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# Mefenamic Acid
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) belonging to the anthranilic acid derivative class. It possesses analgesic, anti-inflammatory, and antipyretic properties.
## Primary Indications
* Short-term management of mild to moderate pain.
* Management of primary dysmenorrhea.
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed. Do not exceed 4000 mg daily.
* **Dysmenorrhea:** 500 mg every 6 hours, starting with the onset of pain and bleeding, and continuing for the duration of symptoms. Do not exceed 4000 mg daily.
## Pediatric Dosing
Mefenamic acid is generally **not recommended** for children under 14 years of age due to limited safety and efficacy data.
## Dose Adjustments
* **Renal Impairment:** Use with caution. Dose reduction may be necessary in severe impairment.
* **Hepatic Impairment:** Use with caution. Dose reduction may be necessary in severe impairment.
## Contraindications
* Known 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.
## Adverse Effects
Common adverse effects include diarrhea, nausea, vomiting, abdominal pain, rash, and dizziness. Serious adverse effects include gastrointestinal bleeding, ulceration, perforation, cardiovascular thrombotic events, myocardial infarction, stroke, renal toxicity, hepatotoxicity, and hypersensitivity reactions.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Aspirin:** May decrease the antiplatelet effect of low-dose aspirin and potentially increase GI toxicity.
* **Corticosteroids:** Increased risk of GI adverse effects.
* **Diuretics:** May reduce diuretic efficacy and increase nephrotoxicity.
* **Lithium:** Increased serum lithium levels and risk of toxicity.
* **Methotrexate:** Increased risk of methotrexate toxicity.
## Monitoring
* Signs and symptoms of gastrointestinal bleeding or ulceration.
* Renal and hepatic function, especially with prolonged use or in patients with pre-existing impairment.
* Blood pressure.
* Signs and symptoms of cardiovascular events.
## Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Limit duration of use to the shortest effective period due to increased risk of adverse events with prolonged therapy.
* Avoid concurrent use with other NSAIDs.
* Consider risk factors for cardiovascular events and gastrointestinal bleeding prior to initiation.
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*This information is intended for healthcare professionals. Always consult the most current prescribing information and relevant clinical guidelines for complete details and to confirm appropriate use.*
