Menstrual Cramps? Headache? Not All Painkillers Are Safe

They Shouldn’t Contain Mefenamic Acid, Warns Drug Standards Agency

Newsreel Asia Insight #68
Dec. 9, 2023

Menstrual cramps and arthritis pain can be intense. However, hastily purchasing over-the-counter painkillers from a pharmacy might not be the wisest choice. The drug standards agency in India has issued a warning about mefenamic acid, which is present in several popular pain relief medications.

The Indian Pharmacopoeia Commission (IPC) warns that painkillers containing mefenamic acid can trigger a severe allergic reaction, known as Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome, as reported by The Print.

The syndrome typically emerges two to six weeks after starting a new medication and can progress rapidly. Symptoms often include fever, skin rashes, and lymphadenopathy (swollen lymph nodes). In more severe cases, it can lead to liver, kidney, lung, and heart complications.

Mefenamic acid, known to many under brand names like Meftal, has been a staple in Indian households for managing pain. Its efficacy is not in question, but its safety now is.

It reportedly has a range of other side effects that extend beyond its intended use.

Users may experience abdominal discomfort, indigestion, and dry mouth, according to a report in India Today. Additionally, blurred vision and elevated blood pressure are not uncommon, it says, adding that the drug can also cause swelling and skin rashes, along with more serious gastrointestinal issues, including stomach ulcers and bleeding.

Moreover, the long-term use of this drug raises further concerns. It has been linked to potential risks to women’s fertility and can contribute to kidney complications, according to the report, which further suggests that for those with pre-existing heart conditions, the drug poses an increased risk of cardiovascular events, adding a layer of caution for these individuals.

In the realm of medicine, the journey from relief to risk is often a short one. Doctors emphasise that no drug is entirely risk-free. They say drugs containing mefenamic acid should not be used without a prescription.

“This may be particularly important for individuals with a history of gastrointestinal bleeding and cardiovascular issues. Regular monitoring and adherence to prescribed doses help mitigate risks,” Dr. Anusha Rao P., a consultant for obstetrics and gynaecology with Yashoda Hospitals in Hyderabad, tells The Print.

Dr. Rao urges patients to be open with their doctors about any allergic reactions or pre-existing conditions. This transparency is crucial for the safe and effective use of mefenamic acid. Additionally, she recommends promptly reporting any unusual symptoms that may arise during the course of any medication prescribed by doctors.

Which is the “safest” painkiller? It depends on an individual’s health condition, the type of pain and the duration of use. The risks and benefits of each medication should be weighed, considering the individual’s medical history and other medications they may be taking.

For instance, acetaminophen – also known as Paracetamol or Tylenol – is often recommended for short-term pain relief due to its lower risk of causing stomach issues, but it must be used cautiously to avoid liver damage.

Nonsteroidal anti-inflammatory drugs (NSAIDs) – including Meftal-Spas, Disprin, Nurofen and Naprosyn – should be taken with care, especially by those with gastrointestinal, kidney or heart problems.

Navigating the world of pain relief requires a tailored approach, making it essential for individuals to engage with healthcare professionals. This collaboration ensures the selection of not just an effective painkiller, but one that aligns safely with their unique health profile and needs.

The situation with mefenamic acid sheds light on the evolving nature of our understanding of drugs. What was once deemed safe can, over time and with more extensive use, reveal less obvious risks. This is not an indictment of the medical community or the drug itself but a reflection of the ongoing journey of medical discovery.