Mefenamic Acid

Pronunciation: (MEH-fen-AM-ik acid) Class: NSAID Trade Names: Ponstel - Capsules 250 mg

Pharmacology
Decreases inflammation, pain, and fever, probably through inhibition of cyclooxygenase activity and prostaglandin synthesis.

Indications and Usage

Relief of moderate pain lasting less than 1 wk; treatment of primary dysmenorrhea.

Unlabeled Uses
Treatment of sunburn, migraine (acute attack), PMS.

Contraindications
Patients in whom aspirin, iodides, or any NSAID has caused allergic-type reactions; preexisting renal disease; active ulceration or chronic inflammation of GI tract.

Dosage and Administration

Acute Pain Adults and Children (14 yr or age and older) PO 500 mg, followed by 250 mg every 6 h as needed. Usually not used more than 1 wk. Primary Dysmenorrhea Adults and Children (14 yr of age and older) PO 500 mg, followed by 250 mg every 6 h starting with onset of bleeding and associated symptoms.

Drug Interactions
Anticoagulants Increased risk of gastric erosion and bleeding. Cyclosporine Nephrotoxicity of both agents may be increased.

Lithium Serum lithium levels may be increased. Methotrexate Increased methotrexate levels. Salicylates Additive GI toxicity.

Adverse Reactions
Cardiovascular
Edema; weight gain; CHF; altered BP; palpitations; chest pain; bradycardia; tachycardia.

CNS
Headache; vertigo; drowsiness; dizziness; insomnia.

Dermatologic
Rash; urticaria; purpura.

EENT
Blurred vision; tinnitus; salivation; glossitis.

GI
Diarrhea; dry mouth; vomiting; abdominal pain; dyspepsia; GI bleeding; nausea; constipation; flatulence.

Genitourinary
Hematuria; proteinuria; dysuria; renal failure.

Hematologic
Decreased hematocrit; bleeding; neutropenia; leukopenia; pancytopenia; eosinophilia; thrombocytopenia.

Hepatic
Mild elevations in LFT results.

Respiratory
Bronchospasm; laryngeal edema; rhinitis; dyspnea; pharyngitis; hemoptysis; shortness of breath.

Miscellaneous
Autoimmune hemolytic anemia may occur if used long term.

Precautions
Pregnancy
Category C .

Lactation
Undetermined.

Children
Not recommended for children younger than 14 yr of age.

Elderly
Increased risk of adverse reactions.

Hypersensitivity
May occur; use with caution in aspirin-sensitive individuals because of possible cross sensitivity.

Renal Function
Acute renal insufficiency, interstitial nephritis, hyperkalemia, hyponatremia, and renal papillary necrosis may occur. Lower doses may be necessary in patients with renal function impairment.

Diarrhea
If diarrhea occurs, reduce dosage or temporarily discontinue.

GI toxicity
Bleeding, ulceration, or perforation can occur at any time, with or without warning symptoms.

Rash
Promptly discontinue if rash develops.

Overdosage
Symptoms
Acute renal failure, coma, grand mal seizures, muscle twitching, status epilepticus.

Patient Information

Inform patient not to use drug for longer than 1 wk. If given for dysmenorrhea, instruct patient to begin taking drug with onset of bleeding and associated symptoms. Warn patient about potential for bleeding, and advise patient to notify other health care professionals that drug is being taken. Advise patient to discontinue medication if rash develops and to contact health care provider. Instruct patient to report the following symptoms to health care provider: rash, visual problems, dark stools, decreased urinary output, persistent headache or stomach pain and unusual bruising or bleeding. Advise patient to avoid intake of alcoholic beverages. Instruct patient that drug may cause drowsiness and to use caution while driving or performing other activities requiring mental alertness. Caution patient to avoid prolonged exposure to sunlight and to use sunscreen or wear protective clothing to avoid photosensitivity reaction. Instruct patient not to take OTC medications, including aspirin and ibuprofen or other prescription drugs, without consulting health care provider.