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# Mefenamic Acid
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) of the fenamate class, used for the management of mild to moderate pain and for the treatment of 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.
* **Primary Dysmenorrhea:** 500 mg every 6 hours as needed, starting at the onset of pain and bleeding.
Maximum daily dose for adults is 1500 mg.
## Pediatric Dosing
Mefenamic acid is not generally recommended for use in children under 14 years of age.
## Dose Adjustments
No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised. Patients with severe renal or hepatic impairment should use with extreme caution or avoid.
## Contraindications
* Hypersensitivity to mefenamic acid, aspirin, or other NSAIDs.
* History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.
* Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery.
## Adverse Effects
* **Common:** Gastrointestinal upset (nausea, vomiting, diarrhea, abdominal pain), dizziness, rash.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; cardiovascular thrombotic events; renal toxicity; hepatic toxicity; hypersensitivity reactions.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Other NSAIDs and Salicylates:** Increased risk of gastrointestinal toxicity and adverse effects.
* **ACE Inhibitors and ARBs:** Reduced antihypertensive effect, increased risk of renal impairment.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased methotrexate toxicity.
## Monitoring
* Signs and symptoms of gastrointestinal bleeding.
* Renal function (especially in those with pre-existing renal disease or at risk).
* Hepatic function.
* Blood pressure.
## Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Should not be used for longer than 7 days for pain management without medical supervision.
* Has a relatively short half-life, requiring frequent dosing.
* Due to potential for serious gastrointestinal events, consider the lowest effective dose for the shortest duration.
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*This information is intended for clinical pharmacists and healthcare professionals. Always consult the most current prescribing information and relevant clinical guidelines for definitive patient management.*
