Substances depleted by this drug
View Depletions
  Interactions with herbs
Cat's Claw
Feverfew
  Interactions with supplements
Copper
Docosahexaenoic Acid (DHA)
Eicosapentaenoic Acid (EPA)
Glucosamine
Omega-3 Fatty Acids
Potassium
Vitamin C (Ascorbic Acid)
Zinc
Look Up > Drugs > Meclofenamate
Meclofenamate
Pronunciation
Generic Available
Synonyms
Pharmacological Index
Use
Pregnancy Risk Factor
Contraindications
Warnings/Precautions
Adverse Reactions
Overdosage/Toxicology
Drug Interactions
Mechanism of Action
Pharmacodynamics/Kinetics
Usual Dosage
Dietary Considerations
Test Interactions
Mental Health: Effects on Mental Status
Mental Health: Effects on Psychiatric Treatment
Dental Health: Local Anesthetic/Vasoconstrictor Precautions
Dental Health: Effects on Dental Treatment
Patient Information
Nursing Implications
Dosage Forms
References

Pronunciation
(me kloe fen AM ate)

Generic Available

Yes


Synonyms
Meclofenamate Sodium

Pharmacological Index

Nonsteroidal Anti-Inflammatory Agent (NSAID)


Use

Treatment of inflammatory disorders


Pregnancy Risk Factor

B (D in 3rd trimester)


Contraindications

Active GI bleeding, ulcer disease, hypersensitivity to aspirin, meclofenamate, or other NSAIDs


Warnings/Precautions

May have adverse effects on fetus; use with caution with dehydration


Adverse Reactions

>10%:

Central nervous system: Dizziness

Dermatologic: Rash

Gastrointestinal: Abdominal cramps, heartburn, indigestion, nausea

1% to 10%:

Central nervous system: Headache, nervousness

Dermatologic: Itching

Endocrine & metabolic: Fluid retention

Gastrointestinal: Vomiting

Otic: Tinnitus

<1%: Congestive heart failure, hypertension, arrhythmia, tachycardia, confusion, hallucinations, aseptic meningitis, mental depression, drowsiness, insomnia, urticaria, erythema multiforme, toxic epidermal necrolysis, Stevens-Johnson syndrome, angioedema, polydipsia, hot flashes, gastritis, GI ulceration, cystitis, polyuria, agranulocytosis, anemia, hemolytic anemia, bone marrow suppression, leukopenia, thrombocytopenia, hepatitis, peripheral neuropathy, toxic amblyopia, blurred vision, conjunctivitis, dry eyes, decreased hearing, acute renal failure, allergic rhinitis, shortness of breath, epistaxis


Overdosage/Toxicology

Symptoms of overdose include drowsiness, lethargy, nausea, vomiting, seizures, paresthesia, headache, dizziness, GI bleeding, cerebral edema, cardiac arrest, tinnitus

Management of a nonsteroidal anti-inflammatory drug (NSAID) intoxication is primarily supportive and symptomatic. Fluid therapy is commonly effective in managing the hypotension that may occur following an acute NSAID overdose, except when this is due to an acute blood loss. Seizures tend to be very short-lived and often do not require drug treatment. Although, recurrent seizures should be treated with I.V. diazepam. Since many of the NSAID undergo enterohepatic cycling, multiple doses of charcoal may be needed to reduce the potential for delayed toxicities.


Drug Interactions

Decreased effect with aspirin; decreased effect of diuretics, antihypertensives; ACE-inhibitor effects may be decreased by concurrent therapy with NSAIDs

Increased effect/toxicity of warfarin, methotrexate


Mechanism of Action

Inhibits prostaglandin synthesis by decreasing the activity of the enzyme, cyclo-oxygenase, which results in decreased formation of prostaglandin precursors


Pharmacodynamics/Kinetics

Duration of action: 2-4 hours

Distribution: Crosses the placenta

Protein binding: 99%

Half-life: 2-3.3 hours

Time to peak serum concentration: Within 0.5-1.5 hours

Elimination: Principally in urine and in feces as glucuronide conjugates


Usual Dosage

Children >14 years and Adults: Oral:

Rheumatoid arthritis/osteoarthritis: 200-400 mg/day in 3-4 equal doses


Dietary Considerations

May be administered with food, milk, or antacids


Test Interactions

chloride (S), sodium (S)


Mental Health: Effects on Mental Status

Dizziness is common; may cause drowsiness, confusion, hallucinations, or depression


Mental Health: Effects on Psychiatric Treatment

May rarely cause agranulocytosis; use caution with clozapine or carbamazepine; may decrease lithium clearance resulting in an increase in serum lithium levels and potential lithium toxicity; monitor serum lithium levels


Dental Health: Local Anesthetic/Vasoconstrictor Precautions

No information available to require special precautions


Dental Health: Effects on Dental Treatment

NSAID formulations are known to reversibly decrease platelet aggregation via mechanisms different than observed with aspirin. The dentist should be aware of the potential of abnormal coagulation. Caution should also be exercised in the use of NSAIDs in patients already on anticoagulant therapy with drugs such as warfarin (Coumadin®). Recovery of platelet function usually occurs 1-2 days after discontinuation of NSAIDs.


Patient Information

Take with food, milk, or with antacids


Nursing Implications

Should be used for short-term only (<7 days); advise patient to report persistent GI discomfort, sore throat, fever, or malaise


Dosage Forms

Capsule, as sodium: 50 mg, 100 mg


References

Brooks PM and Day RO, "Nonsteroidal Anti-inflammatory Drugs - Differences and Similarities," N Engl J Med, 1991, 324(24):1716-25.

Clinch D, Banerjee AK, Ostick G, "Absence of Abdominal Pain in Elderly Patients With Peptic Ulcer," Age Ageing, 1984, 13:120-3.

Clive DM, Stoff JS, "Renal Syndromes Associated With Nonsteroidal Anti-inflammatory Drugs," N Engl J Med, 1984, 310(9):563-72.

Court H and Volans GN, "Poisoning After Overdose With Nonsteroidal Anti-inflammatory Drugs," Adverse Drug React Acute Poisoning Rev, 1984, 3(1):1-21.

"Drugs for Pain," Med Lett Drugs Ther, 1998, 40(1033):79-84.

Graham DY, "Prevention of Gastroduodenal Injury Induced by Chronic Nonsteroidal Anti-inflammatory Drug Therapy," Gastroenterology, 1989, 96(2 Pt 2 Suppl):675-81.

Gurwitz JH, Avorn J, Ross-Degnan D, et al, "Nonsteroidal Anti-Inflammatory Drug-Associated Azotemia in the Very Old," JAMA, 1990, 264(4):471-5.

Hawkey CJ, Karrasch JA, Szczepanski L, et al, "Omeprazole Compared With Misoprostrol for Ulcers Associated With Nonsteroidal Anti-inflammatory Drugs," N Engl J Med, 1998, 338(11):727-34.

Hoppmann RA, Peden JG, and Ober SK, "Central Nervous System Side Effects of Nonsteroidal Anti-inflammatory Drugs. Aseptic Meningitis, Psychosis, and Cognitive Dysfunction," Arch Intern Med, 1991, 151(7):1309-13.

Pounder R, "Silent Peptic Ulceration: Deadly Silence or Golden Silence?" Gastroenterology, 1989, 96(2 Pt 2 Suppl):626-31.

Smolinske SC, Hall AH, Vandenberg SA, et al, "Toxic Effects of Nonsteroid Anti-inflammatory Drugs in Overdose. An Overview of Recent Evidence on Clinical Effects and Dose-Response Relationships," Drug Saf, 1990, 5(4):252-74.

Vale JA and Meredith TJ, "Acute Poisoning Due to Nonsteroidal Anti-inflammatory Drugs," Med Toxicol, 1986, 1(1):12-31.

Verbeeck RK, "Pharmacokinetic Drug Interactions With Nonsteroidal Anti-inflammatory Drugs," Clin Pharmacokinet, 1990, 19(1):44-66.

Yeomans ND, Tulassay Z, Juhasz L, et al, "A Comparison of Omeprazole With Ranitidine for Ulcers Associated With Nonsteroidal Anti-inflammatory Drugs," N Engl J Med, 1998, 338(11):719-26.


Copyright © 1978-2000 Lexi-Comp Inc. All Rights Reserved