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# Mefenamic Acid (Meftal-P)
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term management of mild to moderate pain. It has analgesic, anti-inflammatory, and antipyretic properties.
## Primary Indications
* Pain associated with osteoarthritis
* Pain associated with rheumatoid arthritis
* Primary dysmenorrhea
* Mild to moderate pain
## Adult Dosing
* **Initial dose:** 500 mg every 6 hours as needed.
* **Maximum dose:** 1500 mg per day for short-term use (up to 7 days). Do not exceed 2000 mg per day if used for longer periods under strict medical supervision, though this is generally not recommended.
## Pediatric Dosing
* **Children 6 months and older:** 6.5 mg/kg every 6 hours as needed.
* **Maximum pediatric dose:** Typically not to exceed adult maximums per dose or per day. Specific pediatric dosing guidelines may vary; consult product labeling or local protocols.
## Dose Adjustments
* **Renal Impairment:** Use with caution. May require dose reduction based on renal function. Data is limited.
* **Hepatic Impairment:** Use with caution. May require dose reduction. Data is limited.
* **Elderly:** Consider lower doses due to potential increased risk of adverse effects.
## Contraindications
* Known hypersensitivity to mefenamic acid, aspirin, other NSAIDs, or any component of the formulation.
* History of NSAID-induced bronchospasm, urticaria, or allergic rhinitis.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Active peptic ulceration or gastrointestinal bleeding.
* Severe renal or hepatic impairment.
* Third trimester of pregnancy.
## Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, abdominal pain, dyspepsia, constipation, headache, dizziness, rash.
* **Serious:** Gastrointestinal bleeding, perforation, ulceration; cardiovascular thrombotic events (MI, stroke); renal failure; hepatic failure; Stevens-Johnson syndrome; anaphylaxis.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Aspirin:** May decrease the antiplatelet effect of low-dose aspirin and increase the risk of gastrointestinal toxicity.
* **Diuretics, ACE inhibitors, ARBs:** May reduce antihypertensive efficacy and increase risk of renal impairment.
* **Lithium, Methotrexate:** Increased serum levels and toxicity.
## Monitoring
* **Renal function:** Especially in patients with pre-existing renal disease, the elderly, or those on concomitant nephrotoxic agents.
* **Hepatic function:** Monitor liver enzymes, especially in patients with hepatic impairment or those on long-term therapy.
* **Gastrointestinal symptoms:** Assess for signs of bleeding or ulceration.
* **Blood pressure:** NSAIDs can increase blood pressure.
## Clinical Pearls
* Mefenamic acid is generally recommended for short-term use only due to increased risk of gastrointestinal and cardiovascular adverse events with prolonged use.
* Administer with food or milk to minimize gastrointestinal upset.
* Avoid concurrent use with other NSAIDs.
* Monitor for signs of fluid retention and edema.
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*This information is intended for healthcare professionals. Always consult the most current prescribing information and relevant guidelines before making clinical decisions.*
