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Mefenamic Acid: Indications

The analgesic efficacy of mefenamic acid is documented for inflammatory and non-inflammatory pain. Its
use for acute pain is well known: pain after dental interventions or after traumas are significantly reduced
with mefenamic acid. Mefenamic acid is one of the drugs of choice for dysmenorrhea (alongside with
fenamaten, ibuprofen and naproxen). The drug can also help reduce blood loss caused by
meno/metrorrhagias and it can reduce pain caused by premenstrual syndrome. Whether mefenamic acid
should be used for other acute pain or fever is controversial as there are other better tolerated analgesics
(e.g. paracetamol).
The efficacy of mefenamic acid against chronic rheumatic pain (arthrosis, polyarthritis) has also been
demonstrated. However, the drug is not as thoroughly researched for these indications as many other
non-steroidal anti-inflammatory agents. Because of its relatively short half-life, the drug must be taken
three times daily which can cause problems with chronic ailments. Most likely with respect to its adverse
reactions, the recommendation in the USA is to not use mefenamic acid for longer than a week.

Mechanism of action[edit]
Like other members of the anthranilic acid derivatives (or fenamate) class of NSAID drugs, it inhibits
both isoforms of COX and prevents formation of prostaglandins.[3][8]

Side effects


Known mild side effects of mefenamic acid include

headaches,nervousness and vomiting. Serious side effects may include diarrhea,
hematemesis (vomiting blood), haematuria (blood in urine), blurred vision, skin
rash, itching and swelling, sore throat and fever.
CNS: Drowsiness, insomnia, dizziness, nervousness, confusion,
headache. GI: Severe diarrhea, ulceration, and bleeding; nausea,
vomiting, abdominal cramps, flatus, constipation, hepatic
toxicity. Hematologic:Prolonged prothrombin time, severe autoimmune hemolytic
anemia (long-term use), leukopenia, eosinophilia, agranulocytosis,
thrombocytopenic purpura, megaloblastic anemia, pancytopenia, bone marrow
hypoplasia.Urogenital: Nephrotoxicity, dysuria, albuminuria, hematuria, elevation of
BUN. Skin: Urticaria, rash, facial edema. Special Senses: Eye irritation, loss of color
vision (reversible), blurred vision, ear pain. Body as a
Whole: Perspiration. CV: Palpitation. Respiratory: Dyspnea; acute exacerbation of
asthma; bronchoconstriction (in patients sensitive to aspirin).
Nursing responsibilities

Nursing Implications
Assessment & Drug Effects

Assess patients who develop severe diarrhea and vomiting for dehydration
and electrolyte imbalance.

Lab tests: With long-term therapy (not recommended) obtain periodic

complete blood counts, Hct and Hgb, and kidney function tests.

Patient & Family Education

Discontinue drug promptly if diarrhea, dark stools, hematemesis,

ecchymoses, epistaxis, or rash occur and do not use again. Contact

Notify physician if persistent GI discomfort, sore throat, fever, or malaise


Do not drive or engage in potentially hazardous activities until response to

drug is known. It may cause dizziness and drowsiness.

Monitor blood glucose for loss of glycemic control if diabetic.

Do not breast feed while taking this drug without consulting physician.