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# Mefenamic Acid
## Overview
Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for the short-term relief of mild to moderate pain. It is also used for the treatment of primary dysmenorrhea.
## Primary Indications
* Mild to moderate pain
* Primary dysmenorrhea
## Adult Dosing
* **Pain:** 500 mg every 6 hours as needed.
* **Primary Dysmenorrhea:** 500 mg as the first dose, followed by 250 mg every 6 hours as needed.
* Treatment should not exceed 7 days.
## Pediatric Dosing
* Mefenamic acid is generally not recommended in children under 12 years of age due to limited safety and efficacy data.
## Dose Adjustments
* **Renal Impairment:** Use with caution. Dose reduction may be necessary in severe renal impairment.
* **Hepatic Impairment:** Use with caution. Dose reduction may be necessary in severe hepatic impairment.
## 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.
* Inflammatory bowel disease.
* Severe heart failure.
* Severe renal impairment.
* Severe hepatic impairment.
## Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, abdominal pain, constipation, headache, dizziness, rash.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation; renal toxicity; hepatic toxicity; cardiovascular events (MI, stroke); 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.
* **Diuretics:** Reduced antihypertensive effect and increased risk of renal impairment.
* **Lithium:** Increased serum lithium levels.
* **Methotrexate:** Increased methotrexate toxicity.
* **Other NSAIDs:** Increased risk of adverse effects.
## Monitoring
* **Renal function:** Monitor periodically, especially in patients with pre-existing renal disease or those on concomitant nephrotoxic agents.
* **Hepatic function:** Monitor periodically.
* **Signs of GI bleeding:** Monitor for stool guaiac, melena, hematemesis.
* **Blood pressure:** Monitor for potential increase.
## Clinical Pearls
* Administer with food or milk to minimize gastrointestinal upset.
* Limit duration of use to 7 days to reduce the risk of adverse effects.
* Consider the risk of serious cardiovascular and gastrointestinal events with NSAID use, particularly in elderly patients or those with a history of these events.
* Hypersensitivity reactions can occur even in patients with no prior history of NSAID sensitivity.
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*This information is intended for healthcare professionals and is not a substitute for professional medical advice. Always consult with a qualified healthcare provider regarding any medical condition or treatment options. Prescribing information can vary, and it is essential to review the most current product information and local protocols before prescribing.*
