A fixed-dose combination analgesic and antipyretic agent. Mefenamic acid is a non-steroidal anti-inflammatory drug (NSAID) of the fenamate class, providing anti-inflammatory and analgesic effects. Paracetamol (acetaminophen) is a centrally-acting analgesic and antipyretic with weak peripheral anti-inflammatory activity. This combination offers synergistic pain relief by targeting both peripheral and central pain pathways, commonly used for moderate to severe pain with an inflammatory component.
Adult: One tablet (Mefenamic Acid 500mg + Paracetamol 325mg) every 6-8 hours as needed for pain. Maximum: 3 tablets in 24 hours. Should be taken with or after food.
Note: Take with a full glass of water, preferably with food or milk to minimize gastric irritation. Do not crush or chew. Do not lie down for at least 10 minutes after taking. Use for the shortest duration necessary to control symptoms.
Mefenamic Acid: Inhibits cyclooxygenase (COX-1 and COX-2) enzymes, reducing the synthesis of prostaglandins (PGs), thromboxanes, and prostacyclins from arachidonic acid. This leads to decreased inflammation, pain, and fever. Paracetamol: Precise mechanism is complex; it acts centrally, likely inhibiting prostaglandin synthesis in the CNS (via COX-2 and COX-3 inhibition) and modulating the endocannabinoid and serotonergic systems, providing analgesic and antipyretic effects with minimal peripheral anti-inflammatory action.
Pregnancy: Category C (first and second trimester): Use only if potential benefit justifies potential fetal risk. Avoid in third trimester (Category D) due to risk of premature closure of ductus arteriosus, delayed labor, and potential renal dysfunction in the neonate.
Driving: May cause dizziness, drowsiness, or blurred vision. Patients should not drive or operate machinery until they know how the medication affects them.
| Warfarin/Acenocoumarol | Increased risk of bleeding due to protein binding displacement and antiplatelet effect of mefenamic acid. | Major |
| Other NSAIDs (e.g., Aspirin, Ibuprofen) | Increased risk of GI toxicity and renal impairment without added benefit. | Major |
| Methotrexate | Mefenamic acid may reduce renal clearance of methotrexate, increasing toxicity risk. | Major |
| Lithium | Mefenamic acid may decrease renal clearance, increasing lithium levels and risk of toxicity. | Major |
| Diuretics (Furosemide, Thiazides) | Reduced diuretic and antihypertensive efficacy; increased risk of renal impairment. | Moderate |
| ACE Inhibitors (Ramipril) / ARBs (Losartan) | Reduced antihypertensive effect; increased risk of renal impairment. | Moderate |
| Corticosteroids (Prednisolone) | Markedly increased risk of GI ulceration and bleeding. | Major |
| Antiplatelets (Clopidogrel) | Additive risk of GI bleeding. | Moderate |
| Probenecid | May increase levels and toxicity of mefenamic acid. | Moderate |
| Cholestyramine | Reduces absorption of paracetamol if taken within 1 hour. | Moderate |
| Alcohol (Chronic use) | Increased risk of paracetamol-induced hepatotoxicity and GI bleeding with mefenamic acid. | Major |
| Anticonvulsants (Phenytoin, Carbamazepine, Phenobarbital) | Increased metabolism of paracetamol to toxic metabolite (NAPQI), increasing hepatotoxicity risk. | Moderate |
Same composition (Mefenamic Acid (500mg) + Paracetamol (325mg)), different brands: