Drug interactions
Mefenamic acid + Pegaspargase
Severity: Major
Mefenamic acid and Pegaspargase: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Pegaspargase can cause coagulopathy through reduced clotting factor synthesis and thrombocytopenia, and NSAIDs add platelet dysfunction and GI bleeding risk. Combined use raises the chance of significant bleeding.
What this interaction means in plain words
Mefenamic acid and Pegaspargase can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Mefenamic acid belongs to Musculoskeletal; Pegaspargase belongs to Oncology.
Why it happens
Additive hemostatic impairment: asparaginase-related reduction in coagulation proteins plus NSAID antiplatelet and mucosal effects.
What to do
Avoid NSAIDs during pegaspargase therapy where possible, using paracetamol instead, and monitor coagulation parameters and platelet counts if unavoidable.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Mefenamic acid
- Ketorolac intranasal + Mefenamic acid Contraindicated
- Ketorolac + Mefenamic acid Contraindicated
- Aceclofenac + Mefenamic acid Major
- Acemetacin + Mefenamic acid Major
- Acetylsalicylic acid + Mefenamic acid Major
- Alteplase + Mefenamic acid Major
Other interactions of Pegaspargase
- Etodolac + Pegaspargase Major
- Ketorolac + Pegaspargase Major
- Acetylsalicylic acid + Pegaspargase Moderate
- Argatroban + Pegaspargase Moderate
- Celecoxib + Pegaspargase Moderate
- Dabigatran etexilate + Pegaspargase Moderate
Frequently asked questions
Can I take Mefenamic acid with Pegaspargase?
MediHelp rates the interaction as major. Mefenamic acid and Pegaspargase can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Pegaspargase can cause coagulopathy through reduced clotting factor synthesis and thrombocytopenia, and NSAIDs add platelet dysfunction and GI bleeding risk. Combined use raises the chance of significant bleeding.
How serious is the interaction between Mefenamic acid and Pegaspargase?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid NSAIDs during pegaspargase therapy where possible, using paracetamol instead, and monitor coagulation parameters and platelet counts if unavoidable.
What other medicines interact with Mefenamic acid?
MediHelp also lists interactions of Mefenamic acid with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Mefenamic acid page.
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