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# Mefenamic Acid
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term management of mild to moderate pain. It is also used for the management of primary dysmenorrhea.
## Primary Indications
* Mild to moderate pain
* Primary dysmenorrhea
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed.
* **Primary Dysmenorrhea:** 500 mg initially, followed by 250 mg every 6 hours as needed.
* Maximum daily dose: 1500 mg for short-term use.
## Pediatric Dosing
Mefenamic acid is not generally recommended for children under 14 years of age. For specific pediatric indications and dosing, consult specialized pediatric guidelines or resources.
## Dose Adjustments
No dose adjustment is typically required for renal or hepatic impairment, but caution is advised, and the lowest effective dose should be used. Mefenamic acid is generally not recommended for patients with severe renal or hepatic impairment.
## Contraindications
* Hypersensitivity to mefenamic acid, aspirin, or other NSAIDs.
* History of NSAID-induced bronchospasm, urticaria, or allergic rhinitis.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Inflammatory bowel disease.
* Active peptic ulceration or history of recurrent peptic ulceration.
* Severe heart failure, renal impairment, or hepatic impairment.
* Third trimester of pregnancy.
## Adverse Effects
Common adverse effects include nausea, vomiting, diarrhea, abdominal pain, constipation, and dizziness. Serious adverse effects include gastrointestinal bleeding, ulceration, perforation, cardiovascular thrombotic events, renal toxicity, hepatotoxicity, hypersensitivity reactions, and exacerbation of asthma.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **Other NSAIDs and Aspirin:** Increased risk of GI toxicity and other adverse effects.
* **ACE inhibitors, ARBs, beta-blockers:** May reduce antihypertensive effect; increased risk of renal impairment.
* **Diuretics:** May reduce diuretic effect; increased risk of renal impairment.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased risk of methotrexate toxicity.
## Monitoring
* Monitor for signs and symptoms of GI bleeding (e.g., melena, hematemesis).
* Monitor renal function, especially in patients with pre-existing renal disease or those taking diuretics or ACE inhibitors.
* Monitor liver function tests periodically.
* Assess pain relief and for signs of adverse effects.
## Clinical Pearls
* Administer with food or milk to minimize GI upset.
* Use for the shortest duration necessary to control symptoms.
* Assess risk factors for cardiovascular and gastrointestinal events before initiating therapy.
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*Disclaimer: This information is for educational purposes only and does not substitute for professional medical advice. Always verify current prescribing information and consult with a healthcare professional before making any decisions about patient care.*
