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# Mefenamic Acid (meftal-P)
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term treatment of mild to moderate pain.
## Primary Indications
* Pain associated with dysmenorrhea.
* Mild to moderate pain in adults.
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed.
* **Dysmenorrhea:** 500 mg initially, followed by 250 mg every 6 hours as needed.
* **Maximum Daily Dose:** 1500 mg.
* **Duration of Therapy:** Typically recommended for short-term use, not exceeding 7 days.
## Pediatric Dosing
* Mefenamic acid is **not generally recommended** for use in children under 14 years of age due to lack of established safety and efficacy.
## Dose Adjustments
* **Renal Impairment:** Use with caution. No specific dose adjustment guidelines are established, but monitor renal function closely.
* **Hepatic Impairment:** Use with caution. No specific dose adjustment guidelines are established.
## Contraindications
* Known 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 ulceration or bleeding.
* Severe renal or hepatic impairment.
* Severe heart failure.
## Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, abdominal pain, dyspepsia, constipation.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; cardiovascular thrombotic events (MI, stroke); renal failure; hepatic failure; hypersensitivity reactions (including anaphylaxis, Stevens-Johnson syndrome, toxic epidermal necrolysis); exacerbation of asthma.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **SSRIs/SNRIs:** Increased risk of gastrointestinal bleeding.
* **Other NSAIDs/Aspirin:** Increased risk of gastrointestinal adverse effects and potential for additive pharmacodynamic effects.
* **Diuretics, ACE inhibitors, ARBs:** May reduce antihypertensive efficacy and increase risk of renal impairment.
* **Lithium:** May increase lithium levels and toxicity.
* **Methotrexate:** May increase methotrexate levels and toxicity.
## Monitoring
* Signs and symptoms of gastrointestinal bleeding or ulceration.
* Renal function (BUN, creatinine).
* Hepatic function (LFTs).
* Blood pressure.
* Signs of hypersensitivity reactions.
## Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Use the lowest effective dose for the shortest duration necessary to minimize risks.
* Avoid concurrent use with other NSAIDs.
* Discontinue if significant gastrointestinal bleeding or other serious adverse effects occur.
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**Disclaimer:** This information is intended for healthcare professionals. Always consult the most current prescribing information and institutional protocols before administering any medication.
