Please check your internet connection and try again.
# 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
* Dysmenorrhea
* Mild to moderate pain (e.g., dental pain, musculoskeletal pain)
## Adult Dosing
* **Initial dose:** 500 mg orally every 8 hours as needed.
* **Maximum daily dose:** 1500 mg orally.
* **Duration:** Typically for short-term use only (maximum 7 days for pain).
## Pediatric Dosing
Dosing in pediatric patients is not well-established and should be guided by specific institutional protocols or specialist recommendations.
## Dose Adjustments
No specific dose adjustments are routinely required for renal or hepatic impairment. However, caution is advised in patients with severe impairment.
## Contraindications
* Known hypersensitivity to mefenamic acid or other NSAIDs.
* History of bronchospasm, asthma, rhinitis, or urticaria induced by aspirin or other NSAIDs.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Inflammatory bowel disease.
* Severe heart failure.
* Active peptic ulceration or history of recurrent peptic ulcers.
* Third trimester of pregnancy.
## Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, abdominal pain, dyspepsia, constipation, dizziness, headache.
* **Serious:** Gastrointestinal bleeding, perforation, ulceration; cardiovascular thrombotic events (MI, stroke); renal impairment; hepatic impairment; hypersensitivity reactions; Stevens-Johnson syndrome; toxic epidermal necrolysis.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **Aspirin:** May reduce the cardioprotective effect of low-dose aspirin.
* **Diuretics, ACE inhibitors, ARBs:** May impair renal function and reduce antihypertensive effect.
* **Lithium:** Increased lithium levels.
* **Methotrexate:** Increased methotrexate toxicity.
## Monitoring
* **GI bleeding:** Monitor for signs and symptoms (e.g., melena, hematemesis).
* **Renal function:** Assess baseline and periodically during therapy, especially in patients with pre-existing renal disease.
* **Hepatic function:** Assess baseline and periodically during therapy.
* **Blood pressure:** Monitor for potential increase.
## Clinical Pearls
* Mefenamic acid should be taken with food or milk to minimize gastrointestinal upset.
* Due to the risk of serious GI events, use the lowest effective dose for the shortest duration necessary.
* Avoid concurrent use with other NSAIDs.
* Consider gastroprotective agents (e.g., PPIs) in patients at high risk for GI complications.
***
*Disclaimer: This information is intended for clinical use and does not substitute for professional medical judgment. Always consult the most current prescribing information and relevant literature before making clinical decisions.*
