Mefenamic Acid and Breastfeeding

Summary of use during lactation

Because there is little published experience with mefenamic acid during breastfeeding and it is potentially toxic, other agents may be preferred, especially while nursing a newborn or preterm infant.

Drug levels in milk and infant serum

Maternal Levels. Ten postpartum women received a 500 mg loading dose of mefenamic acid followed by 250 mg orally 3 times daily through the fourth postpartum day. Mefenamic acid and its metabolites were measured using an old, insensitive assay method. Milk samples taken 2 hours after the first dose of each day found average mefenamic acid milk levels of 170 mcg/L (range 30 to 660 mcg/L), although these levels might be inaccurate because the concentration measured in blank milk samples in this study was 200 mcg/L and potentially active metabolites were not measured.[1] Infant Levels. Ten postpartum women received a 500 mg loading dose of mefenamic acid followed by 250 mg orally 3 times daily. Infant serum and urine specimens were obtained one hour after nursing on the afternoon of the fourth day. Only 3 of the 10 infants had blood levels at or above the blank level of the assay (10 mg/L). Average urine recovery was similar to the blank level. Five of the 10 infants had urine levels greater than blank urine.[1]

Effects in breastfed infants

Relevant published information was not found as of the revision date.

Effects on lactation and breastmilk

Relevant published information was not found as of the revision date.

Alternative drugs to consider

Acetaminophen, Celecoxib, Flurbiprofen, Ibuprofen, Indomethacin, Naproxen, Piroxicam

References

1. Buchanan RA, Eaton CJ, Koeff ST, et al. The breast milk excretion of mefenamic acid. Curr Ther Res 1968;10:592-64973976 PubMed