Mefenamic%252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520acid%252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520%252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252528meftal-P%252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252529

# Mefenamic Acid ## Overview Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term treatment of mild to moderate pain, including menstrual pain. ## Primary Indications * Short-term management of mild to moderate pain. * Primary dysmenorrhea. ## Adult Dosing * **Pain:** 500 mg every 6 hours as needed. Maximum daily dose: 1500 mg. * **Dysmenorrhea:** 500 mg every 6 hours as needed, typically started at the onset of pain and bleeding. Maximum daily dose: 1500 mg. * Treatment should generally not exceed 7 days. ## Pediatric Dosing * Mefenamic acid is **not recommended** for children under 14 years of age for over-the-counter use. * Prescription use in children varies, and specific dosing depends on indication and physician guidance. Doses are typically based on weight, for example, 6.5 mg/kg every 6 hours. ## Dose Adjustments * No specific dose adjustment is typically required for renal or hepatic impairment, but caution is advised due to potential for adverse effects. Patients with severe renal or hepatic impairment should generally avoid mefenamic acid. ## 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. * Active gastrointestinal (GI) bleeding or history of GI bleeding/ulceration. * Severe heart failure. * Third trimester of pregnancy. ## Adverse Effects * **Common:** Diarrhea, nausea, vomiting, abdominal pain, constipation, dizziness, rash. * **Serious:** GI bleeding, ulceration, perforation; renal toxicity (including interstitial nephritis and papillary necrosis); cardiovascular thrombotic events (myocardial infarction, stroke); exacerbation of asthma; hepatic toxicity; hypersensitivity reactions. ## Key Drug Interactions * **Anticoagulants (e.g., warfarin):** Increased risk of bleeding. * **Aspirin:** May decrease the cardioprotective effect of low-dose aspirin; increased risk of GI toxicity. * **Corticosteroids:** Increased risk of GI ulceration and bleeding. * **Diuretics, ACE inhibitors, ARBs:** May reduce antihypertensive effects and increase risk of renal impairment. * **Lithium, Methotrexate:** Increased serum levels and toxicity. * **SSRIs:** Increased risk of GI bleeding. ## Monitoring * Monitor for signs and symptoms of GI bleeding (e.g., melena, hematemesis). * Monitor renal function, especially in patients with pre-existing renal disease or those at risk for renal toxicity. * Monitor blood pressure. * Assess for signs of hypersensitivity or allergic reactions. ## Clinical Pearls * Mefenamic acid is generally for short-term use only. * Administer with food or milk to minimize GI upset. * Due to the risk of diarrhea, it may not be suitable for all patients. * NSAIDs carry a boxed warning for cardiovascular thrombotic events, myocardial infarction, and stroke, as well as GI risks. **Disclaimer:** Always verify the current prescribing information and consult with a healthcare professional for personalized medical advice.