Mefenamic Acid

Indications
 Oral
Rheumatoid arthritis, Mild to moderate pain, Dental pain, Postoperative pain, Dysmenorrhoea, Osteoarthritis, Menorrhagia
Adult: 250-500 mg tid.
Child: >6 mth: 25 mg/kg daily in divided doses for up to 7 days.
Contraindications
 Inflammatory bowel disease; peptic ulcer; neonates; pregnancy (3rd trimester), lactation. Coronary artery bypass graft surgery, severe renal impairment, severe heart failure.
Warnings / Precautions
 Renal and hepatic impairment, asthma. Monitor blood counts and liver function during long-term therapy. Drowsiness may affect ability to perform skilled tasks. Elderly.
Adverse Reactions
 Abdominal pain, dyspepsia, constipation, diarrhoea, nausea, GI ulcers; oedema; bronchospasm; headache, drowsiness, insomnia, visual disturbances; CHF, hypertension, tachycardia, syncope; urticaria, rash; thrombocytopenia, aplastic anaemia, agranulocytosis; tinnitus; elevated liver enzymes; abnormal renal function.
Potentially Fatal: Autoimmune haemolytic anaemia; convulsions (overdosage).
Drug Interactions
 Enhances activity of oral anticoagulants but rarely significant. Increases risk of GI irritation with alcohol. Increased ciclosporin, lithium toxicity and convulsions reported with ciprofloxacin. Absorption increased by magnesium hydroxide antacids. ACE inhibitor effects may be antagonised.
See Below for More mefenamic acid Drug Interactions
Lab Interactions
 False-positive test for bile in urine.
Mechanism of Actions
 Mefenamic acid inhibits the enzymes cyclooxygenase (COX)-1 and COX-2 and reduces the formation of prostaglandins and leukotrienes. It also acts as an antagonist at prostaglandin receptor sites. It has analgesic and antipyretic properties with minor anti-inflammatory activity.
Absorption: Absorbed from the GIT (oral); peak plasma concentrations after 2-4 hrs.
Distribution: Enters breast milk (small amounts). >90% bound to plasma albumin. Apparent volume of distribution 1.06 l/kg.
Metabolism: Hepatic via enzyme CYP2C9.
Excretion: Urine (52%) as unchanged drug and metabolites; faeces (20%). Elimination half life 2-4 hrs.
Administration
 Should be taken with food.
ATC Classification
 M01AG01 - mefenamic acid ; Belongs to the class of non-steroidal antiinflammatory and antirheumatic products, fenamates.
Available As
  • Mefenamic Acid 100 mg
  • Mefenamic Acid 200 mg
  • Mefenamic Acid 25 mg
  • Mefenamic Acid 250 mg
  • Mefenamic Acid 325 mg
  • Mefenamic Acid 40 mg
  • Mefenamic Acid 50 mg
  • Mefenamic Acid 500 mg

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