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# Mefenamic Acid (Meftal-P)
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) from the fenamate class.
## Primary Indications
* Short-term relief of mild to moderate pain, particularly for conditions like dysmenorrhea and headache.
* Management of pain associated with musculoskeletal disorders.
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed.
* **Dysmenorrhea:** 500 mg every 6 hours as needed, initiated at the onset of pain and continued for up to 3 days.
* **Maximum Dose:** 1500 mg per 24 hours. Treatment duration should generally not exceed 7 days.
## Pediatric Dosing
* **Pain and Inflammation:** 6.5 mg/kg/dose every 6 to 8 hours as needed.
* **Maximum Dose:** Not to exceed adult maximums. Use in children under 14 years of age should be under medical supervision. Specific guidelines for younger children are not well-established.
## Dose Adjustments
No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised due to potential for drug accumulation and toxicity. Monitor patients closely.
## Contraindications
* Known hypersensitivity to mefenamic acid, aspirin, or other NSAIDs.
* History of gastrointestinal (GI) bleeding or perforation related to prior NSAID use.
* Active peptic ulceration or history of recurrent peptic ulceration.
* Severe heart failure, renal impairment (CrCl < 30 mL/min), or hepatic impairment.
* Third trimester of pregnancy.
## Adverse Effects
Common: Diarrhea, nausea, vomiting, abdominal pain, dyspepsia, headache, dizziness.
Serious: GI bleeding, ulceration, perforation, renal dysfunction, elevated liver enzymes, hypersensitivity reactions, cardiovascular thrombotic events (MI, stroke).
## 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 potentially other adverse effects.
* **Diuretics, ACE Inhibitors, ARBs:** Reduced antihypertensive effect and increased risk of renal impairment.
* **Lithium, Methotrexate:** Increased serum levels and toxicity.
## Monitoring
* **GI Bleeding/Ulceration:** Monitor for signs and symptoms (e.g., melena, hematemesis, abdominal pain).
* **Renal Function:** Monitor BUN and creatinine, especially in patients with pre-existing renal disease or those taking concomitant nephrotoxic agents.
* **Hepatic Function:** Monitor liver enzymes, particularly with prolonged use or in patients with hepatic impairment.
* **Blood Pressure:** NSAIDs can cause hypertension and fluid retention.
## Clinical Pearls
* Mefenamic acid is generally recommended for short-term use only due to increased risk of GI adverse effects with prolonged use.
* Administer with food or milk to minimize GI upset.
* Diarrhea is a common side effect and may necessitate discontinuation.
* Consider lower doses or alternative analgesics in elderly patients or those with risk factors for GI bleeding.
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*This information is intended for healthcare professionals. Always consult the full prescribing information and local guidelines before use. Dosing and safety may vary.*
