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# Meftal spas
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) with analgesic and antipyretic properties.
## Primary Indications
* **Pain:** Management of mild to moderate pain, including menstrual pain (dysmenorrhea), dental pain, and postpartum pain.
* **Inflammation:** Reduction of inflammation associated with various conditions.
## Adult Dosing
* **Pain/Dysmenorrhea:** 500 mg every 8 hours as needed.
* **Maximum Daily Dose:** 1500 mg per day. Dosing duration typically limited to a few days.
## Pediatric Dosing
* **Children 6 months to 12 years:** Dosing varies based on weight. A common guideline is 6.5 mg/kg every 8 hours.
* **Maximum Dose:** Not to exceed adult doses.
* *Note:* Pediatric dosing for mefenamic acid can vary, and specific recommendations should be based on weight and clinician judgment. Consult pediatric-specific resources or local protocols.
## Dose Adjustments
* **Renal Impairment:** Use with caution. No specific dose adjustment guidelines are established, but dose reduction may be considered in severe impairment.
* **Hepatic Impairment:** Use with caution. No specific dose adjustment guidelines are established.
## 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.
* Inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis).
* Severe heart failure.
* Severe renal impairment.
* Severe hepatic impairment.
## Adverse Effects
* **Common:** Gastrointestinal upset (nausea, vomiting, diarrhea, abdominal pain), headache, dizziness, rash.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; cardiovascular thrombotic events (MI, stroke); renal toxicity; hepatic toxicity; hypersensitivity reactions; exacerbation of asthma.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Aspirin:** May reduce the cardioprotective effect of low-dose aspirin and increase GI risk.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **Diuretics:** Reduced diuretic efficacy; increased risk of renal toxicity.
* **ACE Inhibitors/ARBs:** Increased risk of renal impairment; reduced antihypertensive effect.
* **Lithium:** Increased lithium levels and toxicity.
* **Methotrexate:** Increased methotrexate toxicity.
## Monitoring
* **Gastrointestinal:** Signs and symptoms of bleeding (e.g., melena, hematemesis, abdominal pain).
* **Renal Function:** Baseline and periodic assessment of serum creatinine and BUN.
* **Hepatic Function:** Baseline and periodic assessment of LFTs.
* **Cardiovascular:** Monitor for signs/symptoms of MI or stroke.
* **Blood Pressure:** NSAIDs can increase blood pressure.
## Clinical Pearls
* Administer with food or milk to minimize GI upset.
* Use the lowest effective dose for the shortest duration necessary.
* Avoid concomitant use with other NSAIDs or aspirin unless specifically indicated and managed.
* Consider gastroprotection (e.g., PPI) in patients at high risk for GI complications.
* Mefenamic acid is generally intended for short-term use due to the risk of GI and cardiovascular events with prolonged therapy.
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*Disclaimer: This information is for educational purposes only and does not constitute medical advice. Always consult the most current prescribing information and a qualified healthcare provider for any health concerns or before making any decisions related to your health or treatment.*
