Please check your internet connection and try again.
# Mefenamic Acid
## Overview
Mefenamic acid is a non-steroidal anti-inflammatory drug (NSAID) used for the short-term relief of mild to moderate pain. It is also used for the treatment 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 every 6 hours starting at the onset of pain or bleeding, whichever occurs first, and continuing for the duration of symptoms, up to 7 days.
## Pediatric Dosing
Mefenamic acid is generally not recommended for children under 12 years of age due to safety concerns and lack of established dosing.
## Dose Adjustments
No dose adjustment is typically needed for renal or hepatic impairment, but caution is advised. Mefenamic acid should be used with caution in patients with pre-existing renal or hepatic disease.
## 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.
* Inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis).
* Severe heart failure.
* Third trimester of pregnancy.
## Adverse Effects
Common adverse effects include gastrointestinal disturbances (nausea, vomiting, diarrhea, abdominal pain), dizziness, and headache. Serious adverse effects can include gastrointestinal bleeding, perforation, ulceration, cardiovascular thrombotic events, renal failure, hepatic failure, and hypersensitivity reactions.
## 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 toxicity and other adverse effects.
* **Diuretics and Antihypertensives (e.g., ACE inhibitors, ARBs, beta-blockers):** May decrease antihypertensive effect and increase risk of renal impairment.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased risk of methotrexate toxicity.
## Monitoring
* Monitor for signs and symptoms of gastrointestinal bleeding or ulceration.
* Monitor renal and hepatic function, especially in patients with pre-existing disease or those on long-term therapy.
* Monitor for signs of cardiovascular events.
## Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Limit use to the shortest duration necessary for symptom control.
* Due to the risk of serious cardiovascular and gastrointestinal events, consider the risks versus benefits carefully, especially for long-term use.
**Disclaimer:** This information is intended for clinical use and does not replace professional judgment. Always consult the most current prescribing information and local protocols before making any treatment decisions.
