The Indian Pharmacopoeia Commission (IPC) recently issued a drug safety alert for doctors and patients regarding the widely-used painkiller mefenamic acid, commonly sold under the brand name Meftal.
In a preliminary analysis of Adverse Drug Reactions (ADRs) from the PvPI database, the pharmaceutical standard body revealed that Meftal can lead to Drug Reactions with Eosinophilia and Systemic Symptoms (DRESS) Syndrome. Dr. Tushar Tayal, Lead Consultant in the Department of Internal Medicine at CK Birla Hospital, Gurugram, explained that this syndrome can cause a range of clinical symptoms, manifesting anywhere from 2 to 8 weeks after initiating the drug.
While antiepileptic medications are often considered the main cause of DRESS syndrome, nonsteroidal anti-inflammatory drugs (NSAIDs) like mefenamic acid have also been implicated. Meftal is commonly prescribed for conditions such as rheumatoid arthritis, osteoarthritis, dysmenorrhea, mild to moderate pain, inflammation, fever, and dental pain.
Healthcare professionals and consumers are advised to closely monitor the possibility of ADR associated with the use of Meftal. If such reactions occur, they are urged to report them to the NCC-PvPI, IPC, by filling out the Suspected Adverse Drug Reactions Reporting Form.
Meftal is widely used by consumers for relieving menstrual pains, headaches, and muscle and joint pain, including in children for high fever. Notable products in this category include Blue Cross Laboratories’ Meftal, Mankind Pharma’s Mefkind P, Pfizer’s Ponstan, Serum Institute’s Mefanorm, and Dr. Reddy’s Ibuclin P.
DRESS Syndrome is a type of drug allergy that can occur as a reaction to various medications. It clinically manifests with fever, facial edema, lymphadenopathy, a morbilliform rash, and organ involvement. While some drugs are more commonly associated with DRESS, virtually any drug could cause it. Symptoms typically appear two to six weeks after starting the medication.
Patients diagnosed with DRESS syndrome may present with a rash, fever, and eosinophilia, and can have symptoms involving the liver, lungs, or kidneys. The primary treatment for DRESS Syndrome involves discontinuing the implicated medication, and in some cases, no further treatment is required. Topical steroids may be administered to treat the rash, and additional treatments, such as systemic steroids, may be necessary to protect organs from damage.
It is advisable to exercise caution with over-the-counter painkillers and use them only when absolutely necessary, under the supervision of a treating physician. Any untoward side effects should be reported to a doctor immediately. While recovery from DRESS syndrome is generally positive, long-term monitoring may be necessary, as some patients may develop autoimmune diseases.