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# Mefenamic Acid
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term management of mild to moderate pain.
## Primary Indications
* Pain management (e.g., dysmenorrhea, headache, dental pain, musculoskeletal pain)
## Adult Dosing
* **Initial dose:** 500 mg orally every 6 hours as needed.
* **Maximum daily dose:** 1500 mg.
* Treatment should not exceed 7 days.
## Pediatric Dosing
* Mefenamic acid is not recommended for children under 14 years of age.
## Dose Adjustments
* No specific dose adjustments are required for renal or hepatic impairment, but caution is advised due to potential for organ toxicity.
## Contraindications
* Hypersensitivity to mefenamic acid or other NSAIDs.
* History of asthma, urticaria, or other 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.
## Adverse Effects
* **Common:** Diarrhea, nausea, vomiting, abdominal pain, constipation, rash, dizziness, headache.
* **Serious:** GI bleeding, ulceration, perforation; cardiovascular thrombotic events (MI, stroke); renal failure; hepatic failure; severe hypersensitivity reactions (including anaphylaxis); Stevens-Johnson syndrome; toxic epidermal necrolysis.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **ACE inhibitors, ARBs, diuretics:** May reduce antihypertensive effect and increase risk of renal impairment.
* **Lithium:** Increased serum lithium levels.
* **Other NSAIDs/Aspirin:** Increased risk of GI toxicity and other adverse effects.
## Monitoring
* Monitor for signs and symptoms of GI bleeding and ulceration.
* Assess for renal and hepatic function if prolonged use or in patients with risk factors.
* Monitor for cardiovascular risk factors.
## Clinical Pearls
* Mefenamic acid is generally indicated for short-term use only.
* Should be taken with food or milk to minimize GI upset.
* Due to the risk of diarrhea, it's important to monitor for dehydration.
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*Disclaimer: This information is intended for clinical use and does not replace a thorough review of the current prescribing information, product monograph, or relevant literature. Always verify drug information with up-to-date resources before administration.*
