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# Mefenamic Acid
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term management of mild to moderate pain.
## Primary Indications
* Pain, including menstrual pain (dysmenorrhea)
* Pain associated with dental procedures
* Pain due to musculoskeletal conditions
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed.
* **Maximum Dose:** Do not exceed 1500 mg in a 24-hour period. Treatment duration should not exceed 7 days.
## Pediatric Dosing
* **Age:** Generally not recommended for children under 14 years of age. Specific dosing for younger children is not well-established and should be guided by expert clinical judgment and appropriate literature.
## Dose Adjustments
* **Renal Impairment:** Use with caution. Data is limited, but dose reduction may be considered in severe impairment.
* **Hepatic Impairment:** Use with caution. Data is limited, dose reduction may be considered.
## Contraindications
* Hypersensitivity to mefenamic acid, aspirin, or other NSAIDs
* History of bronchospasm, asthma, rhinitis, or urticaria induced by aspirin or other NSAIDs
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery
* Active gastrointestinal bleeding or ulcer disease
* Severe renal or hepatic impairment
* Third trimester of pregnancy
## Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, abdominal pain, constipation, dyspepsia, headache, dizziness, rash.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; cardiovascular thrombotic events (MI, stroke); renal failure; hepatic failure; hypersensitivity reactions; bronchospasm; Stevens-Johnson syndrome/toxic epidermal necrolysis.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **SSRIs/SNRIs:** Increased risk of bleeding, especially gastrointestinal.
* **ACE inhibitors, ARBs, Beta-blockers:** Reduced antihypertensive effect; increased risk of renal dysfunction.
* **Diuretics:** Reduced diuretic effect; increased risk of renal dysfunction.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased risk of methotrexate toxicity.
## Monitoring
* **Baseline:** Renal function (creatinine), liver function tests, complete blood count (CBC).
* **During Therapy:** Signs and symptoms of gastrointestinal bleeding (melena, hematemesis), renal function, liver function, blood pressure. Monitor for signs of cardiovascular events.
## Clinical Pearls
* Mefenamic acid is intended for short-term use only.
* Take with food or milk to minimize gastrointestinal upset.
* Avoid concurrent use with other NSAIDs.
* Due to potential for serious adverse effects, use the lowest effective dose for the shortest duration necessary.
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*Disclaimer: This information is for educational purposes and does not substitute for professional medical advice. Always verify current prescribing information with official drug compendia and consult with a healthcare provider for individual patient care decisions.*
