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# Mefenamic Acid
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for short-term management of mild to moderate pain.
## Primary Indications
* Pain, including menstrual pain (dysmenorrhea).
* Rheumatic disorders.
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed. Maximum daily dose is 1500 mg. Therapy should not exceed 7 days.
* **Dysmenorrhea:** 500 mg every 4-6 hours as needed.
* **Rheumatic disorders:** 500 mg three times daily.
## Pediatric Dosing
* **Pain:** Not recommended for children under 14 years of age.
* **Rheumatic disorders:** Not recommended for children under 14 years of age.
## Dose Adjustments
* **Renal Impairment:** Use with caution; dose adjustment may be necessary based on renal function.
* **Hepatic Impairment:** Use with caution; dose adjustment may be necessary based on hepatic function.
## Contraindications
* Hypersensitivity to mefenamic acid or other NSAIDs.
* History of asthma, urticaria, or allergic-type reactions after aspirin or other NSAIDs.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Active gastrointestinal bleeding or perforation.
## Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, abdominal pain, dyspepsia, constipation, headache, dizziness.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; cardiovascular thrombotic events (MI, stroke); renal failure; hepatic failure; hypersensitivity reactions; exacerbation of asthma.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Diuretics, ACE inhibitors, ARBs:** Reduced antihypertensive effect, increased risk of renal impairment.
* **Lithium:** Increased lithium levels.
* **Methotrexate:** Increased methotrexate toxicity.
* **Other NSAIDs, Aspirin:** Increased risk of adverse effects, particularly gastrointestinal.
## Monitoring
* Signs and symptoms of gastrointestinal bleeding (e.g., melena, hematemesis).
* Renal function (serum creatinine, BUN).
* Hepatic function (LFTs).
* Blood pressure.
## Clinical Pearls
* Mefenamic acid should be taken with food or milk to minimize gastrointestinal upset.
* Due to the potential for serious adverse effects, use the lowest effective dose for the shortest possible duration.
* Avoid in patients with a history of peptic ulcer disease or inflammatory bowel disease.
* The maximum duration of therapy for pain is typically 7 days.
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*This information is intended for healthcare professionals. Always consult the most current prescribing information and local protocols before making clinical decisions.*
