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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 and for the treatment of primary dysmenorrhea.
## Primary Indications
* Mild to moderate pain
* Primary 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 pain and bleeding.
* **Maximum Daily Dose:** 1500 mg per day. Treatment duration typically should not exceed 7 days.
## Pediatric Dosing
* Mefenamic acid is generally not recommended for children under 14 years of age. For specific indications and dosing in pediatric patients, consult specialized pediatric guidelines or a pediatrician.
## Dose Adjustments
* **Renal Impairment:** Use with caution. Dose reduction may be necessary in severe renal impairment.
* **Hepatic Impairment:** Use with caution. Dose reduction may be necessary in severe hepatic impairment.
* **Elderly:** No specific dose adjustment, but elderly patients may be more susceptible to adverse effects.
## 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.
* Inflammatory bowel disease.
* Severe heart failure, renal impairment, or hepatic impairment.
* Third trimester of pregnancy.
## Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, abdominal pain, constipation, headache, dizziness, rash.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; renal impairment; hepatic dysfunction; cardiovascular thrombotic events; exacerbation of asthma; hypersensitivity reactions.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **SSRIs/SNRIs:** Increased risk of bleeding.
* **Lithium:** Increased lithium levels.
* **Methotrexate:** Increased methotrexate toxicity.
* **Diuretics and Antihypertensives:** May reduce efficacy and increase risk of renal impairment.
* **Other NSAIDs/Aspirin:** Increased risk of adverse effects.
## Monitoring
* Monitor for signs and symptoms of gastrointestinal bleeding (e.g., melena, hematemesis).
* Monitor renal function, especially in patients with pre-existing renal disease or those taking concomitant nephrotoxic agents.
* Monitor liver function.
* Monitor for signs of cardiovascular events.
## Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Limit duration of use to the shortest effective period due to the risk of serious adverse effects.
* Avoid in patients with a history of NSAID-induced bronchospasm.
* Consider alternatives in patients at high risk for gastrointestinal bleeding or cardiovascular events.
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**Disclaimer:** This information is intended for healthcare professionals. Always verify current prescribing information and consult with a qualified healthcare provider before making any decisions related to patient care. Dosing and recommendations may vary based on individual patient factors and local guidelines.
