Meftal unsafe for kids and pregnant women, say experts after IPC alert

NEW DELHI: Doctors on Friday cautioned the use of Meftal among children, pregnant and lactating women, after the Indian Pharmacopoeia Commission (IPC) issued an alert against the drug.

Meftal is commonly used as a painkiller for menstrual cramps, rheumatoid arthritis, osteoarthritis, dysmenorrhoea, mild to moderate pain, inflammation, fever and dental pain.

According to the IPC alert, the use of Meftal, whose main composition is Mefenamic acid, can lead to potential adverse reactions, causing Eosinophilia and systemic symptoms (DRESS) syndrome.

“Healthcare professionals, patients/consumers are advised to closely monitor the possibility of adverse drug reactions (ADRs),” associated with the use of Mefenamic acid, the IPC alert said.

DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms) is recognised as an intensely painful allergic disease in medical terms. The syndrome occurs in approximately 10 per cent of individuals and is marked by a delayed onset and diverse symptoms, including fever, skin rash, Lymphadenopathy, Eosinophilia, and systemic manifestations.

“Drug reaction with Eosinophilia and systemic symptoms (DRESS) is a severe adverse drug reaction characterised by an extensive skin rash in association with organ involvement, Lymphadenopathy, Eosinophilia, and atypical Lymphocytosis. This syndrome results in a variety of clinical symptoms, emerging between 2 to 8 weeks after initiating the causative drug,” Dr Tushar Tayal, Lead Consultant, Department of Internal Medicine, CK Birla Hospital, Gurugram, told IANS.

“Predicting the occurrence of DRESS syndrome is extremely challenging, so it is recommended to abstain from over-the-counter painkillers unless absolutely necessary and to consume them under the guidance of your treating physician. In case of any adverse effects, you must report them to your doctor on an immediate basis,” Dr Tayal added.

As an NSAID (nonsteroidal anti-inflammatory drugs), Mefenamic acid carries risks and side effects, including gastrointestinal issues, cardiovascular complications, and renal problems.

“Renowned for their effectiveness in managing pain and inflammation, NSAIDs have become a familiar resource for individuals grappling with common discomfort. Yet, with the convenience and relief that these drugs offer, it is imperative to acknowledge the potential side effects inherent in their usage,” Dr. Vikramjeet Singh, Senior Consultant-Internal Medicine, Aakash Healthcare, New Delhi, told IANS.

“NSAIDs, including Metronomic acid, constitute a distinct pharmaceutical group, each carrying its array of side effects. Notably, these drugs should be approached with caution in patients with kidney disease and are strictly contraindicated in cases of epileptic impairment or cardiac dysfunction, conditions where the use of NSAIDs is generally discouraged,” he added.

The doctor said that the recommended strategy involves administering the lowest effective dose for the shortest possible duration.

Dr. Rashmi Baliyan, Gynaecologist and Obstetrician Consultant, Primus Super Speciality Hospital said “Meftal is unsafe for pregnant and nursing women as it may disrupt blood flow to the foetus and make breast milk toxic”.

The IPC’s drug safety alert against reactions of the painkiller “underscores the critical importance of monitoring and awareness within the medical community and among patients,” she told IANS.

Over-reliance on Meftal can also lead to severe allergies and compromise heart health, emphasising the importance of cautious usage and professional medical advice, the doctors said.

Dr Rajath Athreya, Senior Consultant and HOD Paediatrics and Neonatology, Sakra World Hospital Bengaluru also raised concerns over Meftal’s use for managing childhood fevers as there is no data to back its benefits.

“The tiered approach for medications has no scientific basis, urging caution. My practice emphasises paracetamol or occasional ibuprofen, with close attention to danger signs. I avoid prescribing Meftal due to the lack of safety data. Parents and practitioners must prioritise trusted medications, stay informed, and exercise patience in treating fevers,” Dr Athreya said.

The health experts advised that before using Meftal or any medication, it is essential to seek professional medical advice.

“Consult with a healthcare professional to ensure it is appropriate for your condition, understand potential risks, and receive personalised guidance for optimal and safe usage,” they said.