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# Mefenamic Acid (Meftal-P)
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term treatment of mild to moderate pain and for primary dysmenorrhea.
## Primary Indications
* Mild to moderate pain (e.g., dental pain, post-operative pain)
* Primary dysmenorrhea
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed.
* **Dysmenorrhea:** 500 mg every 6 hours as needed, starting with the onset of pain and bleeding, and continuing for no more than 3 days.
* **Maximum:** Not to exceed 1000 mg as a single dose or 4000 mg per day.
## Pediatric Dosing
* **Pain:** 6.5 mg/kg every 6 hours as needed.
* **Maximum:** Duration of use should not exceed 7 days. Dosing for children under 6 months is not established.
## Dose Adjustments
* **Renal Impairment:** Use with caution; dose reduction may be necessary. Data is limited.
* **Hepatic Impairment:** Use with caution; dose reduction may be necessary. Data is limited.
## Contraindications
* Known hypersensitivity to mefenamic acid or other NSAIDs.
* History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.
* Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Active gastrointestinal (GI) bleeding or a history of recurrent GI ulceration/bleeding.
* Severe renal or hepatic impairment.
* Third trimester of pregnancy.
## Adverse Effects
* **Common:** Diarrhea, nausea, vomiting, abdominal pain, constipation, dyspepsia, flatulence.
* **Serious:** GI bleeding, ulceration, perforation; renal toxicity (including interstitial nephritis, papillary necrosis); hepatic dysfunction; cardiovascular thrombotic events (MI, stroke); hypersensitivity reactions (including Stevens-Johnson syndrome, toxic epidermal necrolysis); bronchospasm; exacerbation of asthma.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **Selective Serotonin Reuptake Inhibitors (SSRIs) / Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs):** Increased risk of GI bleeding.
* **Diuretics, ACE inhibitors, ARBs:** May reduce antihypertensive effect and increase risk of renal impairment.
* **Lithium, Methotrexate:** Increased serum levels and toxicity.
## Monitoring
* Signs and symptoms of GI bleeding or ulceration.
* Renal and hepatic function, especially in patients with pre-existing impairment or those on long-term therapy.
* Blood pressure.
* Signs of hypersensitivity reactions.
## Clinical Pearls
* Mefenamic acid is generally recommended for short-term use only.
* Administer with food or milk to minimize GI upset.
* Due to the risk of diarrhea, it should be used with caution in patients with inflammatory bowel disease.
* Consider lowest effective dose for the shortest duration necessary.
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*Disclaimer: This information is intended for healthcare professionals. Always consult the most current prescribing information and relevant guidelines for complete details. Patient-specific factors should always be considered.*
