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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 associated with osteoarthritis and rheumatoid arthritis.
* Primary dysmenorrhea.
* Mild to moderate pain, including dental pain and postoperative pain.
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed. Maximum daily dose is 1500 mg. Treatment duration should not exceed 7 days.
* **Rheumatoid arthritis/Osteoarthritis:** 750 mg three times daily. Maximum daily dose is 2000 mg.
## Pediatric Dosing
* Not established for children under 14 years of age.
## Dose Adjustments
* **Renal Impairment:** Use with caution. Dosage reduction may be necessary in severe impairment.
* **Hepatic Impairment:** Use with caution. Dosage 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.
* Inflammatory bowel disease.
* Third trimester of pregnancy.
## Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, abdominal pain, constipation, dizziness, headache, rash.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; cardiovascular thrombotic events (MI, stroke); renal failure; hepatic failure; hypersensitivity reactions.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **Aspirin:** Reduced efficacy of mefenamic acid, increased risk of GI bleeding.
* **Diuretics:** Reduced antihypertensive and diuretic effects; increased risk of renal impairment.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased risk of methotrexate toxicity.
## Monitoring
* Signs and symptoms of GI bleeding or ulceration.
* Renal function (serum creatinine, BUN).
* Liver function tests (LFTs).
* Blood pressure.
## Clinical Pearls
* Administer with food or milk to reduce gastrointestinal upset.
* Use the lowest effective dose for the shortest possible duration to minimize risks.
* Avoid concurrent use with other NSAIDs.
* Discontinue if signs of hypersensitivity or serious adverse events occur.
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*This information is intended for healthcare professionals. It is crucial to consult the most current prescribing information and relevant clinical guidelines for complete details and to ensure patient safety. Dosing may vary based on local protocols and individual patient factors.*
