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# Mefenamic%25252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520acid%25252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520%25252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252528meftal-P%25252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252529
## 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
* Short-term management of mild to moderate pain, including primary dysmenorrhea.
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed.
* **Dysmenorrhea:** 500 mg every 6 hours, starting at the onset of pain or bleeding, whichever comes first.
* **Maximum duration:** Typically recommended for no more than 7 days.
* **Maximum daily dose:** 1500 mg.
* **Maximum duration of therapy:** Generally limited to 7 days.
## Pediatric Dosing
* Mefenamic acid is generally **not recommended for use in children under 14 years of age** due to limited data and potential for adverse effects.
## Dose Adjustments
* **Renal Impairment:** Use with caution. Data is limited, but dose reduction may be considered in severe impairment.
* **Hepatic Impairment:** Use with caution. Data is limited.
## Contraindications
* Hypersensitivity to mefenamic acid or other NSAIDs.
* History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Active gastrointestinal bleeding or ulceration.
* Severe renal or hepatic impairment.
* Severe heart failure.
## Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, abdominal pain, constipation, dizziness, headache, rash.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; renal toxicity; hepatic toxicity; cardiovascular thrombotic events; hypersensitivity reactions; Stevens-Johnson syndrome/toxic epidermal necrolysis; aplastic anemia; hemolytic anemia.
## 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 gastrointestinal adverse effects and potential for additive pharmacologic effects.
* **Diuretics and antihypertensives:** May decrease diuretic efficacy and antihypertensive effect; increased risk of renal impairment.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased risk of methotrexate toxicity.
## Monitoring
* **Gastrointestinal symptoms:** Monitor for signs of bleeding (melena, hematemesis) or ulceration.
* **Renal function:** Monitor serum creatinine and BUN, especially in patients with pre-existing renal disease or those on concomitant nephrotoxic agents.
* **Hepatic function:** Monitor liver enzymes, especially in patients with pre-existing liver disease or those on long-term therapy.
* **Complete blood count (CBC):** Monitor for signs of anemia, particularly hemolytic anemia, which has been reported.
## Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Should not be used for longer than 7 days due to potential for adverse effects.
* Consider the risks of NSAIDs (GI bleeding, cardiovascular events, renal toxicity) in all patients, especially the elderly and those with risk factors.
* Due to the risk of aseptic meningitis, particularly in patients with existing autoimmune disorders like SLE, use with caution.
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*Please verify the most current prescribing information before use. This information is intended for healthcare professionals and does not replace clinical judgment.*
