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# Mefenamic Acid
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) from the anthranilic acid derivative class. It exhibits analgesic, anti-inflammatory, and antipyretic properties.
## Primary Indications
* Short-term management of mild to moderate pain.
* Management of primary dysmenorrhea.
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed.
* **Dysmenorrhea:** 500 mg every 6 hours as needed, starting at the onset of pain and bleeding.
* **Maximum:** Do not exceed 1500 mg in a 24-hour period.
* Duration of therapy should generally not exceed 7 days.
## Pediatric Dosing
* Mefenamic acid is **not recommended** for use in children under 14 years of age due to limited data and potential for toxicity.
## Dose Adjustments
* **Renal Impairment:** Use with caution; dose reduction may be considered in severe impairment, but specific guidelines are lacking.
* **Hepatic Impairment:** Use with caution; dose reduction may be considered in severe impairment, but specific guidelines are lacking.
## Contraindications
* Hypersensitivity to mefenamic acid or other NSAIDs.
* History of bronchospasm, asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Inflammatory bowel disease.
* Severe renal or hepatic impairment.
* Third trimester of pregnancy.
## Adverse Effects
* **Common:** Diarrhea, nausea, vomiting, abdominal pain, constipation, flatulence, dyspepsia.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; cardiovascular thrombotic events (myocardial infarction, stroke); renal failure; hepatic failure; hypersensitivity reactions; Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN); exacerbation of asthma.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs):** Increased risk of gastrointestinal bleeding.
* **Diuretics and Antihypertensives:** May reduce antihypertensive effect and increase risk of nephrotoxicity.
* **Lithium:** Increased lithium levels.
* **Methotrexate:** Increased methotrexate toxicity.
## Monitoring
* Monitor for signs and symptoms of gastrointestinal bleeding (e.g., melena, hematemesis).
* Monitor for signs of renal and hepatic dysfunction.
* Assess pain relief and inflammatory signs.
* Monitor for cardiovascular events.
## Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Short-term use is generally recommended due to the risk of gastrointestinal complications.
* Consider the risk of cardiovascular events and gastrointestinal bleeding, particularly in elderly patients or those with pre-existing risk factors.
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*Disclaimer: This information is for educational purposes only and does not substitute for professional medical advice. Always consult with a qualified healthcare provider and refer to the most current prescribing information before making any decisions related to your health or treatment.*
