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# Mefenamic Acid (Meftal-P)
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for short-term management of mild to moderate pain.
## Primary Indications
* Pain relief, particularly for conditions like dysmenorrhea, dental pain, and musculoskeletal pain.
* Inflammation reduction.
## Adult Dosing
* **Initial dose:** 500 mg orally every 6 hours as needed.
* **Maximum dose:** 1000 mg orally per day for no more than 7 days.
## Pediatric Dosing
* Mefenamic acid is **not recommended** for use in children under 14 years of age due to limited data and potential risks. If used, dosing is highly individualized and depends on weight and clinical judgment. Refer to specific pediatric guidelines or consult a pediatrician.
## Dose Adjustments
* **Renal impairment:** Use with caution. Data for dose adjustment is limited; consider reducing dose or frequency.
* **Hepatic impairment:** Use with caution. Data for dose adjustment is limited; consider reducing dose or frequency.
## Contraindications
* Hypersensitivity to mefenamic acid, aspirin, or other NSAIDs.
* History of NSAID-induced asthma, urticaria, or allergic-type reactions.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Active gastrointestinal (GI) bleeding or history of recurrent GI ulceration/bleeding.
* Severe heart failure, renal failure, or hepatic failure.
## Adverse Effects
* **Common:** Diarrhea, nausea, vomiting, abdominal pain, constipation, dyspepsia, dizziness, headache.
* **Serious:** GI bleeding, ulceration, perforation; cardiovascular thrombotic events (MI, stroke); renal toxicity; hepatic toxicity; hypersensitivity reactions; bronchospasm; Stevens-Johnson syndrome, toxic epidermal necrolysis.
## 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.
* **ACE inhibitors, ARBs, diuretics:** Reduced antihypertensive effect and increased risk of renal impairment.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased methotrexate toxicity.
## Monitoring
* **GI symptoms:** Monitor for signs and symptoms of GI bleeding or ulceration.
* **Renal function:** Monitor serum creatinine and BUN, especially in patients with pre-existing renal disease or those on concurrent nephrotoxic agents.
* **Hepatic function:** Monitor LFTs if prolonged use or in patients with hepatic impairment.
* **Blood pressure:** Monitor blood pressure, especially in patients with hypertension.
## Clinical Pearls
* Mefenamic acid should be taken with food or milk to minimize GI upset.
* Due to its short duration of action and potential for GI side effects, it is generally recommended for short-term use only.
* The 7-day maximum duration of use is important to mitigate risks.
* Patients with a history of asthma may be at increased risk of bronchospasm.
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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.*
