BMJ 1995;311:392 (5 August)

Letters

Mefenamic acid is more dangerous than most

EDITOR,--We are particularly concerned about the continued use of mefenamic acid in elderly patients.1 Despite its apparent popularity this drug can provoke frank colitis in patients with no known predisposing factors2 and is neurotoxic in overdose. Reports of acute renal failure due to mefenamic acid, mainly affecting elderly people, have appeared steadily over the past 15 years.3 4 Most patients presented with abdominal pain and diarrhoea and were not oliguric; not allcases were reversible.

We have recently seen five patients with non-oliguric renal failure. The table gives their clinical histories. Diarrhoea was a feature in only two patients, the rest presenting non-specifically with immobility and falls, though all were clinically dehydrated. One patient (case 1) had a history of renal calculi but had had normal renal function documented previously; no other patient had a history of renal disease. In all cases, mefenamic acid was stopped and fluid replacement and antibiotic treatment . . . [Full text of this article]


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Relevant Article

Non-steroidal anti-inflammatory drugs and elderly patients
D N Bateman and J G Kennedy
BMJ 1995 310: 817-818. [Extract] [Full Text]

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