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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 and for the treatment of primary dysmenorrhea.
## Primary Indications
* Mild to moderate pain (e.g., dental pain, musculoskeletal pain)
* Primary dysmenorrhea
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed. Maximum dose: 1500 mg/day.
* **Dysmenorrhea:** 500 mg every 6 hours as needed, starting at the onset of pain or bleeding, whichever occurs first. Continue for up to 3 days. Maximum dose: 1500 mg/day.
Treatment should be limited to a maximum of 7 days.
## Pediatric Dosing
* **Pain and Dysmenorrhea:** Not recommended for children under 14 years of age due to lack of established dosing and safety data.
## Dose Adjustments
* **Renal Impairment:** Use with caution. Avoid in severe renal impairment.
* **Hepatic Impairment:** Use with caution. Avoid in severe hepatic impairment.
## Contraindications
* Hypersensitivity to mefenamic acid, aspirin, 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.
* Active gastrointestinal (GI) bleeding or ulcer disease.
* Inflammatory bowel disease (active).
## Adverse Effects
* **Common:** Diarrhea, nausea, vomiting, abdominal pain, constipation, dizziness, rash.
* **Serious:** Severe GI bleeding, ulceration, perforation; myocardial infarction, stroke; renal failure; hepatic failure; Stevens-Johnson syndrome, toxic epidermal necrolysis; anaphylaxis.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **ACE inhibitors, ARBs, Beta-blockers:** Reduced antihypertensive effect; increased risk of renal dysfunction.
* **Diuretics:** Reduced diuretic effect; increased risk of renal dysfunction.
* **Lithium:** Increased lithium levels and risk of toxicity.
* **Methotrexate:** Increased methotrexate levels and risk of toxicity.
## Monitoring
* Signs and symptoms of GI bleeding or ulceration.
* Renal function (especially in elderly or those with pre-existing renal disease).
* Hepatic function (if long-term therapy is required).
* Blood pressure.
## Clinical Pearls
* Administer with food or milk to minimize GI upset.
* Use for the shortest duration necessary.
* Avoid concomitant use with other NSAIDs.
* Monitor for signs of hypersensitivity reactions.
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*This information is intended for healthcare professionals. Always consult the most current prescribing information and institutional guidelines for complete details. Dosing may vary based on patient-specific factors and local protocols.*
