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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. It also possesses anti-inflammatory and antipyretic properties.
## Primary Indications
* Mild to moderate pain, including menstrual pain (dysmenorrhea) and pain associated with dental procedures.
## Adult Dosing
* **Initial Dose:** 500 mg every 6 hours as needed.
* **Maximum Daily Dose:** 1500 mg per day.
* **Duration:** Generally for short-term use (up to 7 days).
## Pediatric Dosing
* **Ages 6 months to 12 years:** Dosing is typically weight-based. A common recommendation is 5 to 7 mg/kg per dose, given every 6 hours.
* **Example:** For a 20 kg child, a dose would be 100 to 140 mg every 6 hours.
* **Maximum Daily Dose:** 500 mg per day for children weighing less than 50 kg.
* **Note:** Specific pediatric dosing may vary based on local guidelines or physician discretion.
## Dose Adjustments
* No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised. Mefenamic acid should be used with particular care in patients with pre-existing renal or hepatic disease due to the potential for NSAID-related organ toxicity.
## 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 renal or hepatic impairment.
* Third trimester of pregnancy.
## Adverse Effects
* **Common:** Diarrhea, nausea, vomiting, abdominal pain, constipation, dyspepsia.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation, renal impairment, hepatic dysfunction, hypersensitivity reactions, cardiovascular thrombotic events, 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.
* **Other NSAIDs (including aspirin):** Increased risk of GI adverse effects and potential for reduced cardioprotective effects of low-dose aspirin.
* **Diuretics, ACE inhibitors, ARBs:** Reduced antihypertensive effect, increased risk of renal dysfunction.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased risk of methotrexate toxicity.
## Monitoring
* Monitor for signs and symptoms of GI bleeding (e.g., melena, hematemesis).
* Monitor renal function (e.g., creatinine, BUN) especially in patients with pre-existing renal disease or those on concurrent nephrotoxic agents.
* Monitor hepatic function in patients with liver disease or those on long-term therapy.
* Assess pain relief and for adverse effects.
## Clinical Pearls
* Administer with food or milk to minimize GI upset.
* Limit duration of use to the shortest effective period to reduce the risk of serious GI and cardiovascular events.
* Mefenamic acid is generally not recommended for long-term use due to its potential for GI toxicity.
* Avoid in patients with a history of NSAID-induced bronchospasm.
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**Disclaimer:** This information is intended for healthcare professionals. Always consult the current prescribing information and relevant clinical guidelines for complete details and to verify dosage and safety information before administering or recommending any medication.
