Indications/Uses
Listed in Dosage.
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Dosage/Direction for Use
Adult: PO Mild to moderate pain; Postoperative pain; Pain and inflammation associated with musculoskeletal and joint disorders; Rheumatoid arthritis; Osteoarthritis; Dental pain; Headache; Primary dysmenorrhoea; Menorrhagia 500 mg tid.
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Administration
Should be taken with food.
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Contraindications
Hypersensitivity. Patients with active or history of recurrent peptic ulcer/haemorrhage, history of gastrointestinal bleeding or perforation (related to previous NSAID therapy), inflammatory bowel disease, severe heart failure, history of asthma, bronchospasm, rhinitis, angioedema, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. Treatment of peri-operative pain in the setting of CABG surgery. Renal (CrCl <30 mL/min) and severe hepatic impairment. Pregnancy (3rd trimester).
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Special Precautions
Patient with risk factors for CV events (e.g. hypertension, hyperlipidaemia, diabetes mellitus, smoking), mild to moderate heart failure, hypovolaemia, dehydration. Debilitated patient. Renal and hepatic impairment. Elderly. Pregnancy (1st-2nd trimester) and lactation. Patient Counselling This drug may cause dizziness, drowsiness, and visual disturbances, if affected, do not drive or operate machinery. Monitoring Parameters Monitor CBC, chemistry profile, occult blood loss, renal and liver function. Blood pressure should be monitored during initiation of treatment and throughout the course of therapy.
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Adverse Reactions
Significant: Anaphylactoid reactions, fluid retention, anaemia, hyperkalaemia.
Blood and lymphatic system disorders: Eosinophilia, leukopenia, thrombocytopenia, purpura, agranulocytosis.
Cardiac disorders: Dyspnoea.
Ear and labyrinth disorders: Tinnitus.
Gastrointestinal disorders: Diarrhoea, nausea, vomiting, abdominal pain, flatulence, constipation, dyspepsia, heartburn, gastritis.
Hepatobiliary disorders: Hepatitis, jaundice.
Investigations: Increased liver enzymes.
Nervous system disorders: Aseptic meningitis, headache.
Psychiatric disorders: Nervousness, insomnia, confusion, depression.
Renal and urinary disorders: Dysuria, cystitis.
Reproductive system and breast disorders: Haematuria.
Respiratory, thoracic and mediastinal disorders: Asthma.
Skin and subcutaneous tissue disorders: Pruritus, urticaria, rash, erythema multiforme.
Vascular disorders: Hypertension.
Potentially Fatal: CV thrombotic events including MI and stroke, gastrointestinal inflammation, bleeding, ulceration, perforation. Rarely, exfoliative dermatitis, toxic epidermal necrolysis, Stevens-Johnson syndrome, fulminant hepatitis, liver necrosis, hepatic failure. |
ROUTE(S) : PO: C
ROUTE(S) : PO: D
Avoid during 3rd trimester or near delivery.
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Drug Interactions
May increase the risk of bleeding with other NSAIDs or salicylates (e.g. aspirin), anticoagulants (e.g. warfarin), corticosteroids, SSRI. Increased the risk of nephrotoxicity of ciclosporin or tacrolimus. May decrease efficacy of antihypertensive agents (e.g. ACE inhibitors, angiotensin II antagonists, β-blockers). Decreased natriuretic effect of diuretics (e.g. furosemide, hydrochlorothiazide). Increased plasma levels and reduced renal clearance of lithium. Increased serum concentration of digoxin and methotrexate.
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ATC Classification
M01AG01 - mefenamic acid ; Belongs to the class of non-steroidal antiinflammatory and antirheumatic products, fenamates.
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