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Related to Meclomen: Protonix
Pregnancy Category: UK
Management of mild to moderate pain, including:
- Rheumatoid arthritis,
Inhibits prostaglandin synthesis.
Suppression of pain and inflammation.
Absorption: Well absorbed from the GI tract.
Protein Binding: >99%.
Metabolism and Excretion: Metabolized by the liver; some active metabolites.
Half-life: 40 min–2 hr.
|PO (analgesic)||within 1 hr||unknown||4–6 hr|
|PO (anti-inflammatory)||days||2–3 wk||days|
Contraindicated in: Hypersensitivity; Cross-sensitivity may occur with other NSAIDs, including aspirin; Active GI bleeding or ulcer disease.
Use Cautiously in: Severe cardiovascular, renal, or hepatic disease; History of ulcer disease; Obstetric / Lactation / Pediatric: Pregnancy, lactation, or children <14 yr (safety not established; avoid use during 2nd half of pregnancy).
Adverse Reactions/Side Effects
Central nervous system
- dizziness (most frequent)
- headache (most frequent)
Ear, Eye, Nose, Throat
- visual disturbances
- GI bleeding (life-threatening)
- drug-induced hepatitis (life-threatening)
- diarrhea (most frequent)
- dyspepsia (most frequent)
- nausea (most frequent)
- vomiting (most frequent)
- renal failure
- blood dyscrasias
- allergic reactions including anaphylaxis and Stevens-Johnson syndrome (life-threatening)
- drug-induced systemic lupus erythematosus–like syndrome
Drug-Drug interactionConcurrent use with aspirin may ↓ meclofenamate blood levels and may ↓ effectiveness.May ↑ risk of bleeding with thrombolytic agents, cefoperazone, cefotetan, valproic acid, clopidogrel, ticlopidine, eptifibatide, andtirofiban.Additive adverse GI side effects with aspirin, alcohol, corticosteroids, potassium supplements, and other NSAIDs.Probenecid ↑ blood levels and may ↑ toxicity.Chronic use with acetaminophen or gold compounds may ↑ the risk of adverse renal reactions.May decrease the effectiveness of antihypertensives or diuretics.May ↑ risk of hypoglycemia from oral hypoglycemic agents or insulins.↑ risk of hematologic adverse reactions with antineoplastics or radiation therapy.May ↑ levels and toxicity from lithium or methotrexate.↑ risk of nephrotoxicity with cyclosporine.↑ bleeding risk with anise, arnica, chamomile, clove, feverfew, garlic, ginger, ginkgo, Panax ginseng, and others.
Oral (Adults) Anti-inflammatory—200–400 mg/day in 3–4 divided doses. Analgesic—50–100 mg q 4–6 hr (not to exceed 400 mg/day). Dysmenorrhea/excessive menstrual flow—100 mg 3 times daily for up to 6 days or until cessation of menses.
Availability (generic available)
Capsules: 50 mg, 100 mg
- Patients who have asthma, aspirin-induced allergy, and nasal polyps are at increased risk for developing hypersensitivity reactions. Monitor for rhinitis, asthma, and urticaria.
- Assess patient for skin rash frequently during therapy. Discontinue meclofenamate at first sign of rash; may be life-threatening. Stevens-Johnson syndrome or toxic epidermal necrolysis may develop. Treat symptomatically; may recur once treatment is stopped.
- Arthritis: Assess pain and range of movement before and periodically during therapy.
- Pain: Assess location, duration, and intensity of pain before and 1 hr after administration.
- Lab Test Considerations: Evaluate BUN, serum creatinine, CBC, and liver function tests periodically in patients receiving prolonged therapy.
- May ↑serum potassium, BUN, serum creatinine, alkaline phosphatase, LDH, AST, and ALT levels. May ↓ hemoglobin and hematocrit concentrations, leukocyte and platelet counts, and CCr.
- Effects on bleeding time are minimal.
Potential Nursing DiagnosesAcute pain (Indications)
Impaired physical mobility (Indications)
- Administration in higher than recommended doses does not provide increased effectiveness but may cause increased side effects.
- Coadministration with opioid analgesics may have additive analgesic effects and may permit lower opioid doses.
- Oral: For rapid initial effect, administer 30 min before or 2 hr after meals. May be administered with food, milk, or antacids to decrease GI irritation.
- Dysmenorrhea: Administer as soon as possible after the onset of menses. Prophylactic treatment has not been shown to be effective.
- Advise patients to take this medication with a full glass of water and to remain in an upright position for 15–30 min after administration.
- Instruct patient to take medication exactly as directed. If a dose is missed, take as soon as remembered but not if almost time for next dose. Do not double doses.
- May occasionally cause drowsiness or dizziness. Advise patient to avoid driving or other activities requiring alertness until response to the medication is known.
- Caution patient to avoid the concurrent use of alcohol, aspirin, acetaminophen, or other OTC medications without consulting health care professional.
- Advise patient to inform health care professional of medication regimen before treatment or surgery.
- Caution patient to wear sunscreen and protective clothing to prevent photosensitivity reactions.
- Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, black stools, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain) occurs.
- Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
- Decreased severity of pain.
- Improved joint mobility. Partial arthritic relief is usually seen within a few days, but maximum effectiveness may require 2–3 wk of continuous therapy. Patients who do not respond to one NSAID may respond to another.
- Decreased menstrual flow.
meclofenamateAn anthranilic-type NSAID, which is tightly bound to albumin, used for arthritic complaints, dysmenorrhoea and vascular headache.