Drug interactions
Mefenamic acid + Prasugrel
Severity: Major
Mefenamic acid and Prasugrel: 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
Combining an NSAID with prasugrel raises the risk of bleeding, particularly gastrointestinal bleeding. Prasugrel is a potent antiplatelet, and NSAIDs add platelet dysfunction and gastric mucosal injury.
What this interaction means in plain words
Mefenamic acid and Prasugrel 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; Prasugrel belongs to Cardiovascular.
Why it happens
Additive antiplatelet effects (irreversible P2Y12 blockade plus reversible COX inhibition) combined with NSAID-related gastric mucosal damage.
What to do
Avoid regular NSAID use in patients on prasugrel; use paracetamol where possible. If an NSAID is unavoidable, use the shortest course and consider gastroprotection with a proton pump inhibitor, monitoring for bleeding.
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 Prasugrel
Frequently asked questions
Can I take Mefenamic acid with Prasugrel?
MediHelp rates the interaction as major. Mefenamic acid and Prasugrel 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. Combining an NSAID with prasugrel raises the risk of bleeding, particularly gastrointestinal bleeding. Prasugrel is a potent antiplatelet, and NSAIDs add platelet dysfunction and gastric mucosal injury.
How serious is the interaction between Mefenamic acid and Prasugrel?
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 regular NSAID use in patients on prasugrel; use paracetamol where possible. If an NSAID is unavoidable, use the shortest course and consider gastroprotection with a proton pump inhibitor, monitoring for bleeding.
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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