Meftal%252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520spas

# Mefenamic Acid (Meftal spas) ## Overview Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) of the fenamate class. It is primarily used for its analgesic and anti-inflammatory properties. ## Primary Indications * Short-term management of mild to moderate pain, including dysmenorrhea and pain associated with dental procedures. ## Adult Dosing * **Pain:** 500 mg every 6-8 hours as needed. * **Dysmenorrhea:** 500 mg every 6-8 hours as needed, typically started at the onset of bleeding and associated pain. * **Maximum Daily Dose:** 1500 mg. ## Pediatric Dosing * Information for pediatric use is limited and not well-established. Use in children under 14 years of age is generally not recommended due to insufficient safety and efficacy data. ## Dose Adjustments * **Renal Impairment:** Use with caution. Dose reduction may be considered in severe impairment, though specific guidelines are lacking. Monitor renal function closely. * **Hepatic Impairment:** Use with caution. Dose reduction may be considered in severe impairment, though specific guidelines are lacking. Monitor hepatic function closely. * **Elderly:** Increased risk of adverse effects, particularly gastrointestinal bleeding and renal issues. Use lowest effective dose for shortest duration. ## Contraindications * Known hypersensitivity to mefenamic acid or other NSAIDs. * History of NSAID-induced bronchospasm, urticaria, or allergic rhinitis. * Active peptic ulceration or history of recurrent peptic ulceration. * Severe renal or hepatic impairment. * Severe heart failure. * Third trimester of pregnancy. ## Adverse Effects * **Common:** Nausea, vomiting, diarrhea, abdominal pain, headache, dizziness. * **Serious:** Gastrointestinal bleeding, perforation, renal failure, hepatic dysfunction, cardiovascular thrombotic events, hypersensitivity reactions, Stevens-Johnson syndrome. ## Key Drug Interactions * **Anticoagulants (e.g., warfarin):** Increased risk of bleeding. Monitor INR closely. * **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding. * **Other NSAIDs (including aspirin):** Increased risk of gastrointestinal toxicity and other adverse effects. * **ACE inhibitors, ARBs, Diuretics:** May reduce antihypertensive effect and increase risk of renal impairment. * **Lithium:** Increased lithium levels. Monitor lithium levels. * **Methotrexate:** Increased risk of methotrexate toxicity. ## Monitoring * **Pain relief and efficacy.** * **Signs and symptoms of gastrointestinal bleeding** (e.g., melena, hematemesis). * **Renal function** (serum creatinine, BUN), especially in patients with pre-existing renal disease or those at risk. * **Hepatic function** (ALT, AST), especially in patients with pre-existing hepatic disease. * **Blood pressure**, as NSAIDs can cause or exacerbate hypertension. ## Clinical Pearls * For short-term use only. * Administer with food or milk to minimize gastrointestinal upset. * Avoid concurrent use with other NSAIDs. * Discontinue if signs of serious adverse effects occur (e.g., rash, GI bleeding, renal dysfunction). *** **Disclaimer:** This information is intended for healthcare professionals. Always refer to the most current prescribing information and consult with appropriate resources before making any clinical decisions. Local protocols and guidelines may vary.