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# Mefenamic Acid
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for short-term relief of mild to moderate pain.
## Primary Indications
* Pain, including menstrual pain (dysmenorrhea)
* Pain associated with dental procedures
* Musculoskeletal pain
## Adult Dosing
* **Initial dose:** 500 mg orally every 6 hours as needed.
* **Maximum dose:** Do not exceed 1500 mg in any 24-hour period. Treatment duration should generally not exceed 7 days.
## Pediatric Dosing
* **Children 12 years and older:** Same as adult dosing: 500 mg orally every 6 hours as needed.
* **Children younger than 12 years:** Safety and efficacy have not been established.
## Dose Adjustments
* **Renal Impairment:** Use with caution. Dose reduction may be necessary in severe impairment.
* **Hepatic Impairment:** Use with caution. Dose reduction may be necessary in severe impairment.
## Contraindications
* Known hypersensitivity to mefenamic acid or other NSAIDs.
* History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
## Adverse Effects
Common adverse effects include nausea, vomiting, diarrhea, abdominal pain, constipation, headache, and dizziness. Serious adverse effects may include gastrointestinal bleeding, ulceration, perforation, cardiovascular thrombotic events, myocardial infarction, stroke, renal toxicity, hepatic toxicity, and hypersensitivity reactions.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Selective Serotonin Reuptake Inhibitors (SSRIs):** Increased risk of gastrointestinal bleeding.
* **Other NSAIDs or Salicylates:** Increased risk of adverse effects, including gastrointestinal toxicity.
* **Diuretics and Antihypertensives:** May reduce their efficacy and increase risk of renal impairment.
## Monitoring
* Monitor for signs and symptoms of gastrointestinal bleeding (e.g., melena, hematemesis).
* Monitor renal function (e.g., serum creatinine) and hepatic function (e.g., LFTs), especially in patients with pre-existing renal or hepatic disease.
* Monitor for signs of cardiovascular events.
## Clinical Pearls
* Mefenamic acid should be taken with food or milk to minimize gastrointestinal upset.
* Due to potential CNS effects, caution is advised when driving or operating machinery.
* Use the lowest effective dose for the shortest possible duration to minimize risks.
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*Disclaimer: This information is for educational purposes only and does not substitute professional medical advice. Always consult with a qualified healthcare provider and refer to the most current prescribing information before making any decisions regarding medication use.*
