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# Mefenamic Acid (Meftal-P)
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term relief of mild to moderate pain. It also possesses anti-inflammatory and antipyretic properties.
## Primary Indications
* Short-term management of mild to moderate pain, particularly dysmenorrhea.
## Adult Dosing
* **Initial dose:** 500 mg orally.
* **Subsequent doses:** 250 mg orally every 6 hours as needed.
* **Maximum daily dose:** 1500 mg.
* **Duration of therapy:** Generally limited to 7 days.
## Pediatric Dosing
* Dosing in pediatric patients is not well-established and should be based on clinical judgment and local protocols. Some sources suggest a dose of 5-7 mg/kg/dose orally every 6-8 hours, not to exceed 500 mg/day.
## Dose Adjustments
* No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised due to potential for exacerbation of existing conditions. Monitor closely.
## 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.
* Active gastrointestinal (GI) bleeding or history of recurrent GI ulceration or bleeding.
* Severe renal or hepatic impairment.
* Severe heart failure.
* Third trimester of pregnancy.
## Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, abdominal pain, constipation, dyspepsia, dizziness, headache.
* **Serious:** GI bleeding, ulceration, perforation; renal toxicity (including interstitial nephritis, papillary necrosis); hepatic toxicity; cardiovascular thrombotic events; hypersensitivity reactions; Stevens-Johnson syndrome/toxic epidermal necrolysis; exacerbation of asthma.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **Other NSAIDs (including aspirin):** Increased risk of GI toxicity and other adverse effects.
* **Diuretics and antihypertensives:** May decrease efficacy and increase risk of renal toxicity.
* **Lithium, Methotrexate:** May increase serum concentrations and toxicity.
## Monitoring
* Monitor for signs and symptoms of GI bleeding (e.g., melena, hematemesis).
* Monitor renal and hepatic function, especially in patients with pre-existing conditions or those on long-term therapy.
* Monitor blood pressure.
## Clinical Pearls
* Administer with food or milk to minimize GI upset.
* Due to potential for drowsiness and dizziness, advise patients to use caution when driving or operating machinery.
* Long-term use is generally not recommended due to increased risk of serious adverse events.
* Consider alternative analgesics if pain is severe or chronic.
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_Please verify the current prescribing information for definitive guidance._
