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# Mefenamic%2525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520acid%252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520%252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252528meftal-P%252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252529
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for short-term management of mild to moderate pain. It is also used for the treatment of primary dysmenorrhea.
## Primary Indications
* Mild to moderate pain (e.g., dental pain, musculoskeletal pain)
* Primary dysmenorrhea
## Adult Dosing
* **Pain:** 500 mg every 4 to 6 hours as needed. Do not exceed 1250 mg in the first 24 hours of treatment, and do not exceed 750 mg on any subsequent day.
* **Primary Dysmenorrhea:** 500 mg every 4 to 6 hours as needed, typically starting with the onset of pain or bleeding and continuing for up to 3 days. The same maximum daily doses as for pain apply.
## Pediatric Dosing
Mefenamic acid is generally not recommended for children under 14 years of age due to a lack of established safety and efficacy data.
## Dose Adjustments
No specific dose adjustments are recommended for renal or hepatic impairment. However, caution is advised, and dosage reduction may be considered in patients with severe impairment, particularly with prolonged use, due to the increased risk of renal and hepatic adverse effects.
## Contraindications
* Hypersensitivity to mefenamic acid or other NSAIDs.
* History of bronchospasm, 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.
* Inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis).
* Severe heart failure.
* Severe renal impairment.
* Severe hepatic impairment.
* Third trimester of pregnancy.
## Adverse Effects
* **Common:** Diarrhea, nausea, vomiting, abdominal pain, dyspepsia, constipation, flatulence, headache, dizziness, rash.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; renal toxicity (including interstitial nephritis, papillary necrosis, renal failure); hepatic toxicity; cardiovascular thrombotic events; hypersensitivity reactions; exacerbation of asthma; Stevens-Johnson syndrome; toxic epidermal necrolysis.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding. Monitor INR closely.
* **Aspirin:** Concurrent use may reduce the cardioprotective effect of low-dose aspirin and increase the risk of GI adverse effects. Mefenamic acid should generally be avoided in patients taking aspirin for cardiovascular protection.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **Diuretics and Antihypertensives (e.g., ACE inhibitors, ARBs):** May diminish the antihypertensive effect and increase the risk of renal toxicity.
* **Lithium:** Increased lithium levels and risk of toxicity.
* **Methotrexate:** Increased methotrexate levels and risk of toxicity.
* **Other NSAIDs and Salicylates:** Increased risk of adverse effects, particularly GI bleeding.
## Monitoring
* Monitor for signs and symptoms of gastrointestinal bleeding (e.g., melena, hematemesis).
* Monitor for signs of renal toxicity (e.g., changes in urine output, edema, elevated serum creatinine).
* Monitor for signs of hepatic toxicity (e.g., jaundice, elevated liver enzymes).
* Monitor blood pressure, especially in patients with hypertension.
* Monitor for signs of hypersensitivity reactions.
## Clinical Pearls
* Mefenamic acid is intended for short-term use only. The maximum duration of use is typically 7 days.
* Administer with food or milk to minimize gastrointestinal upset.
* Diarrhea is a common side effect and may necessitate discontinuation.
* NSAIDs carry a risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke.
* NSAIDs can cause serious gastrointestinal bleeding, ulceration, and perforation.
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*This information is intended for healthcare professionals. Please consult the current prescribing information for complete details and to ensure accuracy before making clinical decisions.*
