Is Meftal Spas safe to have? Here's what doctors have to say

After the central government's watchdog issued an alert highlighting the side effects of Mefenamic Acid, a constituent of Meftal used as a painkiller, the manufacturer has responded to the probable side effects. Blue Cross Laboratories, the pharmaceutical company behind the Meftal and Meftal Spas brands, said that the two medicines are trusted among the medical fraternity.  In response to the IPC alert, Blue Cross Laboratories has said that the advisory issued by the Central government is intended to promote vigilance among doctors and patients- monitoring potential adverse drug reactions (ADRs) related to mefenamic acid. The company has emphasised that, despite the alert, the safety, effectiveness, and high quality of the established brands remain uncompromised. To resolve the confusion, we spoke to experts. Read what the experts have to say after the government's advisory and manufacturers clarification.  

What is Meftal and what does Government’s advisory say? 

Mefenamic Acid, commonly sold under the name Meftal, is a non-steroidal anti-inflammatory drug (NSAID) and is used to get rid of pain. An advisory by the Indian Pharmacopoeia Commission (IPC), released on December 9, said that use of mefenamic acid may trigger severe allergic reactions like DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) which severely impacts internal organs. 

IPC is an autonomous arm of the Ministry of Health and Family Welfare, set up to keep a check on the standard of drugs manufactured and sold in India. Reports suggest that just like other NSAIDs, Meftal is widely sold and purchased over the counter, which means without a prescription. Meftal or mefenamic acid, in recent years, has become the go-to drug for menstrual cramps. 

Is it safe to have Meftal? What doctors say..

Obstetrician-Gynaecologist Dr. Aditi Tandon, also known as ‘The Fertility Doc’ on Instagram, said that in her practicing career has never encountered a single case of DRESS caused by the use of Meftal. “In my practice, I have never seen a single incident of Meftal spas which most Gynaecologists give for dysmenorrhea causing DRESS. I consume the drug myself too. There is no cause for panic,” she said while speaking exclusively with Republic. “But DRESS after mefenamic acid is extremely rare and should not be the reason to prevent you from taking it,” she added. 

Dr. Tandon suggested that there can be multiple reasons behind menstrual cramps and instead of popping any pill, one should consult a medical professional. “Those commonly causing excessive period pain are Endometriosis, Adenomyosis and Fibroids. Especially pain starting earlier than the day of period, more severe and lasting longer than one day. If you do experience any of this, rather than popping a painkiller, consult your Gynaecologist so they can treat the root cause,” said Dr. Tandon. 

Dr Ankita Singh, MD- Obstetrics & Gynaecology, Advanced Diploma in ART & Reproductive Medicine who is currently serving as the Consultant Gynaecologist at Hope Diagnostics & Healthcare, Dumka (Jharkhand) said that Mefenamic acid is commonly prescribed by gynaecologists for menstrual cramps, inflammation & by physicians for Rheumatoid arthritis, osteoarthritis, pain, fever etc. “IPC stated an ADR known as drug reactions with Eosinophilia and Systemic Symptoms (DRESS) that is quite a rare drug reaction,” said Dr. Singh. 

Use medicines as last resort, suggests Doctor 

“Pain during periods can normally occur too and yes if needed, one can take a painkiller. But painkillers must be used judiciously as a last resort after conservative methods don’t work, like hot water bags, tens patches, exercise,” said Dr. Tandon. Dr. Tandon says that there are other common side effects of NSAIDs which must be more concerning that the ones highlighted in the government's advisory. 

“I would advise caution more on the gastro-intestinal effects of NSAIDs, which are more common rather than DRESS! They can lead to gastritis and ulcers. And to combat this, one can use an NSAID skin patch instead to prevent the drug entering the body through the stomach. Or consume an NSAID along with an antacid,” advised Dr. Tandon.

Dr. Singh also asserted that she plans to restrict herself while prescribing Meftal from now on. “Pertaining to the imposed caution, this drug will be used with restriction in our prescriptions and alternatives of this anti-spasmodic would be considered,” said Dr. Singh.