meclofenamate (Rx)

Brand and Other Names:
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

capsule

  • 50mg
  • 100mg

Rheumatoid Arthritis

Indicated for relief of signs and symptoms of rheumatoid arthritis, including acute exacerbations of chronic disease

200-400 mg/day PO divided in 3-4 equal doses; initiate at lower dose, and then increase according to response

After satisfactory response achieved, attempt to reduce dose for long-term administration

Not to exceed 400 mg/day

Osteoarthritis

Indicated for relief of signs and symptoms of osteoarthritis, including acute exacerbations of chronic disease

200-400 mg/day PO divided in 3-4 equal doses; initiate at lower dose, and then increase according to response

After satisfactory response achieved, attempt to reduce dose for long-term administration

Not to exceed 400 mg/day

Ankylosing Spondylitis

Indicated for acute or long-term use for relief of signs and symptoms of ankylosing spondylitis

200-400 mg/day PO divided in 3-4 equal doses; initiate at lower dose, and then increase according to response

After satisfactory response achieved, attempt to reduce dose for long-term administration

Not to exceed 400 mg/day

Bursitis/Tendinitis

Indicated for acute or long-term use for relief of signs and symptoms of acute painful shoulder (acute subacromial bursitis/supraspinatus tendinitis)

200-400 mg/day PO divided in 3-4 equal doses; initiate at lower dose, and then increase according to response

After satisfactory response achieved, attempt to reduce dose for long-term administration

Not to exceed 400 mg/day

Gouty Arthritis

Indicated for acute or long-term use for relief of signs and symptoms of gouty arthritis

200-400 mg/day PO divided in 3-4 equal doses; initiate at lower dose, and then increase according to response

After satisfactory response achieved, attempt to reduce dose for long-term administration

Not to exceed 400 mg/day

Primary Dysmenorrhea

Indicated for primary dysmenorrhea and idiopathic heavy menstrual blood loss

100 mg PO TID for up to 6 days; initiate at onset of menstrual flow

Mild-to-Moderate Pain

50 mg PO q4-6hr; may increase t

100 mg/dose if needed Not to exceed 400 mg/day

Fever

50 mg PO q4-6hr; may increase to 100 mg/dose if needed

Not to exceed 400 mg/day

Dosage Modifications

Renal impairment

  • Kidney Disease Improving Global Outcomes (KDIGO) recommendations
    • eGFR 30-60 mL/ min/1.73 m²: Temporarily discontinue in patients with concurrent illness that increases risk of acute kidney injury
    • eGFR <30 mL/min/1.73 m²: Avoid use

Dosage Forms & Strengths

capsule

  • 50mg
  • 100mg

Juvenile Arthritis

Indicated for relief of signs and symptoms of rheumatoid arthritis, including acute exacerbations of chronic disease

<14 years: Safety and efficacy not established

≥14 years: 200-400 mg/day PO divided in 3-4 equal doses; initiate at lower dose, and then increase according to response

After satisfactory response achieved, attempt to reduce dose for long-term administration

Not to exceed 400 mg/day

Primary Dysmenorrhea

Indicated for primary dysmenorrhea and idiopathic heavy menstrual blood loss

<14 years: Safety and efficacy not established

≥14 years: 100 mg PO TID for up to 6 days; initiate at onset of menstrual flow

Risk for effects on kidneys and bleeding risk may be increased in elderly individuals

Use lowest effect dose for the shortest duration

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Interactions

Interaction Checker

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              Serious - Use Alternative (21)

              • aminolevulinic acid oral

                aminolevulinic acid oral, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid administering other phototoxic drugs with aminolevulinic acid oral for 24 hr during perioperative period.

              • aminolevulinic acid topical

                meclofenamate, aminolevulinic acid topical. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.

              • apixaban

                meclofenamate and apixaban both increase anticoagulation. Avoid or Use Alternate Drug.

              • baricitinib

                meclofenamate will increase the level or effect of baricitinib by decreasing elimination. Avoid or Use Alternate Drug. Coadministration of baricitinib with strong organic anion transporter 3 (OAT3) inhibitors is not recommended.

              • benazepril

                meclofenamate, benazepril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

              • captopril

                meclofenamate, captopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

              • enalapril

                meclofenamate, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

              • fosinopril

                meclofenamate, fosinopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

              • ibuprofen IV

                meclofenamate will increase the level or effect of ibuprofen IV by acidic (anionic) drug competition for renal tubular clearance. Avoid or Use Alternate Drug. Therapeutic duplication

                meclofenamate and ibuprofen IV both increase anticoagulation. Avoid or Use Alternate Drug. Therapeutic duplication

                meclofenamate and ibuprofen IV both increase serum potassium. Avoid or Use Alternate Drug. Therapeutic duplication

              • ketorolac

                meclofenamate, ketorolac. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.

              • ketorolac intranasal

                meclofenamate, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.

              • lisinopril

                meclofenamate, lisinopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

              • methotrexate

                meclofenamate increases levels of methotrexate by decreasing renal clearance. Avoid or Use Alternate Drug. Concomitant administration of NSAIDs with high dose methotrexate has been reported to elevate and prolong serum methotrexate levels, resulting in deaths from severe hematologic and GI toxicity. NSAIDs may reduce tubular secretion of methotrexate and enhance toxicity. .

              • methyl aminolevulinate

                meclofenamate, methyl aminolevulinate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.

              • moexipril

                meclofenamate, moexipril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

              • pemetrexed

                meclofenamate increases levels of pemetrexed by unspecified interaction mechanism. Avoid or Use Alternate Drug. Interrupt dosing in all patients taking NSAIDs with long elimination half-lives for at least 5d before, the day of, and 2d following pemetrexed administration. If coadministration of an NSAID is necessary, closely monitor patients for toxicity, especially myelosuppression, renal toxicity, and GI toxicity.

              • perindopril

                meclofenamate, perindopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

              • quinapril

                meclofenamate, quinapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

              • ramipril

                meclofenamate, ramipril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

              • tacrolimus

                meclofenamate, tacrolimus. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Concomitant administration increases risk of nephrotoxicity.

              • trandolapril

                meclofenamate, trandolapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

              Monitor Closely (235)

              • acebutolol

                meclofenamate decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                acebutolol and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • aceclofenac

                aceclofenac and meclofenamate both increase anticoagulation. Use Caution/Monitor.

                aceclofenac and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • acemetacin

                acemetacin and meclofenamate both increase anticoagulation. Use Caution/Monitor.

                acemetacin and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • agrimony

                meclofenamate and agrimony both increase anticoagulation. Use Caution/Monitor.

              • albuterol

                meclofenamate increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • alfalfa

                meclofenamate and alfalfa both increase anticoagulation. Use Caution/Monitor.

              • alfuzosin

                meclofenamate decreases effects of alfuzosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • aliskiren

                meclofenamate will decrease the level or effect of aliskiren by Other (see comment). Use Caution/Monitor. In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs with drugs that affect RAAS may increase the risk of renal impairment (including acute renal failure) and cause loss of antihypertensive effect. Monitor renal function periodically.

              • alteplase

                meclofenamate and alteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

              • American ginseng

                meclofenamate and American ginseng both increase anticoagulation. Use Caution/Monitor.

              • amiloride

                amiloride and meclofenamate both increase serum potassium. Modify Therapy/Monitor Closely.

              • antithrombin alfa

                antithrombin alfa and meclofenamate both increase anticoagulation. Modify Therapy/Monitor Closely.

              • antithrombin III

                antithrombin III and meclofenamate both increase anticoagulation. Modify Therapy/Monitor Closely.

              • arformoterol

                meclofenamate increases and arformoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • argatroban

                argatroban and meclofenamate both increase anticoagulation. Modify Therapy/Monitor Closely.

              • asenapine

                meclofenamate decreases effects of asenapine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • aspirin

                aspirin and meclofenamate both increase anticoagulation. Use Caution/Monitor.

                aspirin and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • aspirin rectal

                aspirin rectal and meclofenamate both increase anticoagulation. Use Caution/Monitor.

                aspirin rectal and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • aspirin/citric acid/sodium bicarbonate

                aspirin/citric acid/sodium bicarbonate and meclofenamate both increase anticoagulation. Use Caution/Monitor.

                aspirin/citric acid/sodium bicarbonate and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • atenolol

                meclofenamate decreases effects of atenolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                atenolol and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • azficel-T

                azficel-T, meclofenamate. Other (see comment). Use Caution/Monitor. Comment: Patients taking NSAIDS may experience increased bruising or bleeding at biopsy and/or injection sites. Concomitant use of NSAIDs is not recommended.

              • azilsartan

                meclofenamate, azilsartan. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

                meclofenamate decreases effects of azilsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

              • bemiparin

                bemiparin and meclofenamate both increase anticoagulation. Modify Therapy/Monitor Closely.

              • benazepril

                benazepril, meclofenamate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

              • bendroflumethiazide

                meclofenamate increases and bendroflumethiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • betaxolol

                meclofenamate decreases effects of betaxolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                betaxolol and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • betrixaban

                meclofenamate, betrixaban. Either increases levels of the other by anticoagulation. Use Caution/Monitor.

              • bimatoprost

                bimatoprost, meclofenamate. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • bisoprolol

                meclofenamate decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                bisoprolol and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • bivalirudin

                bivalirudin and meclofenamate both increase anticoagulation. Modify Therapy/Monitor Closely.

              • budesonide

                meclofenamate, budesonide. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

              • bumetanide

                meclofenamate increases and bumetanide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                meclofenamate decreases effects of bumetanide by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • candesartan

                meclofenamate decreases effects of candesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

                candesartan and meclofenamate both increase serum potassium. Use Caution/Monitor.

                candesartan, meclofenamate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

              • captopril

                captopril, meclofenamate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

              • carbenoxolone

                meclofenamate increases and carbenoxolone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • carvedilol

                meclofenamate decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                carvedilol and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • celecoxib

                celecoxib and meclofenamate both increase anticoagulation. Use Caution/Monitor.

                celecoxib and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • celiprolol

                meclofenamate decreases effects of celiprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                celiprolol and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • chlorothiazide

                meclofenamate increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • chlorpropamide

                meclofenamate increases effects of chlorpropamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • chlorthalidone

                meclofenamate increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • choline magnesium trisalicylate

                meclofenamate and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

              • cinnamon

                meclofenamate and cinnamon both increase anticoagulation. Use Caution/Monitor.

              • ciprofloxacin

                meclofenamate, ciprofloxacin. Other (see comment). Modify Therapy/Monitor Closely. Comment: Mechanism: unknown. Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

              • citalopram

                citalopram, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. If possible, avoid concurrent use.

              • clobetasone

                meclofenamate, clobetasone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

              • clomipramine

                clomipramine, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.

              • clopidogrel

                clopidogrel, meclofenamate. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Clopidogrel and NSAIDs both inhibit platelet aggregation.

              • cordyceps

                meclofenamate and cordyceps both increase anticoagulation. Use Caution/Monitor.

              • cortisone

                meclofenamate, cortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

              • cyclopenthiazide

                meclofenamate increases and cyclopenthiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • cyclosporine

                meclofenamate, cyclosporine. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Potential for dangerous interaction. Use with caution and monitor closely.

              • dabigatran

                dabigatran and meclofenamate both increase anticoagulation. Use Caution/Monitor. Caution is advised, both drugs have the potential to cause bleeding. Concomitant use may increase risk of bleeding.

              • dalteparin

                dalteparin and meclofenamate both increase anticoagulation. Modify Therapy/Monitor Closely.

              • deferasirox

                deferasirox, meclofenamate. Other (see comment). Use Caution/Monitor. Comment: Combination may increase GI bleeding, ulceration and irritation. Use with caution.

              • defibrotide

                defibrotide increases effects of meclofenamate by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Defibrotide may enhance effects of platelet inhibitors.

              • deflazacort

                meclofenamate, deflazacort. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

              • dexamethasone

                meclofenamate, dexamethasone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

              • diclofenac

                diclofenac and meclofenamate both increase anticoagulation. Use Caution/Monitor.

                diclofenac and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • diflunisal

                diflunisal and meclofenamate both increase anticoagulation. Use Caution/Monitor.

                diflunisal and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • digoxin

                meclofenamate and digoxin both increase serum potassium. Use Caution/Monitor.

              • dobutamine

                meclofenamate increases and dobutamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dong quai

                meclofenamate and dong quai both increase anticoagulation. Use Caution/Monitor.

              • dopexamine

                meclofenamate increases and dopexamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • doxazosin

                meclofenamate decreases effects of doxazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • drospirenone

                drospirenone and meclofenamate both increase serum potassium. Modify Therapy/Monitor Closely.

              • duloxetine

                duloxetine, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

              • edoxaban

                edoxaban, meclofenamate. Either increases toxicity of the other by anticoagulation. Modify Therapy/Monitor Closely. Both drugs have the potential to cause bleeding, monitor closely. Promptly evaluate any signs or symptoms of blood loss.

              • eltrombopag

                eltrombopag increases levels of meclofenamate by decreasing metabolism. Use Caution/Monitor. UGT inhibition; significance of interaction unclear.

              • elvitegravir/cobicistat/emtricitabine/tenofovir DF

                elvitegravir/cobicistat/emtricitabine/tenofovir DF, meclofenamate. Either increases toxicity of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of emtricitabine and tenofovir with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.

              • emtricitabine

                emtricitabine, meclofenamate. Either increases levels of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of emtricitabine with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.

              • enalapril

                enalapril, meclofenamate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

              • enoxaparin

                enoxaparin and meclofenamate both increase anticoagulation. Modify Therapy/Monitor Closely.

              • ephedrine

                meclofenamate increases and ephedrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • epinephrine

                meclofenamate increases and epinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • epinephrine racemic

                meclofenamate increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • epoprostenol

                meclofenamate and epoprostenol both increase anticoagulation. Use Caution/Monitor.

              • eprosartan

                meclofenamate decreases effects of eprosartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

                eprosartan and meclofenamate both increase serum potassium. Use Caution/Monitor.

                eprosartan, meclofenamate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

              • escitalopram

                escitalopram, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

              • esmolol

                meclofenamate decreases effects of esmolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                esmolol and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • ethacrynic acid

                meclofenamate increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • etodolac

                etodolac and meclofenamate both increase anticoagulation. Use Caution/Monitor.

                etodolac and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • fennel

                meclofenamate and fennel both increase anticoagulation. Use Caution/Monitor.

              • feverfew

                meclofenamate and feverfew both increase anticoagulation. Use Caution/Monitor.

              • fish oil triglycerides

                fish oil triglycerides will increase the level or effect of meclofenamate by anticoagulation. Use Caution/Monitor. Prolonged bleeding reported in patients taking antiplatelet agents or anticoagulants and oral omega-3 fatty acids. Periodically monitor bleeding time in patients receiving fish oil triglycerides and concomitant antiplatelet agents or anticoagulants.

              • fludrocortisone

                meclofenamate, fludrocortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

              • fluoxetine

                fluoxetine, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

              • flurbiprofen

                meclofenamate and flurbiprofen both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and flurbiprofen both increase serum potassium. Use Caution/Monitor.

              • fluvoxamine

                fluvoxamine, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.

              • fondaparinux

                fondaparinux and meclofenamate both increase anticoagulation. Modify Therapy/Monitor Closely.

              • formoterol

                meclofenamate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • forskolin

                meclofenamate and forskolin both increase anticoagulation. Use Caution/Monitor.

              • fosinopril

                fosinopril, meclofenamate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

              • furosemide

                meclofenamate increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • garlic

                meclofenamate and garlic both increase anticoagulation. Use Caution/Monitor.

              • gemifloxacin

                gemifloxacin, meclofenamate. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

              • gentamicin

                meclofenamate increases and gentamicin decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ginger

                meclofenamate and ginger both increase anticoagulation. Use Caution/Monitor.

              • ginkgo biloba

                meclofenamate and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.

              • glimepiride

                meclofenamate increases effects of glimepiride by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • glipizide

                meclofenamate increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • glyburide

                meclofenamate increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • green tea

                green tea, meclofenamate. Other (see comment). Use Caution/Monitor. Comment: Combination may increase risk of bleeding.

              • heparin

                heparin and meclofenamate both increase anticoagulation. Modify Therapy/Monitor Closely.

              • horse chestnut seed

                meclofenamate and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

              • hydralazine

                meclofenamate decreases effects of hydralazine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • hydrochlorothiazide

                meclofenamate increases and hydrochlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • hydrocortisone

                meclofenamate, hydrocortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

              • ibrutinib

                ibrutinib will increase the level or effect of meclofenamate by anticoagulation. Use Caution/Monitor. Ibrutinib may increase the risk of hemorrhage in patients receiving antiplatelet or anticoagulant therapies and monitor for signs of bleeding.

              • ibuprofen

                meclofenamate and ibuprofen both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and ibuprofen both increase serum potassium. Use Caution/Monitor.

              • imatinib

                imatinib, meclofenamate. Either increases toxicity of the other by Other (see comment). Modify Therapy/Monitor Closely. Comment: Imatinib may cause thrombocytopenia; bleeding risk increased when imatinib is coadministered with anticoagulants, NSAIDs, platelet inhibitors, and thrombolytic agents.

              • indapamide

                meclofenamate increases and indapamide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • indomethacin

                meclofenamate and indomethacin both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and indomethacin both increase serum potassium. Use Caution/Monitor.

              • irbesartan

                meclofenamate decreases effects of irbesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

                irbesartan and meclofenamate both increase serum potassium. Use Caution/Monitor.

                irbesartan, meclofenamate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

              • isoproterenol

                meclofenamate increases and isoproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ketoprofen

                meclofenamate and ketoprofen both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and ketoprofen both increase serum potassium. Use Caution/Monitor.

              • ketorolac

                meclofenamate and ketorolac both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and ketorolac both increase serum potassium. Use Caution/Monitor.

              • ketorolac intranasal

                meclofenamate and ketorolac intranasal both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.

              • labetalol

                meclofenamate decreases effects of labetalol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                labetalol and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • latanoprost

                latanoprost, meclofenamate. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • latanoprostene bunod ophthalmic

                latanoprostene bunod ophthalmic, meclofenamate. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • levalbuterol

                meclofenamate increases and levalbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • levofloxacin

                levofloxacin, meclofenamate. Other (see comment). Modify Therapy/Monitor Closely. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • levomilnacipran

                levomilnacipran, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. SNRIs may further impair platelet activity in patients taking antiplatelet or anticoagulant drugs.

              • lisinopril

                lisinopril, meclofenamate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

              • lithium

                meclofenamate increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.

              • lornoxicam

                meclofenamate and lornoxicam both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and lornoxicam both increase serum potassium. Use Caution/Monitor.

              • losartan

                meclofenamate decreases effects of losartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

                losartan and meclofenamate both increase serum potassium. Use Caution/Monitor.

                losartan, meclofenamate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

              • mefenamic acid

                meclofenamate and mefenamic acid both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and mefenamic acid both increase serum potassium. Use Caution/Monitor.

              • melatonin

                melatonin increases effects of meclofenamate by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

              • meloxicam

                meclofenamate and meloxicam both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and meloxicam both increase serum potassium. Use Caution/Monitor.

              • mesalamine

                mesalamine, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive nephrotoxicity.

              • metaproterenol

                meclofenamate increases and metaproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • methotrexate

                meclofenamate will increase the level or effect of methotrexate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.

              • methyclothiazide

                meclofenamate increases and methyclothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • methylprednisolone

                meclofenamate, methylprednisolone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

              • metolazone

                meclofenamate increases and metolazone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • metoprolol

                meclofenamate decreases effects of metoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                metoprolol and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • milnacipran

                milnacipran, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

              • mipomersen

                mipomersen, meclofenamate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.

              • mistletoe

                meclofenamate increases and mistletoe decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • moexipril

                moexipril, meclofenamate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

              • moxifloxacin

                moxifloxacin, meclofenamate. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

              • moxisylyte

                meclofenamate decreases effects of moxisylyte by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • mycophenolate

                meclofenamate will increase the level or effect of mycophenolate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.

              • nabumetone

                meclofenamate and nabumetone both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and nabumetone both increase serum potassium. Use Caution/Monitor.

              • nadolol

                meclofenamate decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                nadolol and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • naproxen

                meclofenamate and naproxen both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and naproxen both increase serum potassium. Use Caution/Monitor.

              • nebivolol

                meclofenamate decreases effects of nebivolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                nebivolol and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • nefazodone

                nefazodone, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

              • nettle

                meclofenamate increases and nettle decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • norepinephrine

                meclofenamate increases and norepinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • olmesartan

                meclofenamate decreases effects of olmesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

                olmesartan and meclofenamate both increase serum potassium. Use Caution/Monitor.

                olmesartan, meclofenamate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

              • ospemifene

                meclofenamate, ospemifene. Either increases levels of the other by plasma protein binding competition. Modify Therapy/Monitor Closely.

              • oxaprozin

                meclofenamate and oxaprozin both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and oxaprozin both increase serum potassium. Use Caution/Monitor.

              • panax ginseng

                meclofenamate and panax ginseng both increase anticoagulation. Use Caution/Monitor.

              • parecoxib

                meclofenamate and parecoxib both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and parecoxib both increase serum potassium. Use Caution/Monitor.

              • paroxetine

                paroxetine, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

              • pau d'arco

                meclofenamate and pau d'arco both increase anticoagulation. Use Caution/Monitor.

              • pegaspargase

                pegaspargase increases effects of meclofenamate by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of bleeding events.

              • penbutolol

                meclofenamate decreases effects of penbutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                penbutolol and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • perindopril

                perindopril, meclofenamate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

              • phenindione

                phenindione and meclofenamate both increase anticoagulation. Modify Therapy/Monitor Closely.

              • phenoxybenzamine

                meclofenamate decreases effects of phenoxybenzamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • phentolamine

                meclofenamate decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • phytoestrogens

                meclofenamate and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

              • pindolol

                meclofenamate decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                pindolol and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • pirbuterol

                meclofenamate increases and pirbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • piroxicam

                meclofenamate and piroxicam both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and piroxicam both increase serum potassium. Use Caution/Monitor.

              • pivmecillinam

                pivmecillinam, meclofenamate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

                pivmecillinam, meclofenamate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

              • potassium acid phosphate

                meclofenamate and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.

              • potassium chloride

                meclofenamate and potassium chloride both increase serum potassium. Modify Therapy/Monitor Closely.

              • potassium citrate

                meclofenamate and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.

              • potassium iodide

                potassium iodide and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • pralatrexate

                meclofenamate increases levels of pralatrexate by decreasing renal clearance. Use Caution/Monitor. NSAIDs may delay pralatrexate clearance, increasing drug exposure. Adjust the pralatrexate dose as needed.

              • prasugrel

                meclofenamate, prasugrel. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Chronic use of NSAIDs with prasugrel may increase bleeding risk.

              • prazosin

                meclofenamate decreases effects of prazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • prednisolone

                meclofenamate, prednisolone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

              • prednisone

                meclofenamate, prednisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

              • probenecid

                meclofenamate will increase the level or effect of probenecid by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.

              • propranolol

                meclofenamate decreases effects of propranolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                propranolol and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • protamine

                protamine and meclofenamate both increase anticoagulation. Modify Therapy/Monitor Closely.

              • quinapril

                quinapril, meclofenamate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

              • ramipril

                ramipril, meclofenamate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

              • reishi

                meclofenamate and reishi both increase anticoagulation. Use Caution/Monitor.

              • reteplase

                meclofenamate and reteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

              • rivaroxaban

                rivaroxaban, meclofenamate. Other (see comment). Use Caution/Monitor. Comment: NSAIDs are known to increase bleeding. Bleeding risk may be increased when NSAIDs are used concomitantly with rivaroxaban. Monitor for signs/symptoms of blood loss.

              • rivastigmine

                rivastigmine increases toxicity of meclofenamate by pharmacodynamic synergism. Use Caution/Monitor. Monitor patients for symptoms of active or occult gastrointestinal bleeding.

              • sacubitril/valsartan

                meclofenamate decreases effects of sacubitril/valsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

                sacubitril/valsartan and meclofenamate both increase serum potassium. Use Caution/Monitor.

                sacubitril/valsartan, meclofenamate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

              • salicylates (non-asa)

                meclofenamate and salicylates (non-asa) both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and salicylates (non-asa) both increase serum potassium. Use Caution/Monitor.

              • salmeterol

                meclofenamate increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • salsalate

                meclofenamate and salsalate both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and salsalate both increase serum potassium. Use Caution/Monitor.

              • saw palmetto

                saw palmetto increases toxicity of meclofenamate by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.

              • sertraline

                sertraline, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

              • Siberian ginseng

                meclofenamate and Siberian ginseng both increase anticoagulation. Use Caution/Monitor.

              • silodosin

                meclofenamate decreases effects of silodosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • sodium picosulfate/magnesium oxide/anhydrous citric acid

                meclofenamate, sodium picosulfate/magnesium oxide/anhydrous citric acid. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May be associated with fluid and electrolyte imbalances.

              • sodium sulfate/?magnesium sulfate/potassium chloride

                sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of meclofenamate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • sodium sulfate/potassium sulfate/magnesium sulfate

                sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of meclofenamate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

              • sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol

                meclofenamate, sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol. Other (see comment). Use Caution/Monitor. Comment: Caution when bowel preps are used with drugs that cause SIADH or NSAIDs; increased risk for water retention or electrolyte imbalance.

              • sotalol

                meclofenamate decreases effects of sotalol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                sotalol and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • spironolactone

                spironolactone and meclofenamate both increase serum potassium. Modify Therapy/Monitor Closely.

              • succinylcholine

                meclofenamate and succinylcholine both increase serum potassium. Use Caution/Monitor.

              • sulfasalazine

                meclofenamate and sulfasalazine both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and sulfasalazine both increase serum potassium. Use Caution/Monitor.

              • sulindac

                meclofenamate and sulindac both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and sulindac both increase serum potassium. Use Caution/Monitor.

              • tafluprost

                tafluprost, meclofenamate. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • telmisartan

                meclofenamate decreases effects of telmisartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

                telmisartan and meclofenamate both increase serum potassium. Use Caution/Monitor.

                telmisartan, meclofenamate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

              • temocillin

                temocillin, meclofenamate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

                temocillin, meclofenamate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

              • tenecteplase

                meclofenamate and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.

              • tenofovir DF

                tenofovir DF, meclofenamate. Either increases levels of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of tenofovir DF with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.

              • terazosin

                meclofenamate decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              • terbutaline

                meclofenamate increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ticagrelor

                ticagrelor, meclofenamate. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Increased risk of bleeding with use of ticagrelor and chronic NSAID use. .

              • ticarcillin

                ticarcillin, meclofenamate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

                ticarcillin, meclofenamate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

              • timolol

                meclofenamate decreases effects of timolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                timolol and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • tobramycin inhaled

                tobramycin inhaled and meclofenamate both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity

              • tolazamide

                meclofenamate increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • tolbutamide

                meclofenamate increases effects of tolbutamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • tolfenamic acid

                meclofenamate and tolfenamic acid both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and tolfenamic acid both increase serum potassium. Use Caution/Monitor.

              • tolmetin

                meclofenamate and tolmetin both increase anticoagulation. Use Caution/Monitor.

                meclofenamate and tolmetin both increase serum potassium. Use Caution/Monitor.

              • tolvaptan

                meclofenamate and tolvaptan both increase serum potassium. Use Caution/Monitor.

              • torsemide

                meclofenamate increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • trandolapril

                trandolapril, meclofenamate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

              • travoprost ophthalmic

                travoprost ophthalmic, meclofenamate. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

              • trazodone

                trazodone, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

              • triamcinolone acetonide injectable suspension

                meclofenamate, triamcinolone acetonide injectable suspension. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Concomitant use of NSAIDS and corticosteroids increases the risk of gastrointestinal side effects. .

              • triamterene

                triamterene and meclofenamate both increase serum potassium. Modify Therapy/Monitor Closely.

              • valsartan

                meclofenamate decreases effects of valsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

                valsartan and meclofenamate both increase serum potassium. Use Caution/Monitor.

                valsartan, meclofenamate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

              • venlafaxine

                venlafaxine, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

              • voclosporin

                voclosporin, meclofenamate. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.

              • vorapaxar

                meclofenamate, vorapaxar. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive antiplatelet effect may occur.

              • vortioxetine

                meclofenamate, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.

              • warfarin

                warfarin and meclofenamate both increase anticoagulation. Modify Therapy/Monitor Closely.

              • zanubrutinib

                meclofenamate, zanubrutinib. Either increases effects of the other by anticoagulation. Modify Therapy/Monitor Closely. Zanubrutinib-induced cytopenias increases risk of hemorrhage. Coadministration of zanubritinib with antiplatelets or anticoagulants may further increase this risk.

              • zotepine

                meclofenamate decreases effects of zotepine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

              Minor (75)

              • aceclofenac

                aceclofenac will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • acemetacin

                acemetacin will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • acyclovir

                meclofenamate will increase the level or effect of acyclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • alendronate

                meclofenamate, alendronate. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI ulceration.

              • amikacin

                meclofenamate increases levels of amikacin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • aminohippurate sodium

                meclofenamate will increase the level or effect of aminohippurate sodium by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • anamu

                meclofenamate and anamu both increase anticoagulation. Minor/Significance Unknown.

              • aspirin

                aspirin will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • aspirin rectal

                aspirin rectal will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • aspirin/citric acid/sodium bicarbonate

                aspirin/citric acid/sodium bicarbonate will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • balsalazide

                meclofenamate will increase the level or effect of balsalazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • bendroflumethiazide

                bendroflumethiazide will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • cefadroxil

                cefadroxil will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • cefamandole

                cefamandole will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • cefotetan

                cefotetan will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • cefpirome

                cefpirome will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • ceftibuten

                ceftibuten will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • celecoxib

                celecoxib will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • cephalexin

                cephalexin will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • chlorothiazide

                chlorothiazide will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • chlorpropamide

                meclofenamate will increase the level or effect of chlorpropamide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • chlorthalidone

                chlorthalidone will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • choline magnesium trisalicylate

                meclofenamate will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • creatine

                creatine, meclofenamate. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction) Combination may have additive nephrotoxic effects.

              • cyclopenthiazide

                cyclopenthiazide will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • danshen

                meclofenamate and danshen both increase anticoagulation. Minor/Significance Unknown.

              • devil's claw

                meclofenamate and devil's claw both increase anticoagulation. Minor/Significance Unknown.

              • diclofenac

                diclofenac will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • diclofenac topical

                diclofenac topical, meclofenamate. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Although low, there is systemic exposure to diclofenac topical; theoretically, concomitant administration with systemic NSAIDS or aspirin may result in increased NSAID adverse effects.

              • diflunisal

                diflunisal will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • eplerenone

                meclofenamate decreases effects of eplerenone by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • etodolac

                etodolac will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • feverfew

                meclofenamate decreases effects of feverfew by pharmacodynamic antagonism. Minor/Significance Unknown.

              • flurbiprofen

                meclofenamate will increase the level or effect of flurbiprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • furosemide

                meclofenamate decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • ganciclovir

                meclofenamate will increase the level or effect of ganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • gentamicin

                meclofenamate increases levels of gentamicin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • hydrochlorothiazide

                hydrochlorothiazide will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • ibuprofen

                meclofenamate will increase the level or effect of ibuprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • imidapril

                meclofenamate decreases effects of imidapril by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

              • indapamide

                indapamide will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • indomethacin

                meclofenamate will increase the level or effect of indomethacin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • ketoprofen

                meclofenamate will increase the level or effect of ketoprofen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • ketorolac

                meclofenamate will increase the level or effect of ketorolac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • ketorolac intranasal

                meclofenamate will increase the level or effect of ketorolac intranasal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • lornoxicam

                meclofenamate will increase the level or effect of lornoxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • mefenamic acid

                meclofenamate will increase the level or effect of mefenamic acid by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • meloxicam

                meclofenamate will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • mesalamine

                meclofenamate will increase the level or effect of mesalamine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • methyclothiazide

                methyclothiazide will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • metolazone

                metolazone will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • nabumetone

                meclofenamate will increase the level or effect of nabumetone by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • naproxen

                meclofenamate will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • neomycin PO

                meclofenamate increases levels of neomycin PO by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • nitazoxanide

                nitazoxanide, meclofenamate. Either increases levels of the other by Mechanism: plasma protein binding competition. Minor/Significance Unknown.

              • noni juice

                meclofenamate and noni juice both increase serum potassium. Minor/Significance Unknown.

              • ofloxacin

                ofloxacin, meclofenamate. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • oxaprozin

                meclofenamate will increase the level or effect of oxaprozin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • parecoxib

                meclofenamate will increase the level or effect of parecoxib by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • paromomycin

                meclofenamate increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • piperacillin

                piperacillin will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • piroxicam

                meclofenamate will increase the level or effect of piroxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • rose hips

                rose hips will increase the level or effect of meclofenamate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • salicylates (non-asa)

                meclofenamate will increase the level or effect of salicylates (non-asa) by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • salsalate

                meclofenamate will increase the level or effect of salsalate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • streptomycin

                meclofenamate increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • sulfasalazine

                meclofenamate will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • sulindac

                meclofenamate will increase the level or effect of sulindac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • tobramycin

                meclofenamate increases levels of tobramycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

              • tolfenamic acid

                meclofenamate will increase the level or effect of tolfenamic acid by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • tolmetin

                meclofenamate will increase the level or effect of tolmetin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • triamterene

                meclofenamate increases toxicity of triamterene by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis, increasing the risk of nephrotoxicity.

                triamterene, meclofenamate. Other (see comment). Minor/Significance Unknown. Comment: Risk of acute renal failure. Mechanism: NSAIDs decrease prostaglandin synthesis, which normally protect against nephrotoxicity.

              • valganciclovir

                meclofenamate will increase the level or effect of valganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • vancomycin

                meclofenamate increases levels of vancomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in neonates.

              • willow bark

                meclofenamate will increase the level or effect of willow bark by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

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              Adverse Effects

              >10%

              Diarrhea (10-33%)

              Nausea, with or without vomiting (11%)

              1-10%

              Pyrosis (3-9%)

              Flatulence (3-9%)

              Rash (3-9%)

              Headache (3-9%)

              Dizziness (3-9%)

              Anorexia (1-3%)

              Constipation (1-3%)

              Stomatitis (1-3%)

              Peptic ulcer (1-3%)

              Edema (1-3%)

              Pruritus (1-3%)

              Urticaria (1-3%)

              Tinnitus (1-3%)

              <1%

              Gastrointestinal: Bleeding and/or perforation with or without obvious ulcer formation, colitis, cholestatic jaundice

              Renal: Renal failure

              Hematologic: Neutropenia, thrombocytopenic purpura, leukopenia, agranulocytosis, hemolytic anemia, eosinophilia, decrease in hemoglobin and/or hematocrit

              Dermatologic: Erythema multiforme, Stevens-Johnson syndrome, exfoliative dermatitis

              Hepatic: Alteration of liver function tests

              Allergic: Lupus and serum sickness-like symptoms

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              Warnings

              Black Box Warnings

              Cardiovascular thrombotic events

              • NSAIDs may increase risk of serious cardiovascular (CV) thrombotic events, myocardial infarction (MI), and stroke, which can be fatal
              • Risk may increase with duration of use
              • Patients with risk factors for or existing cardiovascular disease may be at greater risk
              • NSAIDs are contraindicated for perioperative pain in the setting of coronary artery bypass graft (CABG) surgery (increased risk of MI and stroke)

              Gastrointestinal risk

              • NSAIDs increase risk of serious GI adverse events, including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal
              • GI adverse events may occur at any time during use and without warning symptoms
              • Elderly patients are at greater risk for serious GI events

              Contraindications

              Hypersensitivity

              Patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs; severe, rarely fatal, anaphylacticlike reactions to NSAIDs have been reported in such patients

              In the setting CABG surgery

              Cautions

              Increased risk of serious CV thrombotic events, including MI, and stroke, which can be fatal (see Black Box Warnings)

              Two large, controlled clinical trials of a COX-2 selective NSAID for the treatment of pain in the first 10-14 days following CABG surgery found an increased incidence of MI and stroke (see Contraindications)

              Use of NSAIDs in the post-MI period increased risk of reinfarction, CV-related death, and all-cause mortality beginning in the first week of treatment in an observational study; avoid use after a recent MI (see Black Box Warnings)

              Can lead to new-onset hypertension or worsening of preexisting hypertension; patients taking thiazides or loop diuretics may have impaired response to these treatments while taking an NSAID

              May cause fluid retention and edema; avoid use with severe heart failure

              Can cause serious GI adverse events, including inflammation, bleeding, ulceration, and perforation of the stomach, small intestine, or large intestine, which can be fatal

              Long-term administration has resulted in renal papillary necrosis and other renal injury; patients at greatest risk include those with impaired renal function, heart failure, liver dysfunction, those taking diuretics and ACE inhibitors, and elderly individuals

              Anaphylactoid reactions reported (see Contraindications)

              Can cause serious skin adverse events such as exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis

              Heart failure (HF) risk

              • NSAIDS have the potential to trigger HF by prostaglandin inhibition that leads to sodium and water retention, increased systemic vascular resistance, and blunted response to diuretics
              • NSAIDS should be avoided or withdrawn whenever possible
              • AHA/ACC Heart Failure Guidelines; Circulation. 2016; 134
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              Pregnancy & Lactation

              Pregnancy

              Pregnancy category: C; D in third trimester (may cause premature closure of ductus arteriosus)

              Quebec Pregnancy Registry identified 4705 women who had spontaneous abortions by 20 weeks' gestation; each case was matched to 10 control subjects (n=47,050) who had not had spontaneous abortions; exposure to nonaspirin NSAIDs during pregnancy was documented in approximately 7.5% of cases of spontaneous abortions and approximately 2.6% of controls

              Lactation

              Drug excreted in breast milk with multiple doses

              Consider the developmental and health benefits of breastfeeding along with the mother’s clinical need for the drug, and any potential adverse effects on the breastfed infant from the drug or from the underlying maternal condition

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Nonsteroidal anti-inflammatory drug (NSAID) that elicits anti-inflammatory, analgesic, and antipyretic activity

              Inhibits synthesis of prostaglandins in body tissues by inhibiting at least 2 cyclo-oxygenase (COX) isoenzymes, COX-1 and COX-2

              May inhibit chemotaxis, alter lymphocyte activity, decrease proinflammatory cytokine activity, and inhibit neutrophil aggregation; these effects may contribute to anti-inflammatory activity

              Absorption

              Peak plasma time: 0.5-2 hr

              Peak plasma concentration: 4.8 mcg/mL

              Food decreases rate and extent of absorption (bioavailability decreased by 26%; Cmax decreased 4-fold; time to Cmax delayed by 3 hr)

              Distribution

              Vd: 23.3 L

              Metabolism

              Extensively metabolized to an active metabolite (Metabolite I; 3-hydroxymethyl metabolite of meclofenamic acid) and at least 6 other less well-characterized minor metabolites

              Elimination

              Half-life: 0.8-5.3 hr (single-dose); 0.8-2.1 hr (TID x14 days); 15 hr (Metabolite I)

              Clearance: 206 mL/min

              Excretion: 70% urine; ~30% feces via biliary excretion

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              Administration

              Oral Administration

              Take on empty stomach; if GI complaints occur, may take with meals or milk (see Pharmacokinetics)

              Storage

              Store at controlled room temperature 20-25°C (68-77°F)

              Protect from light and moisture

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              meclofenamate oral
              -
              50 mg capsule
              meclofenamate oral
              -
              100 mg capsule

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

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              Formulary

              FormularyPatient Discounts

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              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.