meclofenamate, Meclomen

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GENERIC NAME: meclofenamate

BRAND NAME: Meclomen, Meclodium (These brands no longer are available in the U.S.)

DRUG CLASS AND MECHANISM: Meclofenamate belongs to a class of drugs called nonsteroidal antiinflammatory drugs (NSAIDs). Other NSAIDS include ibuprofen (Motrin), indomethacin (Indocin), naproxen (Naprosyn, Aleve, Anaprox, Naprelan), nabumetone (Relafen) and several others. These drugs are used for the management of mild to moderate pain, fever, and inflammation. They work by reducing the levels of prostaglandins, chemicals that are responsible for pain, fever, and inflammation. Meclofenamate blocks the enzymes that make prostaglandins (cyclooxygenases), resulting in lower concentrations of prostaglandins. As a consequence, inflammation, pain, and fever are reduced. Meclofenamate was approved by the FDA in June 1980.



PREPARATIONS: Capsules: 50 and 100 mg.

STORAGE: Meclofenamate should be stored at 20 to 25 C (68 to 77 F) in a sealed container protected from light and moisture.

PRESCRIBED FOR: Meclofenamate is used for the relief of mild to moderate pain. It also is used to treat dysmenorrhea (painful periods), idiopathic heavy menstrual blood loss, and relief of the signs and symptoms of acute and chronic rheumatoid arthritis and osteoarthritis. Off label uses include ankylosing spondylitis (arthritis that mainly affects the spine) and vascular headache.

DOSING: The usual dose for mild to moderate pain is 50 mg every 4 to 6 hours.

For excessive menstrual blood loss and primary dysmenorrhea the usual dose is 100 mg three times a day, for up to six days.

For rheumatoid arthritis and osteoarthritis the usual dose is 200 to 400 mg per day.

DRUG INTERACTIONS: Concurrent use of meclofenamate and warfarin (Coumadin), a blood thinner, may cause excessive bleeding as meclofenamate enhances the effect of warfarin. It is important, therefore, to reduce the dosage of warfarin.

Meclofenamate, as other NSAIDS may reduce the effects of blood pressure-lowering medications. This may occur because prostaglandins are important in the regulation of blood pressure.

Concurrent use of meclofenamate and cyclosporine (Sandimmune), an immunosuppressant can increase the risk of nephrotoxicity (kidney damage), as meclofenamate tends to increase cyclosporine-induced kidney damage by blocking certain prostaglandins that are important in preventing toxic effects on the kidney. It is important, therefore, to avoid this combination and/or monitor kidney function and blood pressure.

PREGNANCY: There are no adequate studies in pregnant women and, therefore, meclofenamate is not recommended for use during pregnancy.

NURSING MOTHERS: Meclofenamate is excreted in breast milk. Due to possible adverse effects, it is not recommended for nursing women.

SIDE EFFECTS: The most common side effects are abdominal pain with cramps, allergic reactions, diarrhea, dizziness, headache, heartburn, nausea, and skin rash. It is important to note that people who take NSAIDs such as meclofenamate may have a higher risk of having a heart attack or a stroke than people who do not take these medications. Meclofenamate may cause ulcers, bleeding, or holes in the stomach or intestine. The risk may be higher for people who take NSAIDs for a longer period of time, are older in age, have poor health, or drink large amounts of alcohol. If patients experience any of the following symptoms they should stop taking meclofenamate and call their doctor: stomach pain, heartburn, vomiting a substance that is bloody or looks like coffee grounds, blood in the stool, or black and tarry stools.

Reference: FDA Prescribing Information

Last Editorial Review: 10/12/2009

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