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500 mg: Cardiovascular Risk: Mefenamic acid may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal, All NSAIDs may have a similar risk. The risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk.
Exercise caution in patients with ischemic heart disease (e.g., myocardial infarction and/or angina), cerebrovascular disease (e.g., stroke, cerebrovascular accident, transient ischemic attacks and/or amaurosis fugax) and/or congestive heart failure (NYHA II-IV).
The use of NSAIDs such as mefenamic acid can promote sodium retention in a dose-dependent manner, through a renal mechanism, which can result in increased blood pressure and/or exacerbation of congestive heart failure.
Gastrointestinal Risk: NSAIDs, including mefenamic acid, cause an increased risk of serious GI adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious GI events.
