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# Mefenamic Acid
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term treatment of mild to moderate pain and for the management of primary dysmenorrhea.
## Primary Indications
* Pain (mild to moderate)
* Primary dysmenorrhea
## Adult Dosing
* **Pain:** 500 mg orally every 6 hours as needed.
* **Primary Dysmenorrhea:** 500 mg orally every 6 hours as needed, starting at the onset of pain and bleeding and continuing for the duration of symptoms.
The maximum daily dose is 1500 mg. Treatment duration should not exceed 7 days.
## Pediatric Dosing
Mefenamic acid is generally not recommended for pediatric patients less than 14 years of age due to limited data on efficacy and safety.
## Dose Adjustments
No dose adjustments are typically required for renal or hepatic impairment, but caution is advised. Patients with severe renal or hepatic impairment should use mefenamic acid with caution and at the lowest effective dose.
## Contraindications
* Known hypersensitivity to mefenamic acid or other NSAIDs.
* History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.
* Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery.
## Adverse Effects
Common adverse effects include gastrointestinal upset (nausea, vomiting, diarrhea, abdominal pain), dizziness, and headache. Serious adverse effects can include gastrointestinal bleeding, ulceration, perforation, cardiovascular thrombotic events, renal toxicity, hepatic toxicity, 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 toxicity.
* **Diuretics, ACE inhibitors, ARBs:** May reduce antihypertensive effect and increase risk of renal impairment.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased risk of methotrexate toxicity.
## Monitoring
* Monitor for signs and symptoms of gastrointestinal bleeding (e.g., melena, hematemesis).
* Monitor for cardiovascular events.
* Monitor renal and hepatic function, especially in patients with pre-existing conditions or those on long-term therapy.
* Assess pain relief and menstrual symptom management.
## Clinical Pearls
* Mefenamic acid should be taken with food or milk to minimize gastrointestinal upset.
* It is intended for short-term use only.
* Due to potential for dizziness, patients should exercise caution when driving or operating machinery.
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*This information is intended for clinical professionals and is not a substitute for professional medical advice. Always consult the most current prescribing information and relevant guidelines before making any clinical decisions.*
