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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, including menstrual pain (dysmenorrhea).
## Primary Indications
* Mild to moderate pain
* 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.
Maximum duration of use is typically 7 days.
## Pediatric Dosing
* Mefenamic acid is generally **not recommended for children under 14 years of age**. Specific pediatric dosing is not well-established and should be guided by expert medical advice.
## Dose Adjustments
* No specific dose adjustments are required for renal or hepatic impairment, but caution is advised due to potential for renal toxicity with NSAIDs. Mefenamic acid should be used at the lowest effective dose for the shortest duration necessary.
## 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/bleeding.
* Severe renal impairment.
* Severe hepatic impairment.
* Severe heart failure.
## Adverse Effects
Common adverse effects include diarrhea, nausea, vomiting, abdominal pain, constipation, headache, and dizziness.
Serious adverse effects may include GI bleeding, ulceration, perforation, cardiovascular thrombotic events, renal toxicity, hepatic toxicity, and hypersensitivity reactions.
## 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, Angiotensin II Receptor Blockers (ARBs):** May decrease antihypertensive effect and increase risk of renal impairment.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased risk of methotrexate toxicity.
## Monitoring
* Monitor for signs and symptoms of GI bleeding (e.g., melena, hematemesis).
* Monitor renal function, especially in patients with pre-existing renal disease or those at risk.
* Monitor for signs of cardiovascular events.
* Monitor for signs of hypersensitivity.
## Clinical Pearls
* Mefenamic acid should be taken with food or milk to minimize GI upset.
* Due to the risk of diarrhea, ensure adequate hydration.
* Limit duration of use to the shortest effective period, typically no more than 7 days.
* Avoid concurrent use with other NSAIDs.
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**Disclaimer:** This information is intended for healthcare professionals and does not replace a thorough review of the current prescribing information or local protocols. Always verify current drug information before making clinical decisions.
