Two compounds of the fenamate class of antiinflamma-tory drugs are marketed in the United States. Mefenamic acid (Ponstel) is indicated only for analgesia and primary dysmenorrhea when therapy will not exceed 1 week. Meclofenamate sodium (Meclomen) is prescribed for rheumatoid arthritis and osteoarthritis.
The fenamates show no clear superiority in anti-inflammatory activity and may produce more adverse effects than other NSAIDs. Diarrhea may be severe enough to necessitate discontinuation of drug use. Other adverse GI reactions include nausea, vomiting, abdominal pain, bleeding, and peptic ulceration. Decreases in the hematocrit or hemoglobin values occur in approximately one-sixth of patients taking meclofenamic acid, but these do not usually require discontinuation of therapy. Because of the rare possibility of drug-induced hemolytic anemia, hematological analyses should be performed on patients receiving long-term therapy if anemia is suspected.
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