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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. It is also used for the management of primary dysmenorrhea.
## Primary Indications
* Mild to moderate pain (e.g., dental pain, musculoskeletal pain)
* Primary dysmenorrhea
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed. Maximum daily dose: 1500 mg. Treatment duration typically limited to 7 days.
* **Primary Dysmenorrhea:** 500 mg every 6 hours, starting at the onset of pain and bleeding, and continuing for the duration of the pain.
## Pediatric Dosing
Mefenamic acid is generally not recommended for children under 14 years of age due to limited safety and efficacy data. Dosing for pediatric patients, if used, depends on weight and indication and should be determined by a qualified healthcare provider.
## Dose Adjustments
No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised due to potential for exacerbation of underlying conditions.
## Contraindications
* Hypersensitivity to mefenamic acid, aspirin, or other NSAIDs.
* History of bronchospasm, asthma, rhinitis, or urticaria induced by aspirin or other NSAIDs.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Inflammatory bowel disease.
* Severe renal or hepatic impairment.
* Active peptic ulceration or gastrointestinal bleeding.
* Third trimester of pregnancy.
## Adverse Effects
Common adverse effects include gastrointestinal disturbances (diarrhea, nausea, vomiting, abdominal pain), dizziness, and headache. Serious adverse effects may include gastrointestinal bleeding, perforation, renal toxicity, cardiovascular thrombotic events, and hypersensitivity reactions.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **ACE inhibitors, ARBs, diuretics, beta-blockers:** May reduce antihypertensive effects and increase risk of renal impairment.
* **Lithium:** Increased lithium levels and toxicity.
* **Methotrexate:** Increased methotrexate levels and 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 receiving concomitant nephrotoxic agents.
* Assess for cardiovascular risk factors.
## Clinical Pearls
* Mefenamic acid should be taken with food or milk to minimize gastrointestinal upset.
* Due to its short half-life, mefenamic acid is typically used for short-term pain management.
* The risk of serious cardiovascular thrombotic events may be increased with NSAID use.
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*Disclaimer: This information is intended for healthcare professionals. Always consult the most current prescribing information and relevant clinical guidelines before making treatment decisions.*
