Urothelial toxicity (acrolein)

The metabolite that burns the bladder

Acrolein: reactive aldehyde metabolite of cyclophosphamide/ifosfamide, excreted and CONCENTRATED in urine
Direct urothelial injury → hemorrhagic cystitis; dose- and contact-time-dependent
➔ acrolein (the culprit itself — this card is the toxin's own page)
Defenses: mesna (binds it), hyperhydration and frequent voiding (dilute it, shorten contact)

Drugs with this mechanism (1)

Acrolein — Bladder-toxic metabolite of cyclophosphamide and ifosfamide; mesna helps prevent its hemorrhagic cystitis.

All mechanisms · Open the interactive console ↗