Please check your internet connection and try again.
# Mefenamic Acid (meftal-P)
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for short-term management of mild to moderate pain. It is a fenamate derivative.
## Primary Indications
* Short-term treatment of pain, particularly in primary dysmenorrhea.
* Management of mild to moderate pain from other sources (e.g., dental pain, musculoskeletal pain).
## Adult Dosing
* **Initial dose:** 500 mg.
* **Subsequent doses:** 250 mg every 6 hours as needed.
* **Maximum duration:** Do not exceed 7 days of treatment.
* **Maximum daily dose:** 1500 mg.
## Pediatric Dosing
* Mefenamic acid is generally **not recommended** for use in children under 14 years of age due to lack of established safety and efficacy data. Some sources suggest a dose of 6.5 mg/kg every 6 hours for children 6 months and older, but this is off-label and requires careful consideration.
## Dose Adjustments
* No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised. Use in severe renal or hepatic impairment is generally not recommended.
## Contraindications
* Hypersensitivity to mefenamic acid, aspirin, other NSAIDs, or any component of the formulation.
* 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 (GI) bleeding or ulceration.
* Inflammatory bowel disease (Crohn's disease, ulcerative colitis).
* Severe heart failure.
* Last trimester of pregnancy.
## Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, abdominal pain, dyspepsia, constipation, headache, dizziness.
* **Serious:**
* **GI:** GI bleeding, ulceration, perforation. Risk increases with duration of use, higher doses, and in elderly patients.
* **Cardiovascular:** Increased risk of thrombotic events (MI, stroke), hypertension, edema.
* **Renal:** Acute kidney injury, interstitial nephritis, papillary necrosis.
* **Hepatic:** Elevated liver enzymes, hepatitis, jaundice.
* **Hematologic:** Anemia, leukopenia, thrombocytopenia.
* **Dermatologic:** Stevens-Johnson syndrome, toxic epidermal necrolysis, rash.
* **Other:** Bronchospasm, aseptic meningitis.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **SSRIs/SNRIs:** Increased risk of GI bleeding.
* **Lithium:** Increased lithium levels.
* **Methotrexate:** Increased methotrexate toxicity.
* **Diuretics and antihypertensives:** Reduced efficacy; increased risk of nephrotoxicity.
* **Other NSAIDs or salicylates:** Increased risk of adverse effects.
## Monitoring
* Monitor for signs and symptoms of GI bleeding (e.g., melena, hematemesis).
* Monitor blood pressure.
* Assess for signs of fluid retention or edema.
* Monitor renal and hepatic function, especially with prolonged use or in patients with risk factors.
* Consider baseline and periodic complete blood counts.
## Clinical Pearls
* Mefenamic acid is intended for short-term use only.
* Administer with food or milk to minimize GI upset.
* Due to its short duration of action and potential for GI side effects, it is often less preferred than other NSAIDs for chronic pain management.
* Ensure patient is adequately hydrated, especially if experiencing diarrhea.
***
*This information is intended for healthcare professionals. Always consult the official prescribing information and relevant guidelines for complete details. Dosing and safety information can vary.*
