Please check your internet connection and try again.
# Mefenamic Acid (Meftal Spas)
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) of the fenamate class. It possesses analgesic, anti-inflammatory, and antipyretic properties.
## Primary Indications
* Pain, particularly mild to moderate pain such as dysmenorrhea, headache, dental pain, and musculoskeletal pain.
* Inflammation associated with various conditions.
* Fever.
* In some regions, it is used in a combination product (e.g., Meftal Spas) for spasmodic pain, typically of the gastrointestinal or genitourinary tract.
## Adult Dosing
* **Analgesia/Anti-inflammatory:** 500 mg orally every 6 to 8 hours as needed. Maximum daily dose is 1500 mg.
* **Dysmenorrhea:** 500 mg orally every 6 to 8 hours, starting at the onset of pain or bleeding, whichever comes first.
* **For combination product (Meftal Spas):** Dosing of the combination product (mefenamic acid + dicyclomine) will vary. Refer to specific product labeling. A typical dose for mefenamic acid in such combinations might be around 250 mg every 8 hours.
## Pediatric Dosing
Dosing for mefenamic acid in pediatrics is not as well-established and should be individualized based on weight and clinical assessment. General guidelines for analgesic/antipyretic use (not for the combination product) may include:
* **Ages 6 months to 12 years:** 6.5 mg/kg orally every 6 to 8 hours. Do not exceed the adult maximum daily dose.
## Dose Adjustments
* **Renal Impairment:** Use with caution in mild to moderate renal impairment. Avoid in severe renal impairment.
* **Hepatic Impairment:** Use with caution in hepatic impairment.
## Contraindications
* Known 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 ulceration or bleeding.
* Inflammatory bowel disease.
* Severe heart failure.
* Third trimester of pregnancy.
## Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, abdominal pain, dyspepsia, constipation, headache, dizziness, rash.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; cardiovascular thrombotic events (MI, stroke); renal failure; hepatic failure; hypersensitivity reactions; Stevens-Johnson syndrome/toxic epidermal necrolysis.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **SSRIs/SNRIs:** Increased risk of GI bleeding.
* **Diuretics and antihypertensives:** May reduce antihypertensive effect and increase risk of renal toxicity.
* **Lithium:** Increased lithium levels and toxicity.
* **Methotrexate:** Increased risk of methotrexate toxicity.
## Monitoring
* **GI symptoms:** Monitor for signs and symptoms of GI bleeding (e.g., black tarry stools, hematemesis).
* **Renal function:** Particularly in patients with pre-existing renal disease or those at risk.
* **Hepatic function:** Monitor liver enzymes if prolonged use or signs of hepatic dysfunction.
* **Blood pressure:** NSAIDs can elevate blood pressure.
## Clinical Pearls
* Mefenamic acid has a relatively short half-life, requiring frequent dosing (every 6-8 hours).
* It is generally considered less potent than some other NSAIDs but can be effective for dysmenorrhea.
* The combination product (Meftal Spas) implies use for conditions involving both inflammation/pain and smooth muscle spasm. The efficacy and safety of combining these agents should be carefully considered.
* Due to the risk of serious GI and cardiovascular events, use the lowest effective dose for the shortest duration necessary.
***
**Disclaimer:** This information is intended for healthcare professionals. Always consult the most current prescribing information and relevant clinical guidelines before administering any medication.
