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# Mefenamic acid (Meftal-P)
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for short-term relief of mild to moderate pain.
## Primary Indications
* Pain (e.g., dysmenorrhea, headache, dental pain)
* Inflammation
## Adult Dosing
* **Dosage:** 500 mg every 6 hours as needed.
* **Maximum Duration:** Generally recommended for no more than 7 days.
* **Maximum Daily Dose:** Not to exceed 1500 mg per day.
## Pediatric Dosing
* **Age:** Approved for use in patients 14 years and older.
* **Dosage:** 500 mg every 6 hours as needed.
* **Note:** Specific pediatric dosing for younger children is not well-established. Use in younger children should be based on clinical judgment and careful monitoring.
## Dose Adjustments
No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised due to potential for renal toxicity with NSAIDs.
## Contraindications
* Hypersensitivity to mefenamic acid 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.
* Inflammatory bowel disease.
* Severe renal or hepatic impairment.
* Third trimester of pregnancy.
## Adverse Effects
* **Common:** Diarrhea, nausea, vomiting, abdominal pain, dyspepsia, constipation, rash.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; renal impairment; cardiovascular thrombotic events; hypersensitivity reactions; hepatic toxicity; Stevens-Johnson syndrome/toxic epidermal necrolysis.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **SSRIs/SNRIs:** Increased risk of bleeding.
* **ACE inhibitors, ARBs, Beta-blockers:** Reduced antihypertensive efficacy and increased risk of renal impairment.
* **Diuretics:** Reduced diuretic efficacy and increased risk of renal impairment.
* **Lithium:** Increased lithium levels and toxicity.
* **Methotrexate:** Increased methotrexate toxicity.
## Monitoring
* Signs and symptoms of gastrointestinal bleeding.
* Renal function (especially in patients with pre-existing renal disease or those on concomitant nephrotoxic agents).
* Liver function (less common, but monitor if liver issues arise).
## Clinical Pearls
* Mefenamic acid should be taken with food or milk to minimize gastrointestinal upset.
* Due to its short half-life, it is generally used for symptomatic relief of acute pain.
* Limit use to 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 clinical guidelines before making treatment decisions.*
