Mefenamic acid advisory: Drug commonly used for menstrual cramps can cause adverse reactions

The mefenamic-acid painkiller is also prescribed for the treatment of rheumatoid arthritis, osteoarthritis, dysmenorrhoea, mild to moderate pain, inflammation, fever, and dental pain.

Published Dec 07, 2023 | 7:50 PMUpdated Dec 18, 2023 | 7:22 PM

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The Indian Pharmacopoeia Commission (IPC) has issued a drug-safety alert advising healthcare professionals and patients to monitor the adverse reactions of mefenamic acid, which is used in drugs that are commonly prescribed for menstrual cramps. The most commonly used one is Meftal Spas.

The mefenamic-acid painkiller is prescribed for the treatment of rheumatoid arthritis, osteoarthritis, dysmenorrhoea, mild to moderate pain, inflammation, fever, and dental pain.

The commission, in its alert, stated that a preliminary analysis of adverse drug reactions from the Pharmacovigilance Programme of India (PvPI) database revealed instances of drug reactions with eosinophilia and systemic symptoms (DRESS) syndrome.

Although the drug is not available over the counter and requires a prescription for purchase, it is extensively utilised by individuals in India for various purposes such as alleviating menstrual pains, and headaches, as well as muscle and joint pain.

Leading brands within this category encompass Meftal by Blue Cross Laboratories, Mefkind P by Mankind Pharma, Ponstan by Pfizer, Mefanorm by Serum Institute, and Ibuclin P by Dr Reddy’s.

What is DRESS syndrome?

DRESS Syndrome is a severe and potentially life-threatening hypersensitivity reaction to certain medications.

It is a rare but serious condition characterised by a combination of skin rash, fever, inflammation of internal organs, and hematologic abnormalities.

Key features of DRESS syndrome include:

1. Skin rash: Patients with DRESS often develop a widespread rash that can involve various parts of the body. The rash may be maculopapular (flat and raised lesions), erythematous (red), and may resemble other skin conditions.

2. Fever: Individuals with DRESS typically experience a high fever.

3. Internal organ involvement: DRESS can affect multiple organs, including the liver, kidneys, lungs, and heart. It can lead to hepatitis, nephritis, pneumonitis, and myocarditis.

4. Haematologic abnormalities: Blood abnormalities, such as eosinophilia (elevated eosinophil count), atypical lymphocytes, and other hematologic changes, may be present.

5. Lymphadenopathy: Swollen lymph nodes (lymphadenopathy) are common in DRESS Syndrome cases.

The exact cause of DRESS is not fully understood, but it is thought to be an immune-mediated reaction to certain drugs.

Various medications have been associated with DRESS, including antiepileptic drugs, allopurinol, sulfonamides, and certain antibiotics.

It’s crucial to recognise DRESS early, as the condition can progress rapidly and lead to severe complications.

Treatment typically involves discontinuing the culprit medication and providing supportive care. In some cases, corticosteroids or other immunosuppressive medications may be prescribed to help manage the inflammatory response.

If you suspect DRESS or experience symptoms after taking a medication, it is important to seek medical attention promptly.

DRESS is a medical emergency, and early recognition and intervention are essential for a better prognosis. Always consult with healthcare professionals for accurate diagnosis and appropriate management.

The advisory

The IPC has advised healthcare professionals, patients, and consumers to closely monitor the possibility of the above adverse drug reaction (ADR) associated with the use of the suspected drug, according to the alert issued on 30 November.

“If such reaction is encountered, the alert advised, people should report the matter to the national coordination centre of the PvPI under the commission by filing a form on the website — www.ipc.gov.in — or through the Android mobile app ADR PvPI and PvPI Helpline No. 1800-180-3024,” said the IPC alert.

An autonomous institution of the Ministry of Health, the IPC sets standards for all drugs manufactured, sold, and consumed in India.

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