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# Mefenamic Acid (Meftal-P)
### Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for short-term relief of pain. It functions by inhibiting prostaglandin synthesis.
### Primary Indications
* Mild to moderate pain, including menstrual pain (dysmenorrhea) and pain associated with dental procedures.
### Adult Dosing
* **Initial dose:** 500 mg every 4 to 6 hours as needed.
* **Maximum dose:** 1000 mg per day *or* 1500 mg per day for short-term use (up to 7 days) in severe pain, as per local protocol.
### Pediatric Dosing
* **Age:** Generally not recommended for children under 14 years of age due to limited data and potential for adverse effects.
* For children 14 years and older, use adult dosing.
### Dose Adjustments
* **Renal Impairment:** Use with caution. Data is limited, but dose reduction may be considered in severe impairment.
* **Hepatic Impairment:** Use with caution. Data is limited.
* **Elderly:** Increased risk of adverse effects; use judiciously.
### Contraindications
* Hypersensitivity to mefenamic acid or other NSAIDs.
* History of aspirin-induced asthma, urticaria, or allergic rhinitis.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
* Active gastrointestinal (GI) bleeding or ulceration.
* Severe renal or hepatic impairment.
### Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, abdominal pain, constipation, dyspepsia.
* **Serious:** GI bleeding, ulceration, perforation; renal impairment, fluid retention, edema; increased risk of cardiovascular thrombotic events (MI, stroke); hepatic dysfunction; hypersensitivity reactions.
### 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.
* **ACE inhibitors, ARBs, diuretics:** Reduced antihypertensive effect; increased risk of renal dysfunction.
* **Lithium:** Increased lithium levels.
* **Methotrexate:** Increased methotrexate toxicity.
### Monitoring
* Monitor for signs and symptoms of GI bleeding (e.g., melena, hematemesis).
* Monitor renal and hepatic function, especially with prolonged use or in vulnerable patients.
* Monitor blood pressure.
### Clinical Pearls
* Administer with food or milk to minimize GI upset.
* Limit use to the shortest duration necessary to control symptoms.
* Avoid concurrent use with other NSAIDs.
* Discontinue if signs of GI toxicity or hypersensitivity occur.
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**Disclaimer:** This information is intended for healthcare professionals and does not replace the need to consult the most current prescribing information, product monographs, or local institutional protocols before making clinical decisions. Always verify the latest drug information.
