MEFEN

Composition: 
    Capsules    Coated Tablets    Oral Suspension
Mefenamic Acid    250mg/ Cap.    500mg/ C. T.    50mg/ 5ml

Properties:
-    Mefenamic acid is a Non Steroidal Anti Inflammatory drug (NSAID).
-    Mefenamic acid inhibits prostaglandin synthesis. 
-    Mefenamic acid is used as an analgesic, with an anti inflammatory and demonstrable anti pyretic effects.

Indications:
-    Mefen is indicated for the relief of mild to moderate pain including muscular, traumatic and dental pain, headache of most aetiology, post-operative and post-partum pain. 
-    Mefen is indicated for the relief of mild to moderate pain in rheumatoid arthritis (including still’s Disease) and osteoarthrosis.
-    Mefen is indicated for primary dysmenorrhoea.

Contraindications:
-    Mefen is contra-indicated in patients with known hypersensitivity to Mefenamic acid or any of the other NSAIDs.
-    Mefen is contra-indicated in inflammatory bowel disease and in patients suffering from peptic and/or intestinal ulceration.
-    Mefen is contra-indicated in patients with severe renal impairment.

Side effects:
-    The most common side effects are gastro-intestinal disturbances including: abdominal pain, nausea, vomiting, diarrhoea which may occur soon after starting treatment, or after several months of continuous use.
•    The  diarrhoea has been more observed in patients suffering from proctocolitis. 
•    If server diarrhoea does develop, the drug should be stopped immediately and this patient should not receive it again.
-    Skin rashes have been observed in some patients following the administration of Mefen and that case requirs the immediate withdrawn of the drug.
-    Hypotension.
-    Central nervous disturbances such as: headache, blurred vision, fatigue, and dizziness.

Warnings:
-    Peptic ulceration and mild gastro-intestinal bleeding have also been reported in some cases, so Mefen must be used with caution in those with a prior history of ulcer disease. 
-    In rare cases an impairment of hematopoiesis has occured: temporary lowering of the white blood cells count has been reported, in few cases a reversible haemolytic anemia has occurred. Blood studies should therefore  be carried out during long term treatment.
-    Caution must be taken in those showing hypersensitivity reactions to Aspirin and other NSAIDs such as bronchospasm (in asthma patients).
-    Caution must be taken in patients with: fluid retention, edema, heart failure, hypertension, and renal or hepatic dysfunctions.
-    In dysmenorrhoea lack of response the physician should be alert to investigate other causes.

Precautions:
-    Pregnancy: Safety in pregnancy has not been assured yet. It must be avoided particularly in the last trimester of pregnancy (class C).
-    Nursing mothers: Trace amounts of Mefen may be present in breast milk and transmitted to the nursing infant. Because of the potential for serious adverse reactions in nursing infants from Mefen, a decision should be made whethere to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
-    Children: It was not assured yet the effectiveness and safety of this drug in children.  

Drug–Interactions: 
-    Using Mefen may increase the effect of anticoagulants (danger of bleeding), the dose of the anticoagulant may need to be reduced.
-    When given concomitantly with diuretics (Furosemide-Thiazides) patient should be observed closely for renal failure.
-    Mefen has produced an elevation of plasma lithium levels.
Overdosage:
-    Mefen overdose has a toxic effect on the Central Nervous System CSN which appears as drowsiness, somnolence, epigastric pain, and gastro-intestinal bleeding, it even may lead to a coma.
-    Gastric lavage in conscious patient and intensive supportive therapy are necessary.   
-    Activated charcoal has been shown to be a powerful adsorbent for Mefenamic acid and its metabolites.

Dosage:     
-    Mefen should be taken during or after meals to avoid gastric irritation.
-    This medication should not be used more  than one week.
-    Adults:    Pain treatment: the initial dose 500mg Mefenamic acid followed by 250 mg each 6 hours.
Primary dysmenorrhoea treatment: the initial dose 500mg Mefenamic acid followed by 250mg each 6 hours.
-    Children:    6 months-1 year:    5 ml

    2-4 years:    10 ml       The dose may be repeated as necessary, up to three times daily. 
    5-8 years:    15 ml    
    9-12 years:    20 ml    

Presentation: 
-    Mefen Capsules:    Box contains 20 Capsules.
-    Mefen Coated Tablets:    Box contains 20 Coated Tablets.
-    Mefen Oral Suspension:    Bottle contains 100 ml oral suspension.