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# Mefenamic Acid (Meftal-P)
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) that exhibits analgesic, anti-inflammatory, and antipyretic properties by inhibiting cyclooxygenase (COX-1 and COX-2) enzymes. Meftal-P is a common brand formulation often used for pediatric pyrexia/pain.
## Primary Indications
* Mild to moderate pain.
* Primary dysmenorrhea.
* Short-term management of fever and inflammation (common pediatric use).
## Adult Dosing
* **Initial Dose:** 500 mg orally, followed by 250 mg every 6 hours as needed.
* **Maximum Duration:** Should not exceed 7 days of treatment due to potential gastrointestinal and renal toxicity.
## Pediatric Dosing
* **Fever/Pain:** Typical dosing is 6.5 mg/kg body weight administered every 6 to 8 hours.
* *Note:* Dosing protocols vary significantly by region and specific brand formulation (e.g., Meftal-P suspension strength). Consult local pediatric formulary guidelines before prescribing.
* **Age Restriction:** Generally not recommended for children under 6 months of age.
## Dose Adjustments
* **Renal Impairment:** Use with extreme caution. Avoid in cases of severe renal impairment (CrCl < 30 mL/min).
* **Hepatic Impairment:** Use with caution; monitor liver function tests.
## Contraindications
* Known hypersensitivity to mefenamic acid or aspirin/other NSAIDs.
* History of GI ulceration or active inflammatory bowel disease.
* Severe heart failure.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Severe renal impairment.
## Adverse Effects
* **Common:** Abdominal pain, nausea, diarrhea, dyspepsia.
* **Serious:** GI bleeding, ulceration, renal impairment, fluid retention, hypertension, and skin reactions (e.g., Stevens-Johnson syndrome).
## Key Drug Interactions
* **Anticoagulants (e.g., Warfarin):** Increased risk of bleeding.
* **ACE Inhibitors/ARBs/Diuretics:** Reduced antihypertensive effect and increased risk of acute renal failure.
* **Other NSAIDs/Corticosteroids:** Increased risk of GI toxicity and ulceration.
* **Lithium/Methotrexate:** Decreased renal clearance, leading to increased toxicity.
## Monitoring
* **Baseline/Periodic:** Serum creatinine, BUN, and electrolytes for patients on long-term therapy.
* **Clinical:** Monitor for signs of GI bleeding (occult blood in stool), worsening hypertension, and peripheral edema.
## Clinical Pearls
* Administer with food or milk to minimize gastrointestinal irritation.
* Not indicated for long-term use; always use the lowest effective dose for the shortest duration necessary.
* "Meftal-P" is often incorrectly requested by parents for routine fever management; counsel on the necessity of confirming the exact concentration of the suspension to avoid dosing errors.
* Increased risk of cardiovascular events similar to other non-selective NSAIDs.
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**Educational Disclaimer:** This information is for educational purposes only and does not constitute medical advice. Verify all doses, indications, and contraindications against the latest local regulatory prescribing information (Product Insert/SmPC) or institutional drug formulary before administration.
