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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
* Pain, including menstrual pain (dysmenorrhea) and pain associated with dental procedures or minor surgery.
### Adult Dosing
* **Initial Dose:** 500 mg orally every 4 to 6 hours as needed.
* **Maximum Dose:** 1500 mg in 24 hours. Duration of treatment should generally not exceed 7 days.
### Pediatric Dosing
* **Age:** Use is generally not recommended for children under 12 years of age.
* **Dosing:** For children 12 years and older, the adult dosing regimen (500 mg every 4-6 hours) may be used. Specific pediatric dosing based on weight is not well established or commonly utilized.
### Dose Adjustments
* **Renal Impairment:** Use with caution. Dose reduction may be necessary depending on the severity of impairment.
* **Hepatic Impairment:** Use with caution. Dose reduction may be necessary depending on the severity of impairment.
* **Elderly:** May be more susceptible to adverse effects; consider a lower dose.
### 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 bleeding or ulceration.
### Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, abdominal pain, dyspepsia, headache.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; renal impairment; hepatic dysfunction; cardiovascular thrombotic events (myocardial infarction, stroke); hypersensitivity reactions; Stevens-Johnson syndrome/toxic epidermal necrolysis; worsening of asthma.
### Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Other NSAIDs (including aspirin):** Increased risk of adverse effects, particularly gastrointestinal.
* **Diuretics, ACE inhibitors, ARBs:** Reduced antihypertensive effect and increased risk of renal impairment.
* **Lithium, Methotrexate:** Increased serum levels and potential toxicity.
### Monitoring
* **Renal function:** Especially in patients with pre-existing renal disease or those taking concomitant nephrotoxic agents.
* **Hepatic function:** Particularly with prolonged use or in patients with liver disease.
* **Signs of gastrointestinal bleeding:** Monitor for dark, tarry stools or hematemesis.
* **Blood pressure:** NSAIDs can increase blood pressure.
### Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Should be used for the shortest duration necessary to control symptoms.
* Risk of cardiovascular thrombotic events and serious gastrointestinal events increases with duration of use.
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*This information is intended for healthcare professionals and is not a substitute for professional medical advice. Always consult the current prescribing information and your healthcare provider for any medical concerns or before making any decisions related to your health or treatment.*
