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# Mefenamic Acid (Meftal-P)
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term relief of mild to moderate pain, including menstrual pain.
## Primary Indications
* Pain management (mild to moderate)
* Primary dysmenorrhea
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed.
* **Primary Dysmenorrhea:** 500 mg every 6 hours as needed, starting at the onset of pain or bleeding.
* **Maximum:** Not to exceed 1000 mg as a single dose or 4000 mg daily. Duration of treatment should be limited to a maximum of 7 days.
## Pediatric Dosing
Mefenamic acid is generally not recommended for use in children under 14 years of age due to limited data on safety and efficacy. If used, specific pediatric dosing protocols should be followed, which may vary.
## Dose Adjustments
* **Renal Impairment:** Use with caution. No specific dose adjustments are established, but dose reduction may be considered in severe impairment.
* **Hepatic Impairment:** Use with caution. No specific dose adjustments are established, but dose reduction may be considered in severe impairment.
## 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 ulceration.
* Severe heart failure.
* Severe renal or hepatic impairment.
* Third trimester of pregnancy.
## Adverse Effects
Common adverse effects include nausea, vomiting, diarrhea, abdominal pain, constipation, dyspepsia, and headache. Serious adverse effects can include GI bleeding, ulceration, perforation, renal toxicity, hepatic toxicity, cardiovascular thrombotic events, and hypersensitivity reactions.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding. Monitor INR closely.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **Other NSAIDs (including aspirin):** Increased risk of GI and renal adverse effects.
* **Diuretics and Antihypertensives (e.g., ACE inhibitors, ARBs, beta-blockers):** May decrease antihypertensive effect and increase risk of renal impairment.
* **Lithium, Methotrexate:** May increase serum levels and toxicity.
* **Selective Serotonin Reuptake Inhibitors (SSRIs):** Increased risk of GI bleeding.
## Monitoring
* Monitor for signs and symptoms of GI bleeding (e.g., melena, hematemesis).
* Monitor renal and hepatic function, especially with prolonged use or in patients with pre-existing impairment.
* Assess for signs of cardiovascular events.
* Monitor blood pressure.
## Clinical Pearls
* Administer with food or milk to reduce GI upset.
* Use the lowest effective dose for the shortest duration necessary to minimize risks.
* Avoid concomitant use with other NSAIDs.
* Caution in elderly patients and those with a history of GI disease, cardiovascular disease, or renal/hepatic impairment.
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*This information is for educational purposes only and does not substitute professional medical advice. Always consult with a qualified healthcare provider to determine the best course of treatment for your specific condition. Please verify the current prescribing information for the most up-to-date details.*
