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# Mefenamic Acid (meftal-P)
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term treatment of mild to moderate pain and for menstrual pain (dysmenorrhea).
## Primary Indications
* Pain
* Dysmenorrhea
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed.
* **Dysmenorrhea:** 500 mg every 6 hours as needed, starting at the onset of pain and bleeding, and continuing for up to 3 days.
## Pediatric Dosing
* Generally not recommended for children under 14 years of age.
* For children 14 years and older, use adult dosing.
## Dose Adjustments
* No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised due to potential for NSAID-induced organ toxicity. Mefenamic acid should be used with caution or avoided in patients with severe renal or hepatic disease.
## 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.
* Active gastrointestinal bleeding or ulceration.
* Severe heart failure.
* Third trimester of pregnancy.
## Adverse Effects
* **Common:** Diarrhea, nausea, vomiting, abdominal pain, headache, dizziness.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; renal failure; hepatic failure; cardiovascular thrombotic events (myocardial infarction, stroke); hypersensitivity reactions; Stevens-Johnson syndrome/toxic epidermal necrolysis; aseptic meningitis.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Other NSAIDs and Aspirin:** Increased risk of gastrointestinal adverse effects and potential for additive pharmacologic effects.
* **Diuretics and Antihypertensives:** May reduce their efficacy and increase risk of renal damage.
* **Lithium:** Increased lithium levels and toxicity.
* **Methotrexate:** Increased methotrexate toxicity.
## Monitoring
* Monitor for signs and symptoms of gastrointestinal bleeding (e.g., melena, hematemesis).
* Monitor renal function (BUN, creatinine) and liver function (AST, ALT) especially with long-term use or in patients with pre-existing organ dysfunction.
* Monitor for signs of cardiovascular events.
## Clinical Pearls
* Mefenamic acid is generally indicated for short-term use only due to the risk of serious adverse effects, particularly gastrointestinal complications.
* Administer with food or milk to minimize gastrointestinal upset.
* Limit duration of use to a maximum of 7 days.
* Ensure adequate hydration.
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*This information is intended for healthcare professionals. Always consult the official prescribing information and relevant guidelines for complete and up-to-date details before prescribing or dispensing this medication.*
