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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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