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Mefenamic Acid – Overview

Mefenamic acid is a medication sometimes prescribed to people who need relief from mild pain, including menstrual pain. People who might need a mefenamic acid prescription can use Push Health to connect with a local medical provider who can prescribe mefenamic acid medication, including mefenamic acid 500 mg and mefenamic acid 250 mg tablets, when appropriate to do so.

Mefenamic Acid – Dosage and Cost

Mefenamic acid is sometimes marketed under the brand Ponstel and, like celecoxib (Celebrex), ibuprofen (Motrin), meloxicam (Mobic) and naproxen (Naprosyn), belongs to a class of medications known as nonsteroidal anti-inflammatory drugs (NSAIDs). Mefenamic acid can help bring relief from mild to moderate pain, including menstrual pain, and potentially other pain syndromes. It is not entirely clear how mefenamic acid exerts its actions but it may involve modulation of prostaglandins in the body. Mefenamic acid is sometimes prescribed with a loading dose of mefenamic acid 500 mg followed by mefenamic acid 250 mg at various times during the day, depending on the health needs of the patient. Mefenamic acid tablets are moderately affordable, costing approximately $4 per mefenamic acid tablet at many pharmacies in the United States. Mefenamic acid coupons may help reduce the cost of a mefenamic acid prescription and some insurance plans may help with costs associated with a mefenamic acid prescription.

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Can I Buy Mefenamic Acid Online?

Mefenamic acid requires a prescription to be obtained at a pharmacy in the United States. Due to this restriction, mefenamic acid OTC is not available and it is not possible to just buy mefenamic acid online as the initial step is getting a mefenamic acid prescription from a licensed medical provider. People who might need a mefenamic acid prescription, however, can connect with a licensed provider through Push Health who can prescribe mefenamic acid medication, including mefenamic acid 500 mg and mefenamic acid 250 mg tablets, when appropriate to do so.

Mefenamic Acid – Side Effects

Mefenamic acid prescription medication can cause side effects such as nausea, abdominal discomfort, vomiting and fatigue. People with a history of liver problems should generally avoid using mefenamic acid medication. Mefenamic acid can cause kidney dysfunction, particularly when used excessively. Prior to using mefenamic acid tablets, questions and concerns should be discussed with a pharmacist and qualified medical provider. Mefenamic acid and alcohol should generally not be used together. People with an allergy to mefenamic acid or similar medications should avoid using mefenamic acid prescription medication.

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More Mefenamic Acid Information

• Mefenamic Acid – Medline

Last updated March 21, 2022. Given the evolving nature of medicine and science, this information might not be accurate and should not be construed as medical advice or diagnosis / treatment recommendations. Please consult a licensed medical provider if you have additional questions. Please call 911 immediately or go to the nearest emergency room if you believe you are experiencing a medical emergency.

Mefenamic acid-Darnitsa tablets 500 mg No. 20

Mefenamic acid-Darnitsa tablets 500 mg No.

20

Composition

active substance: mefenamic acid;

1 tablet contains mefenamic acid 500 mg;

excipients: potato starch, methylcellulose, croscarmellose sodium, stearic acid, magnesium stearate.

Dosage form

Tablets.

Basic physical and chemical properties: grayish-white tablets with a slightly yellowish or greenish tinge, flat-cylindrical shape, with a chamfer and a risk, marbling is allowed.

Pharmacotherapeutic group

Nonsteroidal anti-inflammatory and antirheumatic drugs. Fenamates. ATX code M01A G01.

Pharmacological properties

Pharmacodynamics.

Mefenamic acid is a non-steroidal anti-inflammatory drug. The mechanism of anti-inflammatory action is due to the ability to inhibit the synthesis of inflammatory mediators (prostaglandins, serotonin, kinins, etc.), to reduce the activity of lysosomal enzymes that are involved in the inflammatory response. Mefenamic acid stabilizes protein ultrastructures and cell membranes, reduces vascular permeability, disrupts the processes of oxidative phosphorylation, inhibits the synthesis of mucopolysaccharides, inhibits cell proliferation in the focus of inflammation, increases cell resistance and stimulates wound healing. Antipyretic properties are associated with the ability to inhibit the synthesis of prostaglandins and influence the center of thermoregulation.

Mefenamic acid stimulates the formation of interferon.

In the mechanism of analgesic action, along with the influence on the central mechanisms of pain sensitivity, a significant role is played by the local influence on the focus of inflammation and the ability to inhibit the formation of algogens (kinins, histamine, serotonin).

Pharmacokinetics.

After oral administration, mefenamic acid is rapidly and fairly completely absorbed from the gastrointestinal tract. The maximum concentration in the blood is observed 2 to 4 hours after ingestion. The blood level is proportional to the dose. The equilibrium concentration (20 μg / ml) is determined on the 2nd day of use (1 g 4 times a day). Contacts on 90% with blood albumin. In the liver, it forms metabolites by oxidation, hydrolysis, and glucuronidation. The half-life (T1 / 2) is 2 – 4 hours. Excreted from the body unchanged and in the form of metabolites mainly by the kidneys (67% of the dose), with feces (20-25%).

Indications

Acute respiratory viral infections and influenza.

Pain of low and moderate intensity: muscle, joint, traumatic, dental, headache of various etiologies, postoperative and postpartum pain.

Primary dysmenorrhea. Dysfunctional menorrhagia, including those caused by the presence of intrauterine contraceptives, in the absence of pathology of the pelvic organs.

Inflammatory diseases of the musculoskeletal system: rheumatoid arthritis, rheumatism, ankylosing spondylitis.

Contraindications

Hypersensitivity to the components of the drug. Bronchospasm, Quincke’s edema, rhinitis, bronchial asthma or a history of urticaria that occurred after the use of acetylsalicylic acid or other non-steroidal anti-inflammatory drugs (NSAIDs). Simultaneous administration of specific COX-2 inhibitors. Peptic ulcer of the stomach and duodenum, including a history, inflammatory bowel disease, diseases of the hematopoietic organs, severe heart failure, severe liver or kidney dysfunction, gastrointestinal bleeding or perforation caused by the use of non-steroidal anti-inflammatory drugs.

Interaction with other drugs and other forms of interaction.

Thiamine, pyridoxine hydrochloride, barbiturates, phenothiazine derivatives, narcotic analgesics, caffeine, diphenhydramine increase the analgesic effect of the drug.
The combined use of mefenamic acid and methotrexate increases the toxic effects of methotrexate.

Antihypertensive agents (ACE inhibitors and angiotensin II receptor antagonists): decreased antihypertensive effect, increased risk of renal failure, especially in elderly patients. Patients should drink enough fluids. It is also necessary to evaluate renal function at the beginning of treatment and during concomitant therapy.

Diuretics: reduction of the diuretic effect. Diuretics may increase the nephrotoxicity of NSAIDs.

Cardiac glycosides: NSAIDs may exacerbate heart failure, reduce glomerular filtration rate and increase plasma levels of cardiac glycosides.
Cyclosporine: increased risk of nephrotoxicity.

Mifepristone: NSAIDs should not be taken within 8 to 12 days after taking mifepristone – NSAIDs may reduce the effect of mifepristone.

Corticosteroids: increased risk of gastrointestinal ulcers and bleeding.

Antiplatelet agents and selective serotonin reuptake inhibitors: increased risk of gastrointestinal bleeding.

Fluoroquinolones: NSAIDs increase the risk of seizures.

Aminoglycosides: NSAIDs increase the risk of nephrotoxicity.

Tacrolimus: possible increased risk of nephrotoxicity.

Zidovudine: NSAIDs increase the risk of hematological toxicity. There is an increased risk of joint hemorrhage and hematoma in HIV-positive hemophiliacs who are concomitantly treated with zidovudine.

Lithium preparations: decreased excretion of lithium and increased risk of lithium toxicity.
Mefenamic acid increases the activity of oral anticoagulants, so their simultaneous use increases the risk of bleeding. The simultaneous use of mefenamic acid with oral anticoagulants requires careful monitoring of prothrombin time. NSAIDs with warfarin or heparin should be used with extreme caution – medical supervision is necessary.

Simultaneous use with other non-steroidal anti-inflammatory drugs increases the anti-inflammatory effect and the likelihood of side effects from the gastrointestinal tract.

Application features

The drug is prescribed with caution to patients with acute cardiovascular insufficiency, arterial hypertension, coronary heart disease.

The drug is prescribed with caution in patients with epilepsy.

Do not use mefenamic acid in patients with a history of hypersensitivity reactions such as asthma, bronchospasm, rhinitis, angioedema or urticaria.

Do not use in dehydrated patients who have lost fluid due to vomiting, diarrhea or increased urination.

In case of long-term treatment of headache, consult your doctor.

There are no special recommendations for the use of the drug in moderate impairment of liver or kidney function.

NSAIDs should be used with caution in patients with a history of gastrointestinal disease (ulcerative colitis, Crohn’s disease), as exacerbation of the disease is possible. If the use of mefenamic acid has led to gastrointestinal bleeding and perforation, treatment should be discontinued.

Elderly patients generally have an increased risk of gastrointestinal side effects, especially gastrointestinal bleeding and perforation, which can be fatal, so treatment should be initiated at the lowest dosage.

Patients with systemic lupus erythematosus and mixed connective tissue diseases are at increased risk of aseptic meningitis.

Mefenamic acid should be used with caution in patients at high risk of serious skin reactions, including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis. Mefenamic acid should be discontinued at the first appearance of a skin rash, mucosal injury, or any other sign of hypersensitivity.

With prolonged use of the drug, it is necessary to monitor blood parameters, since mefenamic acid can cause pathological changes in the blood. If manifestations of any dyscrasia occur, it is necessary to stop therapy with the drug.

Mefenamic acid may cause gastrointestinal disturbances (eg diarrhoea). They can occur both immediately after the use of the drug, and after prolonged use. If such symptoms occur, the drug should be discontinued.

Caution should be exercised when using mefenamic acid in patients receiving therapy with drugs that increase the risk of bleeding: corticosteroids, anticoagulants (warfarin) and aspirin.

Mefenamic acid may interfere with female fertility and is not recommended for women who are trying to become pregnant. When used by women with symptoms of dysmenorrhea and menorrhagia and the absence of a therapeutic effect, you should consult a doctor.

Use during pregnancy or lactation.

The drug is not used by women during pregnancy or lactation.

The ability to influence the rate of reactions when driving vehicles or operating other mechanisms.

Caution should be exercised when driving vehicles or working with mechanisms that require increased attention, as sometimes the use of the drug can cause drowsiness, blurred vision, convulsions.

Route of administration and doses

Use of the drug should be under the supervision of a physician, who determines the dose and duration of treatment. Apply inside. The drug should be taken after meals with milk.

Adults and children over 12 years old: 250-500 mg 3-4 times daily. According to the indications and with good tolerance, the daily dose is increased to a maximum of 3000 mg, after achieving a therapeutic effect, the dose is reduced to 1000 mg / day.

Children aged 5 to 12 years, 250 mg 3 to 4 times a day.

The course of treatment for diseases of the joints can last from 20 days to 2 months or more. In the treatment of pain syndrome, the course of treatment lasts up to 7 days.

Children.

The drug is contraindicated in children under 5 years of age.

Overdose

Symptoms: epigastric pain, nausea, vomiting, drowsiness. In severe cases – gastrointestinal bleeding, respiratory depression, arterial hypertension, twitching of certain muscle groups, coma.

Treatment. There is no specific antidote. Gastric lavage with activated charcoal suspension. Alkalinization of urine, forced diuresis. Symptomatic therapy. Hemosorption and hemodialysis are ineffective due to the strong binding of mefenamic acid to blood proteins.

Adverse reactions

On the part of the organs of vision: blurred vision, reversible loss of the ability to distinguish colors, eye irritation.

From the hearing organs and vestibular apparatus: ringing in the ears, otalgia.

On the part of the respiratory system, chest organs and mediastinum: dyspnea, bronchospasm.

From the gastrointestinal tract: pain in the epigastric region, anorexia, heartburn, nausea, flatulence, vomiting, enterocolitis, colitis, exacerbation of colitis and Crohn’s disease, gastritis, hepatotoxicity, steatorrhea, cholestatic jaundice, hepatitis, pancreatitis, hepatorenal syndrome, hemorrhagic gastritis, peptic ulcer with or without bleeding. Gastrointestinal bleeding, perforation or gastrointestinal bleeding, sometimes fatal, especially in elderly patients, dyspepsia, constipation, diarrhea.

From the side of the kidneys and urinary system: dysuria, cystitis. Renal dysfunction, albuminuria, hematuria, oliguria or polyuria, renal failure, including papillary necrosis, acute interstitial nephritis, nephrotic syndrome, allergic glomerulonephritis, hyponatremia, hyperkalemia.

From the nervous system: drowsiness or insomnia, weakness, irritability, agitation, headache, blurred vision, convulsions, optic neuritis, paresthesia, dizziness, stiff neck, fever, disorientation. On the part of the psyche: confusion, depression, hallucinations.

From the side of the cardiovascular system: arterial hypertension, arrhythmia, rarely – congestive heart failure, peripheral edema, syncope, arterial hypotension, palpitations, shortness of breath, thrombotic complications (for example, myocardial infarction or stroke).

On the part of the blood and lymphatic system: aplastic anemia, autoimmune hemolytic anemia, prolongation of bleeding time, eosinophilia, leukopenia, thrombocytopenia, decreased hematocrit, thrombocytopenic purpura, agranulocytosis, neutropenia, pancytopenia, bone marrow hypoplasia.

From the immune system: hypersensitivity reactions, including skin rashes, pruritus, facial edema, allergic rhinitis, angioedema, laryngeal edema, Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme, urticaria, bullous pemphigus, photosensitivity, asthma, anaphylaxis.

From the side of the skin and subcutaneous tissue: purpura, skin rashes, pruritus, erythema multiforme, urticaria, bullous pemphigus.

Laboratory indicators: impaired glucose tolerance in patients with diabetes mellitus, a positive reaction in some tests for the presence of mefenamic acid and its metabolites in bile and urine. Increased levels of liver enzymes in blood plasma.

Others: aseptic meningitis, sweating, fatigue, malaise, multiple organ failure, hyperthermia.

Shelf life

2 years.

Storage conditions

Keep out of the reach of children in the original packaging at a temperature not exceeding 25 °C.

Packaging

10 tablets in a blister pack; 2 blisters in a pack.

Dispensing category

Without a prescription.

Producer

PrJSC “Pharmaceutical firm “Darnitsa”.

Manufacturer’s location and address of the place of business.

Ukraine, 02093, Kyiv, st. Borispolskaya, 13.

Antipyretic drugs for children and adults – features of choice and administration

In our latitudes, the flu season, SARS and acute respiratory infections are about to begin. All these diseases are usually accompanied by fever. What drugs and what category of patients can be recommended? And does this pandemic season have its own characteristics?

COVID-19 is spreading rapidly. Virologist Nadezhda Zholobak told us in more detail about him earlier. It is known that the SARS-CoV-2 virus, which caused the pandemic, turned out to be so unpredictable that it made even the simplest, long-proven and time-tested medical technologies questionable. Even routine prescriptions for symptomatic treatment, such as temperature reduction, for example, need to be adjusted to the specifics of the current situation.

How can a pharmacist influence the choice of drug for fever reduction today?

“First of all, pharmacists and pharmacists can play a significant role in increasing people’s commitment to vaccination,” notes Natalia Peshkova, a physician of the highest category. – I mean not only anti-influenza vaccines, but also those included in the National Calendar. Already, there are reports that some countries may face a twindemic problem – seasonal flu + COVID-19Unfortunately, one does not interfere with the other. In all previous years, less than 1% of the population was vaccinated against the flu, perhaps now the situation will change. In addition, the pharmacist/pharmacist may be faced with the need to differentiate between acute respiratory disease, influenza, coronavirus infection. With the latter, of course, it is more difficult, since it can be asymptomatic. Today, almost the only pathognomonic symptoms of a mild course of coronavirus are hyposmia or, more often, anosmia (complete loss of smell) and taste inversion. Therefore, if such complaints are made to the pharmacist, it is necessary, according to the current Protocol, to refer the person to a doctor to clarify the cause of such a condition and exclude/confirm coronavirus. The temperature in this case may be within the normal range or slightly elevated. But in the case of other infections, including SARS, acute respiratory infections, and especially influenza, the fever is quite high. But the patient should always be reminded that a fever of less than 38°C does not require treatment for all patients except those at high risk of severe underlying pathology.

In addition, the pharmacist, of course, should remind about age dosages, the peculiarities of taking the drug and the need to consult a doctor in case of any adverse reactions.

What temperature is considered normal and why is its increase a marker of normal immunity?

It is probably worth reminding that an increase in body temperature is an adequate response of the body to an infection (almost all acute infectious diseases are accompanied by it), inflammation, trauma, hormonal imbalance and stress. But besides being a signal, it is also a defense mechanism capable of:

• slow down the growth or kill pathogens;
• stimulate the immune system to produce substances to protect the body from infection (interferon, antibodies, etc.), increase the phagocytic activity of blood leukocytes;
• activate metabolic processes, thereby preventing intoxication.

It is important to remember that not only the infectious process can cause fever. For example, it could be a stroke!

So fever is good news, as it is a normal response of the immune system. In people with a weakened immune system, as a rule, the temperature is not understood above 37.2 – 37.5 ° C.

Without delving into the issues of gender, age and other differences in thermoregulation, let me remind you that the normal temperature is considered to be from 35.5 to 37.2 °C with an average daily fluctuation of 0.5 to 1.0 °C.

Methods for measuring temperature

By the way, when a pharmacist dispenses a thermometer to a visitor, you need to be reminded of the features of electronic and traditional mercury thermometers and how the temperature depends on the place of measurement:

• rectally (in the anus), vagina or ear – 37. 5 °C
• oral (in the mouth) – 37.0 °C
• axillary (in the armpit) – 36.6 °C.

There are other specific features of temperature measurement, for example, in the first week after childbirth, while lactation is established, women sometimes measure the temperature in the elbow bend, since it will not be objective in the armpit (more often, about 38 ° C).

How to measure temperature

As for the device for measuring temperature, the mercury thermometer is considered the most accurate. It is no coincidence that it is also used to control other devices – electronic and infrared thermometers. In addition, it is easy to disinfect, which is important.

On the other hand, electronic thermometers (including those with a soft tip) have the great advantage of being safe to use.

At what temperature are antipyretics needed?

In most cases, if the temperature is below 38.5°C, do not rush to bring it down. As mentioned earlier, fever in viral diseases is rather a blessing than a problem that needs to be eliminated. The whole question is how a person carries it. After all, pyrogens provoke a number of changes in the body – from vasospasm, heart palpitations, increased blood pressure to an increase in the level of glucose and lactic acid in the blood. Therefore, we all tolerate a rise in temperature in different ways: someone can do without medical interventions at a temperature of 38.5 ° C and even 39.5°C. With one caveat – if this is an adult without concomitant pathology: neurological, cardiovascular diseases and so on. In this case, in the first two days, bed rest and plenty of fluids are enough. But, if the temperature remains high for more than 3 days, you can not do without antipyretic drugs.

In some cases, already at a temperature above 38°C, it is necessary to use antipyretic drugs in order not to provoke decompensation of the underlying disease. And in people with a weakened immune system, in particular, in elderly people , against the background of high temperature, complications can develop in the form of oxygen starvation, respiratory, heart failure, the functions of the liver, kidneys and nervous system are impaired.

Children , due to the risk of febrile convulsions, are recommended to bring down the temperature above 38.5 ° C with antipyretic drugs. It is important to recall that acetylsalicylic acid is categorically contraindicated for children! Its use is associated with the risk of developing a severe pathology – Reye’s syndrome (acute liver failure or “White liver disease”). Therefore, whatever the cause of the fever – influenza, measles or chickenpox, all drugs containing acetylsalicylic acid should be excluded! In addition, it should be recalled what side effects acetylsalicylic acid has.

For the treatment of fever during pregnancy, there are recommendations, – recalls the candidate of medical sciences, gynecologist-endocrinologist of the highest category Natalia Silina. – During this period, the woman’s immunity is depressed, so the risk of infection increases, and the reaction to infection can be very fast – within a few hours after meeting with the virus, and the temperature can rise to 40 ° C. The course of the disease and its consequences for the fetus depend on the trimester. Taking into account the trimester, preparations for the treatment of the expectant mother are also selected. But the doctor who leads her pregnancy should deal with the treatment of such a patient. Usually, therapy differs little from that for other adults, and, most likely, just like other patients, the doctor will advise pregnant women not to rush to bring down fever to 38 ° C with antipyretic drugs. The mark of 38.5 ° C is the threshold for lowering the temperature in pregnant women.

What antipyretic drugs are used today, taking into account the COVID-19 pandemic

Antipyretic drugs in Ukraine are drugs that can be purchased at a pharmacy without a prescription. They are represented by two groups of drugs:

• analgesics-antipyretics (paracetamol and metamizole sodium). These drugs have antipyretic and analgesic effects.
• non-steroidal anti-inflammatory drugs (acetylsalicylic acid, ibuprofen, naproxen, ketoprofen, mefenamic acid and a number of combination drugs). In addition to antipyretic and analgesic action, they have a pronounced anti-inflammatory effect.

Combined preparations are used for the symptomatic treatment of acute respiratory viral infections. They usually include paracetamol, levocetirizine hydrochloride, the sweetener erythritol (for patients with diabetes or being overweight), phenylephrine (a decongestant to eliminate the symptoms of rhinorrhea, headache, etc.).

To reduce fever in children WHO recommends 2 drugs: paracetamol (from 1 month) and ibuprofen (from 3 months).

• Ibuprofen – in a single dose of 5-10 mg/kg. The maximum daily dose is 1.2 g (1200 mg).