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# Mefenamic Acid (Meftal-P)
## Overview
Mefenamic acid is a non-steroidal anti-inflammatory drug (NSAID) belonging to the fenamate class. It exhibits analgesic and anti-inflammatory properties by inhibiting cyclooxygenase (COX) enzymes, thereby reducing prostaglandin synthesis.
## Primary Indications
* Short-term management of mild to moderate pain.
* Management of primary dysmenorrhea.
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed.
* **Dysmenorrhea:** 500 mg initially, followed by 250 mg every 6 hours as needed.
* **Maximum Daily Dose:** 1500 mg.
* Treatment duration should not exceed 7 days.
## Pediatric Dosing
* **Age 6 months to 14 years:** 6.5 mg/kg every 6 hours as needed.
* **Maximum dose per administration:** 250 mg.
* **Maximum daily dose:** 500 mg.
* **Maximum treatment duration:** 7 days.
## Dose Adjustments
* No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised due to potential for exacerbation of underlying conditions. Clinical monitoring is essential.
## Contraindications
* 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.
* Third trimester of pregnancy.
## Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, abdominal pain, constipation, dyspepsia.
* **Serious:** Gastrointestinal bleeding, perforation, ulceration; renal toxicity (including interstitial nephritis, papillary necrosis, renal failure); cardiovascular thrombotic events (MI, stroke); hypersensitivity reactions (including Stevens-Johnson syndrome, toxic epidermal necrolysis); exacerbation of asthma.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Selective Serotonin Reuptake Inhibitors (SSRIs):** Increased risk of gastrointestinal bleeding.
* **Other NSAIDs (including aspirin):** Increased risk of adverse effects, particularly gastrointestinal bleeding.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased risk of methotrexate toxicity.
* **Diuretics and antihypertensives:** Reduced efficacy, increased risk of renal impairment.
## Monitoring
* Monitor for signs and symptoms of gastrointestinal bleeding (e.g., melena, hematemesis).
* Assess renal function (creatinine, BUN) periodically, especially in patients with pre-existing renal disease or those on concurrent nephrotoxic agents.
* Monitor for signs of cardiovascular events.
* Monitor for signs of hypersensitivity reactions.
## Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Use the lowest effective dose for the shortest duration necessary.
* Avoid in patients with a history of inflammatory bowel disease.
* May mask signs of infection.
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*This information is intended for clinical use and does not substitute for professional medical advice. Always consult the most current prescribing information and local guidelines.*
