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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. It is also used for primary dysmenorrhea.
## Primary Indications
* Mild to moderate pain
* Primary dysmenorrhea
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed. Do not exceed 7 days of treatment.
* **Primary Dysmenorrhea:** 500 mg every 6 hours starting with the onset of pain and bleeding, usually for 2-3 days.
## Pediatric Dosing
Mefenamic acid is generally not recommended for children under 14 years of age due to lack of established efficacy and safety data, although it has been used in some regions for specific indications. Consult specific pediatric guidelines or local protocols for guidance if use is considered.
## Dose Adjustments
No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised due to potential for increased adverse effects.
## 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 bleeding or a history of recurrent gastrointestinal ulceration or bleeding.
## Adverse Effects
Common adverse effects include diarrhea, nausea, vomiting, abdominal pain, headache, dizziness, and rash. Serious adverse effects include gastrointestinal bleeding, ulceration, perforation, myocardial infarction, stroke, renal failure, and severe skin reactions.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Selective Serotonin Reuptake Inhibitors (SSRIs):** Increased risk of gastrointestinal bleeding.
* **Other NSAIDs and Aspirin:** Increased risk of adverse effects, particularly gastrointestinal.
* **Diuretics, ACE inhibitors, Angiotensin II Receptor Blockers (ARBs):** Potential for decreased antihypertensive effect and increased risk of renal impairment.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased risk of methotrexate toxicity.
## Monitoring
* Monitor for signs and symptoms of gastrointestinal bleeding (e.g., melena, hematemesis).
* Monitor for signs of cardiovascular events.
* Monitor renal function, especially in patients with pre-existing renal disease or those taking concomitant nephrotoxic agents.
* Monitor for signs of hypersensitivity reactions.
## Clinical Pearls
* Mefenamic acid should be taken with food or milk to minimize gastrointestinal upset.
* Due to its short half-life, it is typically dosed every 6 hours.
* Limit treatment duration to the shortest possible period to minimize risks.
* Diarrhea is a common and sometimes dose-limiting side effect.
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**Disclaimer:** This information is intended for healthcare professionals. Always consult the most current prescribing information and local guidelines before administering or recommending any medication.
