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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.
## Primary Indications
* Pain associated with gynecological conditions (e.g., dysmenorrhea)
* Pain associated with dental procedures
* Other mild to moderate pain
## Adult Dosing
* **Initial dose:** 500 mg orally every 6 hours as needed.
* **Maximum daily dose:** 1500 mg orally per day.
* **Duration of therapy:** Typically for short-term use, not exceeding 7 days.
## Pediatric Dosing
Mefenamic acid is generally not recommended for use in children younger than 14 years of age due to lack of established efficacy and safety data.
## Dose Adjustments
No specific dose adjustments are routinely recommended for renal or hepatic impairment. However, caution is advised in patients with severe impairment, and dose reduction may be considered based on clinical judgment.
## Contraindications
* Hypersensitivity to mefenamic acid or other NSAIDs.
* History of bronchospasm, asthma, rhinitis, or urticaria induced by aspirin or other NSAIDs.
* Active gastrointestinal bleeding or ulceration.
* Inflammatory bowel disease.
* Severe renal or hepatic impairment.
* Third trimester of pregnancy.
## Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, abdominal pain, dyspepsia, constipation.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; renal toxicity; hepatic toxicity; hypersensitivity reactions (including anaphylaxis); cardiovascular thrombotic events; bronchospasm; Stevens-Johnson syndrome/toxic epidermal necrolysis.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal bleeding and ulceration.
* **Other NSAIDs or salicylates:** Increased risk of adverse effects.
* **Diuretics, ACE inhibitors, ARBs:** Reduced antihypertensive effect and increased risk of renal impairment.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased risk of methotrexate toxicity.
## Monitoring
* **Renal function:** Monitor serum creatinine and BUN, especially in patients with pre-existing renal disease or those at risk.
* **Hepatic function:** Monitor liver function tests, especially in patients with pre-existing liver disease.
* **Gastrointestinal symptoms:** Assess for signs and symptoms of bleeding or ulceration.
* **Blood pressure:** Monitor for potential increases.
## Clinical Pearls
* Mefenamic acid should be taken with food or milk to minimize gastrointestinal upset.
* Due to its short duration of action, it is generally not suitable for chronic pain management.
* The risk of gastrointestinal adverse effects increases with dose and duration of therapy.
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*Disclaimer: This information is intended for healthcare professionals. Always consult the current prescribing information and relevant guidelines before making clinical decisions. This information may not be exhaustive and does not replace clinical judgment.*
