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# Mefenamic Acid
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term relief of mild to moderate pain, including menstrual pain.
## Primary Indications
* Mild to moderate pain
* Primary dysmenorrhea
## Adult Dosing
* **Initial dose:** 500 mg every 4 to 6 hours as needed.
* **Maximum daily dose:** 1500 mg.
* **Duration:** Not recommended for use for more than 7 days.
## Pediatric Dosing
* Dosing in pediatric patients is not well-established and should be based on clinical judgment and local protocol.
## Dose Adjustments
* No specific dose adjustments are necessary for renal or hepatic impairment, but caution is advised due to the potential for NSAID-induced nephropathy and hepatotoxicity.
## Contraindications
* Known hypersensitivity to mefenamic acid or other NSAIDs.
* History of bronchospasm, asthma, rhinitis, or urticaria precipitated by aspirin or other NSAIDs.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Inflammatory bowel disease.
* Severe renal impairment.
* Severe hepatic impairment.
* Severe heart failure.
## Adverse Effects
Common adverse effects include nausea, vomiting, diarrhea, abdominal pain, and headache. Serious adverse effects include gastrointestinal bleeding, ulceration, perforation, cardiovascular thrombotic events, renal and hepatic toxicity, and hypersensitivity reactions.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Selective Serotonin Reuptake Inhibitors (SSRIs):** Increased risk of gastrointestinal bleeding.
* **Diuretics and antihypertensives:** May reduce their efficacy and increase the risk of nephrotoxicity.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased risk of methotrexate toxicity.
## Monitoring
* Monitor for signs and symptoms of gastrointestinal bleeding.
* Monitor renal function, especially in patients with pre-existing renal disease.
* Monitor liver function, especially in patients with pre-existing hepatic disease.
* Assess pain relief.
## Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Use for the shortest duration necessary.
* Avoid concomitant use with other NSAIDs.
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**Disclaimer:** This information is for educational purposes only and does not constitute medical advice. Always verify current prescribing information with official drug references and consult with a healthcare professional before making any treatment decisions.
