14C Dysmenorrhea
OB/GYN
bleed with aspirin (except low-dose), corticosteroids,
smoking, anticoagulants. May potentiate lithium.
Monitor warfarin.
Adverse reactions: GI upset/pain, edema,
pharyngitis, increase AST/ALT, GI ulcer/bleed; rare:
intracranial bleed, liver failure. See literature re: risk
of cardiovascular events.
How supplied: Caps 100mg, 200mg– 100, 500;
50mg, 400mg– 60
; DICLOFENAC POTASSIUM
CATAFLAM Novartis
NSAID (benzeneacetic acid deriv.). Diclofenac
potassium 50mg; tabs.
Indications: Dysmenorrhea.
Adults: 50mg 3 times daily; may give 100mg
initially.
Children: Not applicable.
Contraindications: Aspirin allergy. Late pregnancy.
Coronary artery bypass graft surgery.
Warnings/Precautions: Advanced renal disease:
not recommended. Peptic ulcer. GI bleeding. Monitor
AST/ALT within 4 weeks and then periodically; also
blood, hepatic, and renal function in chronic use.
Edema. Cardiac failure. Hypertension. Hepatic
porphyria. Elderly. Debilitated. Pregnancy (Cat.C).
Nursing mothers: not recommended.
Interactions: Digoxin, methotrexate, cyclosporine,
lithium toxicity. Antagonizes diuretics. May increase
serum potassium level with K;-sparing diuretics.
Avoid aspirin. Monitor oral anticoagulants, insulin and
sulfonylureas. Increased risk of GI bleed with alcohol.
Adverse reactions: Peptic ulcer, GI bleeding,
elevated AS T/ALT, abdominal discomfort, constipation,
diarrhea, indigestion, nausea, abdominal distention,
headache, dizziness, fluid retention, rash (discontinue
if occurs), pruritus, tinnitus. See literature re: risk of
cardiovascular events.
How supplied: Tabs– 100
;IBUPROFEN
MOTRIN TABLETS Pfizer
NSAID (propionic acid deriv.). Ibuprofen 400mg,
600mg, 800mg.
OTC Also: Ibuprofen
MOTRIN CAPLETS McNeil Cons & Specialty
Ibuprofen 100mg; scored.
OTC Also: Ibuprofen
MOTRIN CHEWABLE McNeil Cons & Specialty
Ibuprofen 50mg, 100mg; scored tabs; citrus flavor;
contains phenylalanine.
OTC Also: Ibuprofen
MOTRIN SUSPENSION McNeil Cons & Specialty
Ibuprofen 100mg/5mL; berry flavor.
Indications: Dysmenorrhea.
Adults: 400mg every 4 hours; max 3.2g/day. May
take with food or milk.
Children: Not applicable.
Contraindications: Aspirin allergy. 3rd trimester
pregnancy. Coronary artery bypass graft surgery.
Warnings/Precautions: Advanced renal disease:
not recommended. History of upper GI disease.
Active peptic ulcer. Impaired renal or hepatic function.
Edema. Hypertension. Cardiac failure. Bleeding
disorders. Diabetes. Monitor blood, hepatic, renal,
and ocular function in chronic use. Discontinue if
visual or liver dysfunction occurs. Dehydration. Elderly.
Debilitated. Pregnancy (Cat.C). Nursing mothers: not
recommended.
Interactions: Avoid aspirin. May increase bleeding
with anticoagulants. Increases serum lithium levels.
May increase toxicity of methotrexate. May decrease
effect of furosemide, thiazide diuretics. Increased risk
of GI bleed with alcohol.
Adverse reactions: Peptic ulcer or perforation, GI
bleeding, vision disorders, nausea, epigastric pain,
heartburn, dizziness, rash (discontinue if occurs),
edema, renal papillary necrosis, jaundice, hepatitis.
See literature re: risk of cardiovascular events.
How supplied: Tabs– 100, 500; Caplets, chew
tabs– 100; Susp–4oz, 16oz
; MEFENAMIC ACID
PONSTEL Shionogi
NSAID (fenamate). Mefenamic acid 250mg; caps.
Indications: Dysmenorrhea.
Adults: Take with food. ;14yrs: 500mg once, then
250mg every 6 hrs; usually for up to 2–3 days.
Children: ;14yrs: not recommended.
Contraindications: Aspirin allergy. GI ulceration
or inflammation. Renal dysfunction. Late pregnancy.
Coronary artery bypass graft surgery.
Warnings/Precautions: Active or history of
hepatic dysfunction. Bleeding disorders. Fluid
retention. Heart failure. Hypertension. Asthma.
Monitor for GI ulcer/bleed (risk is increased if
patient is otherwise at high-risk, extended drug
treatment, high doses, smokers, alcoholics,
history of GI bleed or ulcer); blood, renal, hepatic,
and ocular function in chronic use. Dehydrated.
Debilitated. Elderly (;65yrs). Labor & delivery.
Pregnancy (Cat.C). Nursing mothers: not
recommended.
Interactions: Avoid aspirin. Increased risk of GI
bleed with anticoagulants, aspirin, corticosteroids.
May potentiate methotrexate, oral anticoagulants,
lithium; monitor. May be potentiated by
magnesium-containing antacids. May antagonize
antihypertensives, diuretics. May antagonize or
increase risk of renal failure with concomitant ACE
inhibitors or diuretics. Caution with inhibitors of
CYP2C9.
Adverse reactions: GI disturbances (eg,
abdominal pain, constipation, diarrhea, dyspepsia,
nausea, flatulence, GI ulceration or bleeding),
anemia, dizziness, edema, renal or hepatic
dysfunction, headache, pruritus, rash (discontinue if
occurs), tinnitus, drowsiness, photosensitivity, CNS
effects, alopecia, blurred vision. See literature re:
risk of cardiovascular events.
How supplied: Caps– 100
