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# Mefenamic Acid
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term symptomatic relief of mild to moderate pain and for primary dysmenorrhea.
## Primary Indications
* Mild to moderate pain (e.g., dental pain, post-operative pain)
* Primary dysmenorrhea
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed. Maximum dose: 1500 mg daily.
* **Dysmenorrhea:** 500 mg every 6 hours as needed, starting with the onset of pain or bleeding. Maximum dose: 1500 mg daily.
Treatment duration generally should not exceed 7 days.
## Pediatric Dosing
Mefenamic acid is generally not recommended for use in children under 14 years of age due to lack of established safety and efficacy.
## Dose Adjustments
* **Renal Impairment:** Use with caution. Dose reduction may be necessary in severe renal impairment.
* **Hepatic Impairment:** Use with caution. Dose reduction may be necessary in severe hepatic impairment.
## Contraindications
* Known hypersensitivity to mefenamic acid, aspirin, or other NSAIDs.
* History of gastrointestinal bleeding or perforation related to previous NSAID use.
* Active peptic ulceration or history of recurrent peptic ulceration.
* Severe heart failure.
* Third trimester of pregnancy.
## Adverse Effects
Common: Diarrhea, nausea, vomiting, abdominal pain, dyspepsia, rash, dizziness.
Serious: Gastrointestinal bleeding, perforation, ulceration, renal failure, hepatic impairment, hypersensitivity reactions, cardiovascular thrombotic events.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Other NSAIDs (including aspirin):** Increased risk of gastrointestinal side effects and potential for additive pharmacodynamic effects.
* **ACE inhibitors, Angiotensin II Receptor Blockers (ARBs), Diuretics:** May diminish the antihypertensive effect and increase the risk of renal impairment.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased risk of methotrexate toxicity.
## Monitoring
* **Gastrointestinal symptoms:** Monitor for signs of bleeding or perforation.
* **Renal function:** Monitor BUN and creatinine, especially in patients with pre-existing renal disease or those on concomitant nephrotoxic drugs.
* **Hepatic function:** Monitor liver enzymes, especially in patients with pre-existing liver disease.
* **Blood pressure:** NSAIDs can increase blood pressure.
## Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Use the lowest effective dose for the shortest duration necessary to minimize risks.
* Discontinue if diarrhea, rash, or other signs of hypersensitivity occur.
* Avoid concurrent use with other NSAIDs.
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**Disclaimer:** This information is intended for healthcare professionals and does not replace a thorough review of current prescribing information, institutional protocols, or clinical judgment. Always verify the most up-to-date drug information before administration.
