorine dose                     40 mg/kg BW             --                 -- MESNA dose                                 8 mg/kg BW       8 mg/kg BW          8 mg/kg BW 
Therapeutic experience in children has shown that a more frequent (e.g six times) administration at shorter intervals (e.g 3 hours) is useful.
In the case of continuous infusions of ifosfamide, it has proven effective to administer a mesna bolus injection (20% of the ifosfamide dose) at time 0 (start of infusion) and to add MESNA-cell® to the continous infusion at a dose of up to 100% of the ifosfamide dose. To maintain the uroprotection after the end of the ifosfamide infusion, a mesna dose equivalent to up to 50% of the ifosfamide dose should be given for further 6 - 12 hours.

Example of MESNA-cell® administration with a 24-hour ifosfamide infusion: 
Hours                                          0h                        24 h    30 h    36 h Ifosfamide dose                                5 g/m2 BSA
(approx. 125 mg/kg
BW)
Mesna bolus dose                               1 g/m2 BSA
(approx. 25 mg/kg
BW)
Mesna addition to ifosfamide                   up to 5 g/m2 BSA infusion                                       (approx. 125 mg/kg
BW)
Mesna after end of the 24h-ifosfamide                                    up to 2.5 g/m2 BSA infusion                                                                 (approx. 62.5 mg/kg BW)

Duration of treatment
The duration of treatment with MESNA-cell® is defined by the duration of the oxazaphosphorine therapy.