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# Mefenamic Acid (Meftal-P)
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term management of mild to moderate pain, particularly dysmenorrhea.
## Primary Indications
* Short-term management of mild to moderate pain, including primary dysmenorrhea.
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed.
* **Dysmenorrhea:** 500 mg every 6 hours as needed, starting at the onset of pain and bleeding.
* Maximum daily dose: 1500 mg.
* Duration of treatment should generally not exceed 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.
## Dose Adjustments
* **Renal Impairment:** Use with caution. Dose reduction may be necessary. Avoid in severe renal impairment.
* **Hepatic Impairment:** Use with caution. Dose reduction may be necessary. Avoid in severe hepatic impairment.
## Contraindications
* Hypersensitivity to mefenamic acid or other NSAIDs.
* History of bronchospasm, 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 bleeding or ulceration.
* Inflammatory bowel disease.
* Severe heart failure, renal impairment, or hepatic impairment.
## Adverse Effects
Common: Nausea, vomiting, diarrhea, abdominal pain, constipation, dyspepsia.
Serious: Gastrointestinal bleeding, ulceration, perforation; cardiovascular thrombotic events (MI, stroke); renal and hepatic toxicity; hypersensitivity reactions; hematologic effects.
## 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 adverse effects, particularly GI bleeding.
* **Diuretics, ACE inhibitors, ARBs:** Reduced antihypertensive effect and increased risk of renal impairment.
* **Lithium, Methotrexate:** Increased serum levels and toxicity.
## Monitoring
* Monitor for signs and symptoms of GI bleeding and ulceration.
* Monitor renal and hepatic function, especially in patients with pre-existing impairment or those on long-term therapy.
* Monitor for signs of cardiovascular events.
* Monitor for hypersensitivity reactions.
## Clinical Pearls
* Administer with food or milk to minimize GI upset.
* Use the lowest effective dose for the shortest duration necessary.
* Assess cardiovascular risk factors before initiating therapy.
* Discontinue immediately if signs of GI bleeding, renal dysfunction, or hypersensitivity occur.
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**Disclaimer:** This information is intended for healthcare professionals and is not a substitute for professional medical advice. Always consult the most current prescribing information and guidelines before making any clinical decisions.
