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Mefenamic Acid

MEFENAMIC ACID

Manufacturer: Advanced Rx of Tennessee, LLC

Score: 144.0

Quick Summary

Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used for the relief of mild to moderate pain in adults and adolescents 14 years of age and older, and for the treatment of primary dysmenorrhea. It works by inhibiting the production of prostaglandins, which are substances in the body that cause pain and inflammation. The recommended dose is 500 mg as an initial dose followed by 250 mg every 6 hours as needed, usually not to exceed one week. Mefenamic acid is contraindicated in patients with known hypersensitivity to the drug, asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs, and in the setting of coronary artery bypass graft (CABG) surgery. Important safety information includes the risk of serious cardiovascular and gastrointestinal events, and special population considerations include use during pregnancy, nursing mothers, pediatric use, and geriatric use.

Key Clinical Findings and Indications

  • Relief of mild to moderate pain in adults and adolescents 14 years of age and older
  • Treatment of primary dysmenorrhea

Important Safety Information

Warning

Risk of serious cardiovascular and gastrointestinal events

Contraindications

  • Known hypersensitivity to the drug
  • Asthma
  • Urticaria
  • Other allergic-type reactions after taking aspirin or other NSAIDs
  • Setting of coronary artery bypass graft (CABG) surgery

Adverse Reactions

  • Gastrointestinal bleeding
  • Ulceration
  • Perforation
  • Cardiovascular thrombotic events
  • Hypertension
  • Heart failure
  • Renal toxicity
  • Hyperkalemia
  • Anaphylactic reactions
  • Serious skin reactions

Dosing Recommendations

General Guidance

Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals

Relief of mild to moderate pain

Adult Dose

500 mg as an initial dose followed by 250 mg every 6 hours as needed

Pediatric Dose

Not established for pediatric patients under 14 years of age

Treatment of primary dysmenorrhea

Adult Dose

500 mg as an initial dose followed by 250 mg every 6 hours, given orally, starting with the onset of bleeding and associated symptoms

Pediatric Dose

Not established for pediatric patients under 14 years of age

Special Population Considerations

Pregnancy

  • Use of NSAIDs, including mefenamic acid, can cause premature closure of the fetal ductus arteriosus and fetal renal dysfunction leading to oligohydramnios and, in some cases, neonatal renal impairment
  • Limit dose and duration of mefenamic acid use between about 20 and 30 weeks of gestation, and avoid mefenamic acid use at about 30 weeks of gestation and later in pregnancy

Nursing Mothers

  • Trace amounts of mefenamic acid may be present in breast milk and transmitted to the nursing infant
  • A decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother

Pediatric Use

  • Safety and effectiveness in pediatric patients below the age of 14 have not been established

Geriatric Use

  • Elderly patients, compared to younger patients, are at greater risk for NSAID-associated serious cardiovascular, gastrointestinal, and/or renal adverse reactions
  • Start dosing at the low end of the dosing range, and monitor patients for adverse effects

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