Urothelial toxicity (acrolein)
The metabolite that burns the bladder
- Direct chemical injury to bladder urothelium
- Hemorrhagic cystitis
- A thiol donor plus hydration prevents it
- 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 Urothelial toxicity in the interactive console ↗