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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, particularly dysmenorrhea.
## Primary Indications
* Pain (mild to moderate)
* Dysmenorrhea
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed.
* **Dysmenorrhea:** 500 mg every 8 hours starting from the onset of bleeding and associated pain, for a maximum of 6 months.
* **Maximum daily dose:** 1500 mg. Treatment should not exceed 7 days.
## Pediatric Dosing
* Data for pediatric use is limited and not well-established. Prescribing should be based on specialist advice and careful risk-benefit assessment. Some sources suggest 6.5 mg/kg every 6 hours for children over 6 months.
## Dose Adjustments
* No specific dose adjustments are typically required for hepatic or renal impairment, but caution is advised. Mefenamic acid should be used with caution in patients with pre-existing renal or hepatic disease.
## Contraindications
* Hypersensitivity to mefenamic acid, aspirin, other NSAIDs, or any component of the formulation.
* History of bronchospasm, 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 bleeding or history of recurrent GI ulceration or hemorrhage.
* Severe renal, hepatic, or cardiac impairment.
* Third trimester of pregnancy.
## Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, abdominal pain, dyspepsia, constipation.
* **Serious:** Gastrointestinal bleeding/ulceration, renal impairment, hepatic impairment, cardiovascular thrombotic events, hypersensitivity reactions (including anaphylaxis and severe skin reactions like Stevens-Johnson syndrome/toxic epidermal necrolysis), bronchospasm, fluid retention, edema, hypertension.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **SSRIs/SNRIs:** Increased risk of gastrointestinal bleeding.
* **ACE inhibitors/ARBs/Diuretics:** Reduced antihypertensive effect and increased risk of renal impairment.
* **Lithium:** Increased lithium levels and risk of toxicity.
* **Methotrexate:** Increased risk of methotrexate toxicity.
## Monitoring
* Monitor for signs and symptoms of gastrointestinal bleeding (e.g., melena, hematemesis).
* Assess renal and hepatic function, especially in patients with pre-existing conditions or those on long-term therapy.
* Monitor blood pressure.
* Monitor for signs of hypersensitivity reactions.
## Clinical Pearls
* Mefenamic acid is typically recommended for short-term use only.
* Administer with food or milk to minimize gastrointestinal upset.
* Due to potential for drowsiness, caution patients about driving or operating machinery.
* Avoid concurrent use with other NSAIDs.
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*This information is intended for healthcare professionals. Always consult the most current prescribing information and local guidelines for definitive guidance.*
