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# Mefenamic Acid
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term relief of mild to moderate pain. It is also used for the treatment of menstrual pain (dysmenorrhea).
## Primary Indications
* Mild to moderate pain
* Dysmenorrhea
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed. Maximum daily dose is 1500 mg.
* **Dysmenorrhea:** 500 mg initially, followed by 250 mg every 6 hours as needed. Total duration of treatment typically should not exceed 6 days per month.
## Pediatric Dosing
Mefenamic acid is generally not recommended for use in children under 12 years of age due to limited data and potential for adverse effects.
## Dose Adjustments
No specific dose adjustments are routinely recommended for renal or hepatic impairment, but caution is advised due to potential for organ toxicity with NSAIDs. Use the lowest effective dose for the shortest duration necessary.
## 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 ulceration.
## Adverse Effects
Common adverse effects include diarrhea, nausea, vomiting, abdominal pain, dyspepsia, headache, and dizziness. Serious adverse effects include gastrointestinal bleeding, ulceration, perforation, myocardial infarction, stroke, renal failure, and hypersensitivity reactions.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Other NSAIDs (including aspirin):** Increased risk of adverse effects, particularly gastrointestinal.
* **ACE inhibitors, ARBs, diuretics:** May decrease antihypertensive effect and increase risk of renal impairment.
* **Lithium:** Increased lithium levels and risk of toxicity.
* **Methotrexate:** Increased risk of methotrexate toxicity.
## Monitoring
* Monitor for signs and symptoms of gastrointestinal bleeding or ulceration.
* Monitor renal function, especially in patients with pre-existing renal disease or those taking concomitant nephrotoxic agents.
* Monitor blood pressure.
## Clinical Pearls
* Mefenamic acid should be taken with food or milk to minimize gastrointestinal upset.
* Limit use to the shortest duration possible to manage symptoms.
* Avoid concurrent use with other NSAIDs.
* Due to its potential for diarrhea, patients should be advised to report severe or persistent diarrhea.
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*Disclaimer: This information is intended for educational purposes and does not substitute for professional medical advice. Always verify current prescribing information with official drug compendia or regulatory agencies.*
