mefenamic acid (Ponstel)
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Introduction
Mefenamic acid (Ponstel).
Indications
- short-term relief of mild to moderate pain
- primary dysmenorrhea
- gout[4]
- juvenile rheumatoid arthritis[4]
Dosage
Tabs: 250 mg.
Pharmacokinetics
- 1 g oral dose yields mean plasma concentration of 10 ug/mL
- metabolized to 3'hydroxymethyl & 3'carboxyl metabolites
elimination via liver
1/2life = 3-4 hours
elimination by hemodialysis = -
elimination by peritoneal dialysis = -
Adverse effects
- common (> 10%)
- less common (1-10%)
- uncommon (< 1%)
- congestive heart failure, hypertension, arrhythmia, epistaxis, confusion, hallucinations, aseptic meningitis, depression, peripheral neuropathy, urticaria, erythema multiforme, toxic epidermal necrolysis, Stevens-Johnson syndrome, gastritis, GI ulceration, cystitis, agranulocytosis, anemia, hemolytic anemia, bone marrow suppression, leukopenia, thrombocytopenia, hepatitis, angioedema, allergic rhinitis, toxic amblyopia, blurred vision, conjunctivitis, dry eyes, decreased hearing, polyuria, shortness of breath, polydipsia, tachycardia, hot flashes, drowsiness, insomnia, acute renal failure
Drug interactions
- mefenamate may increase anticoagulant effect of warfarin
- mefenamate decreases clearance & increases toxicity of:
- drug interaction(s) of cholinesterase inhibitors with NSAIDs
- drug interaction(s) of lithium carbonate with NSAIDs
- drug interaction(s) of NSAIDs with oral contraceptive
- drug interaction(s) of NSAIDs with SSRIs
- drug interaction(s) of NSAIDs with antidepressants
- drug interaction(s) of aspirin with NSAIDs
- drug interaction(s) of apixaban with NSAIDs
- drug interaction(s) of warfarin with NSAIDs
- drug interaction(s) of NSAIDs with beta blockers
- drug interaction(s) of NSAIDs with ARBs
- drug interaction(s) of NSAIDs with aldosterone antagonis
- drug interaction(s) of NSAIDs with glucocorticoid
- drug interaction(s) of NSAIDs, diuretics & angiotensin II receptor antagonists
- drug interaction(s) of NSAIDs, diuretics & ACE inhibitors
- drug interaction(s) of NSAIDs with ACE inhibitors
- drug interaction(s) of NSAIDs & antihypertensives
- drug interaction(s) of NSAIDs & loop diuretics
- drug interaction(s) of NSAIDs & aspirin
Test interactions
- may cause false psitive test for urinary bile with diazo tablet test