Home Drug Guide Meclofenamate Sodium

Drug Guide

Generic Name

Meclofenamate Sodium

Brand Names Meclomen, Meclodium

Classification

Therapeutic: Nonsteroidal Anti-Inflammatory Drug (NSAID)

Pharmacological: Phenylacetic acid derivative NSAID

FDA Approved Indications

Relief of mild to moderate pain
Treatment of rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis

Mechanism of Action

Meclofenamate inhibits cyclooxygenase (COX-1 and COX-2), leading to decreased synthesis of prostaglandins, thereby reducing inflammation, pain, and fever.

Dosage and Administration

Adult: Typically 100 mg twice daily; dosage may be adjusted based on response and tolerability.

Pediatric: Not generally recommended for pediatric use due to limited safety data.

Geriatric: Use with caution; start at lower doses due to increased risk of adverse reactions.

Renal Impairment: Adjust dose or avoid use in severe impairment; account for decreased clearance.

Hepatic Impairment: Use cautiously; no specific dose adjustment established.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed; crosses the placenta and is found in breast milk.

Metabolism: Metabolized in the liver.

Excretion: Primarily excreted via the urine; some is eliminated in feces.

Half Life: Approximately 2-4 hours.

Contraindications

History of hypersensitivity to NSAIDs
History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
Active gastrointestinal bleeding or ulceration

Precautions

Use with caution in patients with cardiovascular risks, gastrointestinal history, or hepatic impairment; monitor for adverse effects.

Adverse Reactions - Common

Gastrointestinal upset (nausea, dyspepsia) (Common)
Headache, dizziness (Common)

Adverse Reactions - Serious

Gastrointestinal bleeding, ulceration (Uncommon but serious)
Cardiovascular events (e.g., hypertension, thrombosis) (Serious and potentially life-threatening)

Drug-Drug Interactions

Anticoagulants (increase bleeding risk)
Other NSAIDs or corticosteroids (increase gastrointestinal adverse effects)
Antihypertensives (may reduce efficacy)

Drug-Food Interactions

Alcohol (increases gastrointestinal bleeding risk)

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of gastrointestinal bleeding, renal function, and blood pressure.

Diagnoses:

Risk for bleeding
Impaired renal function
Gastrointestinal discomfort

Implementation: Administer with food or milk to reduce gastrointestinal irritation; monitor renal function and blood pressure regularly.

Evaluation: Assess pain relief, reduction in inflammation, and monitor for adverse effects.

Patient/Family Teaching

Take with food or milk to minimize gastrointestinal upset.
Report any signs of gastrointestinal bleeding (e.g., black stools, abdominal pain).
Avoid alcohol and concurrent use of other NSAIDs without medical advice.
Notify healthcare provider if experiencing chest pain, sudden weakness, or severe allergic reactions.

Special Considerations

Black Box Warnings:

Cardiovascular risk: NSAIDs may increase the risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal.
Gastrointestinal risk: NSAIDs can cause serious gastrointestinal adverse events including bleeding, ulceration, and perforation, which can be fatal.

Genetic Factors: No specific genetic considerations currently identified.

Lab Test Interference: NSAIDs can interfere with urinary tests for kidney function and blood tests for coagulation.

Overdose Management

Signs/Symptoms: Nausea, vomiting, dizziness, gastrointestinal bleeding, hypotension, respiratory depression (rare).

Treatment: Supportive care; activated charcoal if ingestion is recent; monitor renal function and hemodynamic status; gastrointestinal protective agents if bleeding occurs.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable under recommended storage conditions for the duration of the expiration date.