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# Mefenamic Acid (meftal-P) ## Overview Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for short-term relief of mild to moderate pain. It is also used for the management of primary dysmenorrhea. ## Primary Indications * Pain (mild to moderate) * Primary dysmenorrhea ## Adult Dosing * **Pain:** 500 mg orally every 6 hours as needed. * **Primary dysmenorrhea:** 500 mg orally initially, followed by 250 mg every 6 hours as needed. * Maximum duration of use: 7 days for pain. ## Pediatric Dosing * Dosing for pediatric patients is not well established by the manufacturer. Consult specialized pediatric resources for guidance. ## Dose Adjustments * **Renal Impairment:** Use with caution. No specific dose adjustments are recommended, but monitor renal function closely. Mefenamic acid is largely eliminated by the kidneys and may accumulate in severe impairment. * **Hepatic Impairment:** Use with caution. No specific dose adjustments are recommended, but monitor hepatic function. ## Contraindications * Hypersensitivity to mefenamic acid, aspirin, other NSAIDs, or any component of the formulation. * 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 (active or history). * Severe renal or hepatic impairment. * Third trimester of pregnancy. ## Adverse Effects Common adverse effects include gastrointestinal disturbances (nausea, vomiting, diarrhea, abdominal pain), dizziness, and rash. Serious adverse effects include gastrointestinal bleeding, ulceration, perforation, renal toxicity, hepatic toxicity, cardiovascular thrombotic events, and hypersensitivity reactions. ## 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. * **Diuretics and Antihypertensives:** May reduce their efficacy and increase risk of renal damage. * **Lithium:** Increased lithium levels and toxicity. * **Methotrexate:** Increased risk of methotrexate toxicity. ## Monitoring * Monitor for signs and symptoms of gastrointestinal bleeding (e.g., melena, hematemesis). * Monitor renal function (BUN, creatinine) especially in patients with pre-existing renal disease. * Monitor liver function (AST, ALT) especially with long-term use or in patients with hepatic impairment. * Assess for signs of hypersensitivity reactions. ## Clinical Pearls * Administer with food or milk to minimize gastrointestinal upset. * Limit use to the shortest duration necessary to control symptoms due to the risk of serious adverse events. * Avoid concomitant use with other NSAIDs. *** **Disclaimer:** This information is intended for healthcare professionals. Always consult the most current prescribing information and relevant literature before making clinical decisions.