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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. It possesses analgesic, anti-inflammatory, and antipyretic properties.
## Primary Indications
* Pain, mild to moderate (e.g., dysmenorrhea, dental pain, musculoskeletal pain)
## Adult Dosing
* **Initial Dose:** 500 mg orally every 8 hours as needed.
* **Maximum Dose:** 1500 mg orally per day.
* **Duration:** Typically used for a maximum of 7 days.
## Pediatric Dosing
* **Age:** Not recommended for use in children under 14 years of age due to insufficient data on safety and efficacy.
## Dose Adjustments
* **Renal Impairment:** Use with caution. Severe renal impairment is a contraindication.
* **Hepatic Impairment:** Use with caution. Severe hepatic impairment is a contraindication.
## Contraindications
* 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.
* Severe renal impairment.
* Severe hepatic impairment.
* Active gastrointestinal bleeding or a history of gastrointestinal bleeding.
## Adverse Effects
* **Common:** Diarrhea, nausea, vomiting, abdominal pain, constipation, rash, dizziness, headache.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation, myocardial infarction, stroke, renal failure, hepatic failure, Stevens-Johnson syndrome, anaphylaxis.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Other NSAIDs/Aspirin:** Increased risk of gastrointestinal toxicity and other adverse effects.
* **Diuretics:** May reduce diuretic efficacy and increase risk of renal toxicity.
* **Lithium:** Increased serum lithium levels, potentially leading to toxicity.
* **ACE Inhibitors/ARBs:** May increase the risk of renal impairment.
## Monitoring
* **Gastrointestinal:** Signs and symptoms of bleeding or ulceration (e.g., melena, hematemesis, abdominal pain).
* **Renal Function:** Particularly in patients with pre-existing renal disease or those taking concurrent nephrotoxic agents.
* **Hepatic Function:** Particularly in patients with pre-existing hepatic disease.
* **Blood Pressure:** NSAIDs can cause or worsen hypertension.
## Clinical Pearls
* Mefenamic acid is generally intended for short-term use only.
* Advise patients to take with food or milk to minimize gastrointestinal upset.
* Discontinue if diarrhea occurs.
* Be aware of the increased risk of cardiovascular thrombotic events associated with NSAID use.
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*This information is intended for healthcare professionals. Always consult the official prescribing information and current clinical guidelines for the most up-to-date and complete drug information.*
