Please check your internet connection and try again.
# Mefenamic Acid (Meftal-P)
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) belonging to the fenamate class. It possesses analgesic, anti-inflammatory, and antipyretic properties.
## Primary Indications
* Short-term management of mild to moderate pain, particularly in conditions such as dysmenorrhea and headache.
* Relief of inflammation and pain associated with musculoskeletal disorders.
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed.
* **Dysmenorrhea:** 500 mg every 6 hours, initiated at the onset of pain or bleeding, whichever occurs first, and continued for up to 3 days.
* **Maximum daily dose:** 1500 mg.
* **Duration of use:** Generally recommended for no longer than 7 days for pain.
## Pediatric Dosing
* **Pain and Inflammation:** 6.5 mg/kg every 6 hours.
* **Maximum dose:** Not to exceed 500 mg per dose.
* **Age range:** Typically recommended for children 14 years of age and older. Dosing for younger children may be considered based on clinical judgment and available evidence, but specific guidelines are less established.
## Dose Adjustments
* **Renal Impairment:** Use with caution. Dose reduction may be necessary in patients with severe renal impairment.
* **Hepatic Impairment:** Use with caution. Dose reduction may be necessary in patients with severe hepatic impairment.
* **Elderly:** Elderly patients may be at increased risk of adverse effects, particularly gastrointestinal bleeding and renal events. Consider a lower dose or alternative agent.
## Contraindications
* Known hypersensitivity to mefenamic acid, aspirin, 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.
* Severe renal or hepatic impairment.
* Third trimester of pregnancy.
## Adverse Effects
Common: Nausea, vomiting, diarrhea, abdominal pain, dyspepsia, constipation, dizziness, headache, rash, pruritus.
Serious: Gastrointestinal bleeding, ulceration, perforation; renal toxicity (including interstitial nephritis, papillary necrosis, renal failure); cardiovascular thrombotic events (MI, stroke); hypersensitivity reactions (including Stevens-Johnson syndrome, toxic epidermal necrolysis); exacerbation of asthma; hepatic dysfunction.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs):** Increased risk of gastrointestinal bleeding.
* **Lithium:** Increased lithium levels and risk of toxicity.
* **Methotrexate:** Increased methotrexate levels and risk of toxicity.
* **Diuretics and Antihypertensives (e.g., ACE inhibitors, ARBs, beta-blockers):** Reduced efficacy and increased risk of renal impairment.
* **Other NSAIDs:** Increased risk of adverse effects, especially gastrointestinal.
## Monitoring
* **Renal function:** Especially in patients with pre-existing renal disease, elderly patients, or those on concomitant nephrotoxic agents.
* **Hepatic function:** Especially in patients with pre-existing liver disease.
* **Signs and symptoms of gastrointestinal bleeding:** Such as melena, hematemesis, or occult blood in stool.
* **Blood pressure:** NSAIDs can increase blood pressure.
## Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Use the lowest effective dose for the shortest duration necessary.
* Avoid concurrent use with other NSAIDs, including aspirin, unless specifically indicated and managed.
* Discontinue immediately if signs of hypersensitivity or severe adverse reactions occur.
* Consider alternative analgesics for patients with a history of peptic ulcer disease or other significant gastrointestinal issues.
***
*Please verify the current prescribing information and consult with a healthcare professional for personalized medical advice and treatment decisions.*
