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# Mefenamic Acid (Meftal spas is a brand name)
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) belonging to the fenamate class. It possesses analgesic, anti-inflammatory, and antipyretic properties.
## Primary Indications
* Mild to moderate pain, including menstrual pain (dysmenorrhea).
* Pain associated with inflammation.
## Adult Dosing
* **Pain/Dysmenorrhea:** 500 mg orally every 6 hours as needed.
* **Maximum Daily Dose:** 1500 mg. Dosing should not exceed 7 days for self-medication.
## Pediatric Dosing
Mefenamic acid is generally not recommended for children under 14 years of age due to lack of established safety and efficacy data.
## Dose Adjustments
* **Renal Impairment:** Use with caution. Dosage reduction may be necessary in severe renal impairment, though specific guidelines are not well-established.
* **Hepatic Impairment:** Use with caution. Dosage reduction may be necessary in severe hepatic impairment, though specific guidelines are not well-established.
## Contraindications
* Hypersensitivity to mefenamic acid, aspirin, or other NSAIDs.
* History of gastrointestinal (GI) bleeding or perforation related to NSAID use.
* Active peptic ulceration or a history of recurrent peptic ulceration.
* Severe heart failure.
* Third trimester of pregnancy.
## Adverse Effects
Common: Nausea, vomiting, diarrhea, abdominal pain, constipation, headache, dizziness, rash.
Serious: Gastrointestinal bleeding/perforation, myocardial infarction, stroke, renal failure, hepatic impairment, Stevens-Johnson syndrome, toxic epidermal necrolysis, anaphylaxis.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of GI ulcers and bleeding.
* **Other NSAIDs (including aspirin):** Increased risk of GI toxicity and other adverse effects.
* **ACE inhibitors, ARBs, diuretics:** Reduced antihypertensive effect, increased risk of renal impairment.
* **Lithium:** Increased lithium levels.
* **Methotrexate:** Increased methotrexate levels and toxicity.
## Monitoring
* Monitor for signs and symptoms of GI bleeding (e.g., melena, hematemesis).
* Monitor for signs and symptoms of cardiovascular events.
* Monitor renal and hepatic function, especially in patients with pre-existing impairment or those on long-term therapy.
## Clinical Pearls
* Mefenamic acid is typically used for short-term pain management.
* Advise patients to take with food or milk to minimize GI upset.
* Discontinue if signs of GI bleeding or serious adverse effects occur.
**Disclaimer:** This information is for educational purposes only and does not substitute for professional medical advice. Always consult with a qualified healthcare provider to determine the best course of treatment for your specific condition. Verify current prescribing information and guidelines before making any treatment decisions.
