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# Mefenamic Acid (Meftal-P)
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) belonging to the anthranilic acid derivative class. It functions by inhibiting cyclooxygenase (COX) enzymes, thereby reducing prostaglandin synthesis.
## Primary Indications
* Short-term relief of mild to moderate pain.
* Primary dysmenorrhea.
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed.
* **Dysmenorrhea:** 500 mg initially, followed by 250 mg every 6 hours as needed.
* **Maximum Duration:** Typically recommended for no more than 7 days.
## Pediatric Dosing
* Mefenamic acid is generally not recommended for children under 14 years of age due to limited safety and efficacy data. Some sources suggest a dose of 6.5 mg/kg every 6 hours, but this is off-label and requires careful consideration.
## Dose Adjustments
* No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised, especially in severe cases, due to potential for NSAID-related complications.
## Contraindications
* Known hypersensitivity to mefenamic acid, aspirin, or other NSAIDs.
* History of bronchospasm, asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Inflammatory bowel disease.
* Severe heart failure, renal impairment, or hepatic impairment.
* Third trimester of pregnancy.
## Adverse Effects
Common adverse effects include: nausea, vomiting, diarrhea, abdominal pain, constipation, dizziness, headache, and rash. More serious effects include: gastrointestinal bleeding, ulceration, perforation, renal toxicity, hepatic toxicity, cardiovascular events (MI, stroke), and hypersensitivity reactions.
## 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, ACE inhibitors, ARBs:** Reduced antihypertensive effect and increased risk of renal impairment.
* **Lithium, Methotrexate:** Increased serum levels and toxicity.
## Monitoring
* Monitor for signs and symptoms of gastrointestinal bleeding (melena, hematemesis).
* Monitor renal and hepatic function, especially with prolonged use or in patients with pre-existing conditions.
* Monitor blood pressure.
* Assess pain relief.
## Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Should not be used for more than 7 days consecutively.
* Due to its potential for adverse effects, consider alternative analgesics when feasible, especially for chronic pain management.
* Advise patients to avoid concurrent use of alcohol and other NSAIDs.
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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 ensure patient safety.*
