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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**
* Mild to moderate pain, including menstrual pain (dysmenorrhea).
**Adult Dosing**
* **Pain:** 500 mg orally every 6 hours as needed.
* **Dysmenorrhea:** 500 mg orally every 6 hours as needed, starting at the onset of menstrual pain.
* **Maximum:** Do not exceed 1500 mg in a 24-hour period.
* **Duration:** Typically for short-term use only (not to exceed 7 days).
**Pediatric Dosing**
* Mefenamic acid is generally not recommended for children under 14 years of age. Limited data exists for use in younger children.
**Dose Adjustments**
* No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised due to potential for NSAID-induced toxicity.
**Contraindications**
* Hypersensitivity to mefenamic acid or other NSAIDs.
* History of bronchospasm, asthma, rhinitis, or urticaria after taking aspirin or other NSAIDs.
* Inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis).
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Third trimester of pregnancy.
**Adverse Effects**
* **Common:** Gastrointestinal upset (nausea, vomiting, diarrhea, abdominal pain), dizziness, drowsiness.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; renal toxicity; cardiovascular thrombotic events; hypersensitivity reactions; hepatic dysfunction.
**Key Drug Interactions**
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **SSRIs and SNRIs:** Increased risk of gastrointestinal bleeding.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased risk of methotrexate toxicity.
* **ACE inhibitors, ARBs, Beta-blockers:** May reduce antihypertensive effects and increase risk of renal impairment.
**Monitoring**
* Monitor for signs and symptoms of gastrointestinal bleeding.
* Monitor renal function (BUN, creatinine) with long-term use or in at-risk patients.
* Monitor for signs of hypersensitivity.
**Clinical Pearls**
* Administer with food or milk to minimize gastrointestinal upset.
* Should be used at the lowest effective dose for the shortest duration necessary.
* Avoid concurrent use with other NSAIDs.
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***Disclaimer:** This information is intended for healthcare professionals. Always consult the most current prescribing information and institutional guidelines for complete details and to ensure patient safety. Dosing and indications may vary by local protocol and patient-specific factors.*
