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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 and for the relief of primary dysmenorrhea.
## Primary Indications
* Mild to moderate pain (e.g., dental pain, postoperative pain)
* Primary dysmenorrhea
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed. Do not exceed 4000 mg per day.
* **Primary Dysmenorrhea:** 500 mg every 6 hours starting with the onset of pain and bleeding, and continuing for the duration of dysmenorrhea.
## Pediatric Dosing
Mefenamic acid is **not recommended** for use in children under 14 years of age.
## Dose Adjustments
* **Hepatic Impairment:** Use with caution. No specific dose adjustments are established, but monitoring for hepatic effects is crucial.
* **Renal Impairment:** Use with caution. No specific dose adjustments are established, but monitoring for renal effects is crucial.
## Contraindications
* Hypersensitivity to mefenamic acid, aspirin, or other NSAIDs.
* History of NSAID-induced bronchospasm, asthma, urticaria, or allergic-type reactions.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Third trimester of pregnancy.
## Adverse Effects
* **Common:** Diarrhea, nausea, vomiting, abdominal pain, constipation, flatulence, dyspepsia.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; renal failure; hepatic failure; cardiovascular thrombotic events; hypersensitivity reactions; exacerbation of asthma.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **ACE inhibitors and ARBs:** Increased risk of renal impairment.
* **Lithium:** Increased lithium levels.
* **Methotrexate:** Increased methotrexate toxicity.
* **Other NSAIDs or Salicylates:** Increased risk of adverse effects, particularly GI toxicity.
## Monitoring
* Signs and symptoms of GI bleeding or ulceration.
* Renal function (BUN, creatinine).
* Liver function tests (ALT, AST).
* Blood pressure.
## Clinical Pearls
* Mefenamic acid should be taken with food or milk to minimize gastrointestinal upset.
* Treatment should be limited to the shortest duration necessary.
* Due to the risk of diarrhea, it is often recommended for short-term use only.
* Avoid concomitant use with other NSAIDs.
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**Disclaimer:** This information is intended for healthcare professionals and is not a substitute for professional medical advice. Always consult the most current prescribing information and your healthcare provider for any medical decisions.
