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Absorption
Urinary bioavailability of oral mesna is 45% to 79%.
Distribution
Protein binding is 69% to 75%; Vd is 0.652 L/kg.
Metabolism
The major metabolite is dimesna.
Elimination
Approximately 32% is excreted in urine within 24 h. The t ½ is 1.2 to 8.3 h (after IV plus oral dose); the plasma Cl is 1.23 L/kg/h.
The mesna disulfide is reduced to the free thiol compound that reacts chemically with the urotoxic ifosfamide metabolites, resulting in their detoxification. At doses of 2 to 4 g, the terminal elimination t ½ is approximately 4 to 8 h. It is rapidly eliminated by the kidneys.
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