Indications

Pain and inflammation. Mild to moderate pain and fever.

Contraindication

Hypersensitivity to mefenamic acid, aspirin or other NSAIDs. Patient w/ inflammatory bowel disease, active ulceration or chronic inflammation of the upper or lower GI tract, renal failure. History of asthma, urticaria, allergic-type reactions. Treatment of perioperative pain in the setting of CABG surgery.

Special Precautions

Patient w/ known CV disease or risk factors for CV disease, history of GI bleeding or peptic ulceration, fluid retention or heart failure. Renal and hepatic impairment. Pregnancy and lactation. Patient Counselling May impair ability to drive or operate machinery. Monitoring Parameters Monitor CBC, chemistry profile, hepatic and renal function during long-term therapy. BP should be monitored closely during initiation and throughout therapy. Patient w/ chronic alcoholism, known G6PD deficiency, severe hypovolaemia, chronic malnutrition. Renal and hepatic impairment. Pregnancy and lactation. Monitoring Parameters Monitor serum paracetamol levels esp when acute overdosage is suspected and w/ long-term use.

Side Effects

CHF, HTN, tachycardia, syncope, arrhythmia, vasculitis, hypotension, palpitations; abdominal pain, vomiting, dyspepsia, constipation, diarrhoea, nausea, heartburn, GI perforation, peptic ulcer, flatulence; decrease in haematocrit, thrombocytopenia, haemolytic anaemia, aplastic anaemia, agranulocytosis, leucopenia, eosinophilia; headache, dizziness, nervousness, drowsiness, insomnia, nervousness, anxiety, confusion, tremors, vertigo; blurred vision, conjunctivitis, tinnitus, hearing impairment; abnormal renal function, oedema, proteinuria, cystitis; elevated LFTs, urticaria, rash, pruritus, alopecia, perspiration, photosensitivity, resp depression, pneumonia, fever, infection.Thrombocytopenia, leucopenia, pancytopenia, neutropenia, agranulocytosis, pain and burning sensation at inj site. Rarely, hypotension and tachycardia.

Drug Interactions

Concomitant use w/ CYP2C9 isoenzyme inhibitors may alter safety and efficacy of mefenamic acid. May enhance methotrexate toxicity. Reduced BP response to ACE inhibitors or angiotensin II receptor antagonists. Increased risk of serious GI events w/ aspirin. May reduce the natriuretic effects of furosemide or thiazide diuretics. Reduced renal lithium clearance and elevated plasma lithium levels. May enhance anticoagulant effect of warfarin.May reduce serum levels w/ anticonvulsants (e.g. phenytoin, barbiturates, carbamazepine). May enhance the anticoagulant effect of warfarin and other coumarins w/ prolonged use. Accelerated absorption w/ metoclopramide and domperidone. May increase serum levels w/ probenecid. May increase serum levels of chloramphenicol. May reduce absorption w/ colestyramine w/in 1 hr of admin. May cause severe hypothermia w/ phenothiazine.

Route of Administration

Oral

Dosage

As directed by the physician