Meclofenamate

Aka: Meclofenamate, Meclofenamate Sodium, Meclomen

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II. Indications

  1. See NSAID
  2. FDA approved indications in Adults
    1. Mild to moderate pain
    2. Dysmenorrhea
    3. Menorrhagia
    4. Osteoarthritis
    5. Rheumatoid Arthritis
  3. Non-FDA approved indications in children (off-label use)
    1. Juvenile Rheumatoid Arthritis

III. Contraindications

  1. See NSAID

IV. Mechanism

  1. See NSAID
  2. Anthranilic Acid NSAID in the Fenamate Class

V. Medications

  1. Meclofenamate capsules 50 mg, 100 mg

VI. Dosing: Adults

  1. Mild to moderate pain
    1. Meclofenamate 50 mg orally every 4 to 6 hours
  2. Primary Dymenorrhea
    1. Meclofenamate 100 mg orally every 8 hours for up to 6 days
  3. Arthritis (OA, RA)
    1. Meclofenamate 200 to 400 mg/day divided 3-4 times daily

VII. Dosing: Child

  1. Juvenile Rheumatoid Arthritis (not FDA approved)
    1. Meclofenamate 3 to 7.5 mg/kg/day (max: 300 mg/day) orally in divided doses

VIII. Adverse Effects

  1. See NSAID
  2. Autoimmune Hemolytic Anemia
    1. Associated with prolonged use >1 year
  3. Diarrhea
    1. Occurs in up to 35% of patients

IX. Safety

  1. See NSAID
  2. Avoid in Lactation
  3. Avoid NSAIDs in pregnancy outside the first part of the second trimester (13 to 20 weeks)
    1. Teratogenic in first trimester
    2. Risk of premature ductus arteriosus closure in the fetus in third trimester
    3. Most NSAIDs carry a legacy system Pregnancy Category B or C designation (aside from third trimester)
      1. However, many obstetricians avoid NSAIDs entirely in pregnancy (even in second trimester)

X. Efficacy

  1. Comparable to Aspirin in its Analgesic effects

XI. Resources

  1. Meclofenamate (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=96f19af4-de8f-4fd7-90d8-55fe6ebdd81d

XII. References

  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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