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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.
## Primary Indications
* Pain management (e.g., dysmenorrhea, dental pain, headache)
## Adult Dosing
* **Pain:** 500 mg orally every 6 hours as needed.
* **Maximum daily dose:** 1500 mg.
* **Duration:** Typically for short-term use only (up to 7 days).
## Pediatric Dosing
* **Age:** Approved for patients 14 years and older.
* **Dosing:** 500 mg orally every 6 hours as needed.
* **Maximum daily dose:** 1500 mg.
* **Duration:** Typically for short-term use only (up to 7 days).
* *There is limited data for use in younger pediatric patients.*
## Dose Adjustments
* **Renal Impairment:** Use with caution; dose reduction may be necessary. Avoid if severe renal impairment.
* **Hepatic Impairment:** Use with caution; dose reduction may be necessary. Avoid if severe hepatic impairment.
* **Elderly:** Use with caution; increased risk of adverse effects.
## Contraindications
* Known 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.
* Third trimester of pregnancy.
* Active gastrointestinal bleeding or history of recurrent GI ulceration/bleeding.
## Adverse Effects
* **Common:** Diarrhea, nausea, vomiting, abdominal pain, constipation, dyspepsia.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; cardiovascular thrombotic events (MI, stroke); renal failure; hepatic failure; hypersensitivity reactions; Stevens-Johnson syndrome/toxic epidermal necrolysis.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding. Monitor INR closely.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **Other NSAIDs/Aspirin:** Increased risk of GI toxicity and other adverse effects.
* **ACE inhibitors/ARBs:** May reduce antihypertensive effect; increased risk of renal impairment.
* **Diuretics:** May reduce diuretic effect; increased risk of renal impairment.
* **Lithium:** Increased serum lithium levels and risk of toxicity.
* **Methotrexate:** Increased methotrexate toxicity.
## Monitoring
* **Renal function:** Monitor BUN and creatinine, especially in patients with pre-existing renal disease, dehydration, or those on concomitant nephrotoxic agents.
* **Hepatic function:** Monitor liver enzymes, especially in patients with liver disease.
* **Signs of GI bleeding:** Monitor for occult blood in stool, melena, hematemesis.
* **Blood pressure:** NSAIDs can increase blood pressure.
* **Signs of cardiovascular events:** Educate patients on symptoms of MI and stroke.
## Clinical Pearls
* Mefenamic acid is generally intended for short-term use.
* Administer with food or milk to minimize GI upset.
* Discontinue immediately if signs of GI bleeding, renal impairment, hepatic impairment, or hypersensitivity occur.
* Avoid concurrent use with other NSAIDs.
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**Disclaimer:** This information is intended for healthcare professionals. Always consult the most current prescribing information and relevant clinical guidelines before making therapeutic decisions. Dosing and safety information may vary based on patient-specific factors and local protocols.
