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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, particularly menstrual pain. ## Primary Indications * Mild to moderate pain * Primary dysmenorrhea ## Adult Dosing * **Pain:** 500 mg every 6 hours as needed. * **Primary Dysmenorrhea:** 500 mg every 6 hours as needed, starting at the onset of pain and bleeding. **Maximum Daily Dose:** 1250 mg. Treatment duration should not exceed 7 days. ## Pediatric Dosing Mefenamic acid is not generally recommended for use in children under 14 years of age. ## Dose Adjustments No dose adjustments are typically required for renal or hepatic impairment, but caution is advised. Mefenamic acid should be used with caution in patients with pre-existing renal or hepatic disease. ## Contraindications * Hypersensitivity to mefenamic acid or other NSAIDs. * History of gastrointestinal bleeding or perforation related to NSAID use. * Active peptic ulceration or a history of recurrent peptic ulceration/hemorrhage. * Severe heart failure. * Third trimester of pregnancy. ## Adverse Effects Common adverse effects include gastrointestinal upset (nausea, vomiting, diarrhea, abdominal pain), dizziness, and rash. Serious adverse effects can include gastrointestinal bleeding, renal toxicity, hepatic dysfunction, cardiovascular events, and hypersensitivity reactions. ## Key Drug Interactions * **Anticoagulants (e.g., warfarin):** Increased risk of bleeding. * **Other NSAIDs, Aspirin, Corticosteroids:** Increased risk of gastrointestinal toxicity. * **ACE inhibitors, ARBs, Diuretics:** May reduce antihypertensive effect and increase risk of renal impairment. * **Lithium:** Increased serum lithium levels. * **Methotrexate:** Increased methotrexate toxicity. ## Monitoring * Monitor for signs and symptoms of gastrointestinal bleeding. * Monitor renal and hepatic function, especially in patients with pre-existing conditions or those on long-term therapy (though short-term use is typical). * Monitor blood pressure. ## Clinical Pearls * Mefenamic acid is intended for short-term use only. * Administer with food or milk to minimize gastrointestinal upset. * Due to its short half-life, it is typically dosed every 6 hours. **Disclaimer:** This information is intended for healthcare professionals. Always consult the most current prescribing information and institutional protocols before administering any medication.