Major Research Findings

Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) commonly used to relieve pain, particularly menstrual cramps. However, long-term use of mefenamic acid and NSAID-based therapies can lead to various unwanted side effects. 13 highlights the potential for mefenamic acid to cause rare but severe hepatotoxicity, nephrotoxicity, gastrointestinal toxicity, and hypersensitivity reactions. These toxicities are believed to stem from the formation of reactive metabolites. 19 notes that mefenamic acid has demonstrated limited efficacy in closing the ductus arteriosus in premature infants, suggesting potential limitations in its use for this condition. 2 presents a comparative study of mefenamic acid and auriculotherapy, a non-pharmacological pain relief method, for managing primary dysmenorrhea. While both approaches exhibited effectiveness in reducing dysmenorrhea symptoms, the study underscores the need for considering alternative pain management strategies alongside mefenamic acid. 7 compared the effectiveness of mefenamic acid and honey in managing dysmenorrhea pain, revealing that mefenamic acid was more effective. 11 investigated the potential of a mefenamic acid prodrug designed to minimize gastrointestinal toxicity. focuses specifically on the side effects of mefenamic acid in the context of primary dysmenorrhea. 12 compared the efficacy of mefenamic acid with herbal products (fennelin and vitagnus) for dysmenorrhea treatment, concluding that mefenamic acid was more effective. 3 examined the effectiveness and tolerability of mefenamic acid versus celecoxib, another NSAID, in managing dysmenorrhea. The findings demonstrated comparable effectiveness and tolerability between the two drugs. 1 suggests potential vocal cord impact associated with mefenamic acid, but further research is warranted to clarify this finding. 17 investigated a novel mutual prodrug combining mefenamic acid and paracetamol, aiming to reduce ulcerogenic side effects, demonstrating promising results. 10 compared mefenamic acid and Teucrium polium (a herbal remedy) in treating dysmenorrhea, with mefenamic acid exhibiting superior effectiveness. 16 explored the synthesis and analgesic activity of new hydrazide and hydrazine derivatives, aiming to develop alternative analgesics with fewer side effects. 9 compared stretching exercises and mefenamic acid for dysmenorrhea pain relief, indicating that mefenamic acid was more effective. 5 examined the efficacy and safety of a herbal decoction versus mefenamic acid for spasmodic dysmenorrhea, demonstrating the herbal decoction's effectiveness in pain relief and improvement in quality of life. 15 focused on developing a transdermal drug delivery system for mefenamic acid using proniosomes, aiming to enhance delivery while minimizing gastrointestinal side effects. 14 assessed the effectiveness of Dill (Anethum graveolens) compared to mefenamic acid in managing primary dysmenorrhea. 8 delved into the synthesis and evaluation of mefenamic acid derivatives with the goal of developing anti-inflammatory agents with fewer adverse reactions. 6 systematically reviewed the hepatotoxicity of NSAIDs, including mefenamic acid, emphasizing the need for further research on the frequency of these side effects. 18 explored the design, synthesis, and pharmacological evaluation of amide derivatives of mefenamic acid as potential prodrugs to enhance drug effectiveness and minimize gastrointestinal side effects.

Reasons for Side Effects

Mefenamic acid's mechanism of action involves inhibiting the production of prostaglandins, which are substances in the body that cause inflammation and pain. However, prostaglandins also play a protective role in the stomach lining. The inhibition of prostaglandin synthesis by mefenamic acid can lead to damage to the stomach lining and contribute to gastrointestinal side effects. 13

General Side Effects

Gastrointestinal Side Effects

The most commonly observed side effects of mefenamic acid are gastrointestinal in nature. These can include stomach pain, nausea, vomiting, indigestion, diarrhea, constipation, and gastric ulcers. 13 , 11 , 17 , 8

Liver Side Effects

Mefenamic acid may potentially affect the liver, leading to abnormal liver function, jaundice, and hepatitis. 13 , 6

Kidney Side Effects

Kidney complications associated with mefenamic acid use include abnormal kidney function and kidney failure. 13 , 19

Allergic Reactions

Mefenamic acid can trigger allergic reactions characterized by symptoms such as rash, itching, and difficulty breathing. 13

Other

Additional potential side effects of mefenamic acid include dizziness, headache, tinnitus, and vision problems. 1

Countermeasures for Side Effects

Gastrointestinal Side Effects

To mitigate gastrointestinal side effects, it is recommended to take mefenamic acid with food. Antacids can also be helpful in reducing these side effects. 11 , 17 , 8

Liver Side Effects

Regular liver function tests are crucial to monitor for potential liver side effects. 6

Kidney Side Effects

Regular kidney function tests are recommended to detect any kidney-related complications. 19

Allergic Reactions

In the event of an allergic reaction, immediate medical attention is essential. 13

Comparison of Studies

Similarities in Studies

Numerous studies have consistently demonstrated that mefenamic acid is effective in alleviating the symptoms of dysmenorrhea. 2 , 7 , 12 , 3 , 10 , 14

Differences in Studies

While research findings generally support the effectiveness of mefenamic acid in managing dysmenorrhea, there are some variations in specific results. For example, 19 suggests that mefenamic acid may be less effective in closing the ductus arteriosus in premature infants, a finding not replicated in all studies. Similarly, 7 indicates that mefenamic acid is more effective than honey for dysmenorrhea pain relief, a finding that requires further corroboration. These discrepancies in results might be attributed to differences in study populations, methodologies, or other factors.

Cautions for Real-Life Applications

It is crucial to remember that while mefenamic acid can provide relief from pain, such as menstrual cramps, it also carries the risk of side effects on the digestive system, liver, and kidneys. When considering mefenamic acid, it is essential to consult a doctor to determine if it is the appropriate treatment option for your specific needs. It is also crucial to strictly follow the prescribed dosage and instructions for taking mefenamic acid, avoiding self-medication, and never stopping medication or combining it with other drugs without a doctor's guidance. 13 , 11 , 17 , 8

Limitations of Current Research

The research on mefenamic acid remains relatively limited, particularly concerning the long-term effects of its use. Further research is warranted to fully understand the potential impact of prolonged mefenamic acid use. 13 , 6

Future Research Directions

Future research should prioritize investigating the long-term effects of mefenamic acid. Developing drugs that mitigate the side effects of mefenamic acid and exploring alternative medications for dysmenorrhea are also crucial research areas. 13 , 11 , 17 , 8 , 18

Conclusion

While mefenamic acid can effectively relieve pain, such as menstrual cramps, it comes with the risk of side effects affecting the digestive system, liver, and kidneys. When considering mefenamic acid, consulting a doctor for personalized treatment advice is essential. Always follow the prescribed dosage and instructions, avoid self-medication, and never discontinue or modify your medication regimen without medical guidance. 13 , 11 , 17 , 8