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# Mefenamic Acid ## Overview Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term treatment of mild to moderate pain. ## Primary Indications * Pain associated with dysmenorrhea * Mild to moderate pain, including headache, muscle ache, dental pain, and backache. ## Adult Dosing * **Pain:** 500 mg every 6 hours as needed. * **Dysmenorrhea:** 500 mg every 6 hours as needed, starting with the onset of pain or bleeding. * **Maximum Daily Dose:** 1500 mg. ## Pediatric Dosing * **Ages 14 years and older:** Dosing is the same as adults. * **Under 14 years:** Not recommended due to insufficient data. ## Dose Adjustments * **Renal Impairment:** Use with caution. No specific dose adjustment is established, but may require reduced frequency or dose. Monitor renal function closely. * **Hepatic Impairment:** Use with caution. No specific dose adjustment is established, but may require reduced frequency or dose. Monitor liver function. ## Contraindications * Known hypersensitivity to mefenamic acid, aspirin, other NSAIDs, or any component of the formulation. * History of bronchospasm, asthma, rhinitis, or urticaria following aspirin or other NSAID administration. * Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery. * Active gastrointestinal (GI) bleeding or ulcer disease. * Severe renal or hepatic impairment. * Pregnancy in the third trimester. ## Adverse Effects * **Common:** Nausea, vomiting, diarrhea, abdominal pain, dyspepsia, constipation, dizziness, headache, rash. * **Serious:** GI bleeding, ulceration, perforation; renal toxicity (including interstitial nephritis, papillary necrosis, renal failure); hepatic toxicity (including elevated liver enzymes, hepatitis, jaundice); cardiovascular thrombotic events (myocardial infarction, stroke); hypersensitivity reactions (including anaphylaxis, Stevens-Johnson syndrome, toxic epidermal necrolysis); bronchospasm; exacerbation of heart failure. ## Key Drug Interactions * **Anticoagulants (e.g., warfarin):** Increased risk of bleeding. * **Corticosteroids:** Increased risk of GI bleeding. * **SSRIs and SNRIs:** Increased risk of GI bleeding. * **ACE inhibitors, ARBs, Beta-blockers:** May decrease antihypertensive effect; increased risk of renal toxicity. * **Diuretics:** May decrease diuretic effect; increased risk of renal toxicity. * **Lithium:** Increased serum lithium levels. * **Methotrexate:** Increased risk of methotrexate toxicity. ## Monitoring * **Renal function:** Creatinine, BUN. * **Hepatic function:** AST, ALT. * **Signs and symptoms of GI bleeding:** Melena, hematochezia, abdominal pain. * **Blood pressure:** Especially when used concurrently with antihypertensives. * **Signs and symptoms of hypersensitivity reactions.** ## Clinical Pearls * Mefenamic acid is generally recommended for short-term use only. * Take with food or milk to minimize GI upset. * Advise patients to discontinue use and seek medical attention if signs of GI bleeding, cardiovascular events, or severe hypersensitivity reactions occur. * Avoid concurrent use with other NSAIDs. --- *This information is intended for healthcare professionals. Always verify current prescribing information and consult with a pharmacist or physician for patient-specific guidance.*