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# Mefenamic Acid (Meftal Spas)
## 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
* **Pain:** Mild to moderate pain, including menstrual pain (dysmenorrhea), dental pain, and musculoskeletal pain.
* **Inflammation:** Associated with various conditions.
* **Fever:** Reduction of fever.
## Adult Dosing
* **Pain/Dysmenorrhea:** 500 mg every 6 to 8 hours as needed.
* **Maximum Dose:** 1500 mg per day. Therapy duration should not exceed 7 days.
## Pediatric Dosing
Mefenamic acid is generally not recommended for children under 14 years of age. Specific pediatric dosing is not well-established and should be guided by clinical judgment and available literature.
## Dose Adjustments
* **Renal Impairment:** Use with caution. No specific dose adjustments are established, but dose reduction may be considered in severe impairment.
* **Hepatic Impairment:** Use with caution. No specific dose adjustments are established, but dose reduction may be considered in severe impairment.
* **Elderly:** Increased risk of adverse effects; consider lower doses and closer monitoring.
## Contraindications
* Hypersensitivity to mefenamic acid or other NSAIDs.
* History of bronchospasm, asthma, rhinitis, or urticaria induced by aspirin or other NSAIDs.
* Active peptic ulceration or history of recurrent peptic ulceration.
* Severe renal or hepatic impairment.
* Severe heart failure.
* Third trimester of pregnancy.
## Adverse Effects
* **Gastrointestinal:** Nausea, vomiting, diarrhea, abdominal pain, dyspepsia, constipation, and gastrointestinal bleeding (can be serious).
* **Central Nervous System:** Dizziness, drowsiness, headache.
* **Renal:** Acute kidney injury, interstitial nephritis.
* **Hematologic:** Anemia, leukopenia.
* **Hypersensitivity:** Rash, pruritus, bronchospasm.
* **Other:** Tinnitus, blurred vision.
## Key Drug Interactions
* **Anticoagulants (e.g., Warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **SSRIs/SNRIs:** Increased risk of gastrointestinal bleeding.
* **Diuretics, ACE Inhibitors, ARBs:** May reduce antihypertensive effect and increase risk of renal impairment.
* **Lithium:** Increased lithium levels.
* **Methotrexate:** Increased methotrexate toxicity.
## Monitoring
* **Renal Function:** Particularly in patients with pre-existing renal disease, elderly patients, or those on concomitant nephrotoxic agents.
* **Hepatic Function:** Monitor for signs of liver dysfunction.
* **Gastrointestinal Symptoms:** Assess for signs of bleeding or ulceration.
* **Blood Pressure:** NSAIDs can cause fluid retention and hypertension.
## Clinical Pearls
* Due to its gastrointestinal risks, administer with food or milk.
* Short-term use is generally preferred.
* Be aware of potential cross-reactivity with other NSAIDs and aspirin.
* Mefenamic acid should not be used as a substitute for aspirin in cardiovascular prophylaxis.
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*This information is intended for healthcare professionals. Always consult the most current prescribing information and local guidelines for definitive patient management.*
