Fenamates
Meclofenamate (Meclomen) and mefenamic acid (Ponstel) exhibit potency and side
effects similar to those of other nonsalicylate NSAIDs. However, both drugs
produce serious side effects, have a short duration of action, and are not safe
for children. Their use is lim-ited to patients who fail to respond to other
treatments. They are analgesic, antipyretic, and antiinflammatory agents
indicated for mild to moderate pain, treatment of dysmenorrhea, rheumatoid
arthritis, and osteoarthri-tis. These drugs are metabolized via glucuronidation
in the liver and excreted via the kidney. Thus, fenamates require normal liver
and kidney function for excretion and are contraindicated in patients with
either liver or renal failure. Overdose with fenamates leads to seizures that
are sometimes insensitive to traditional treatment with benzodiazepines. In
cases of overdose with meclofenamate dialysis may be required to restore fluid
and electrolyte balance.
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