Mefenamic Acid (Oral)

Mefenamic Acid features analgesic and anti-inflammatory properties and is mainly used to treat pain associated with arthritis or menstruation.

Overview

Mefenamic acid is a prescription only NSAID indicated for the treatment of bodily aches and pains that are mild to moderate and short-term. It is predominantly prescribed in women who commonly experience pain during menstruation, including migraines and cramps. It is not, however, indicated for patients under the age of 14 years of age, except in rare cases.

Mefenamic Acid is also widely used for the treatment of arthritis. Mefenamic Acid is sold under the drug name Ponstel and is available in capsule form.

NSAIDs are otherwise known as nonsteroidal anti-inflammatory drugs (NSAID). These belong to a class of drugs whose main functions are to reduce pain and inflammation. NSAIDs are extensively used in the medical field for pain and inflammation associated with several conditions. As a member of the fenamate group of NSAIDs, however, Mefenamic Acid targets specific hormones responsible for swelling and pain throughout the body.

You may be familiar with over the counter (OTC) NSAIDs, such as Acetaminophen or Ibuprofen, for example. These pain medications may have little to no effect on the pain associated with Dysmenorrhea. When no relief is available from over the counter NSAIDs due to Dysmenorrhea, doctors may prescribe Mefenamic Acid during menstruation only, and for a limited time.

This condition is marked by painful menstrual cramps, cycle after cycle. Patients may experience throbbing sensations and cramps in the lower abdomen or pelvic region. Patients who are prescribed Mefenamic Acid for Dysmenorrhea usually take it around 24 hours before the time of the expected menstruation start date to help alleviate the symptoms. The treatment usually lasts for 2-3 days to sync with the duration of Dysmenorrhea.

Conditions Treated

  • Menstrual Pain
  • Cramps
  • Migraines
  • Arthritis
  • Dysmenorrhea

Type Of Medicine

  • Fenamate Nonsteroidal Anti-Inflammatory Drug (NSAID)

Side Effects

Patients using Mefenamic Acid may develop unwanted side effects. The most common reported adverse reactions of this drug include:

  • A burning sensation in the abdominal region
  • Appetite loss
  • Bloating
  • Blood in the stools or urine
  • Changes in stool color
  • Cramps and pain in the stomach
  • Dehydration
  • Edema, especially in the legs, hands, or facial area
  • Feeling nauseous
  • Fluctuations in weight
  • High blood pressure
  • Indigestion
  • Low output of urine
  • More menstrual bleeding
  • Pain in the side and/or back
  • Rashes and itching
  • Skin that bruises easily
  • Skin that looks pale
  • Throwing up a substance resembling coffee-grounds

Rare side effects
Some of the rare side effects that may develop with Mefenamic Acid use include:

  • A headache
  • A rapid or slow heartbeat
  • A stiff neck
  • An all-over feeling of being sick
  • Bad breath
  • Blurriness
  • Chest tightness
  • Convulsions
  • Difficulty passing stools
  • Dry or scaly skin
  • Extreme drowsiness
  • Extreme perspiration
  • Fainting, dizziness, or lightheadedness
  • Feeling cold
  • Feeling confused
  • Feeling famished
  • Feeling fatigued
  • Feeling nervous
  • Fluctuations in temperature
  • Hallucinations
  • Hives
  • Jaundice
  • Labored breathing
  • Marks or spots on the skin
  • Pain in the chest
  • Pain in the joints or muscles
  • Pain in the legs
  • Pain, burning, or difficulty while urinating
  • Red eyes
  • Ringing or pounding ears
  • Sensitive gums that bleed easily
  • Shaking
  • Skin patches that look blue or purple
  • Skin that blisters or peels
  • Sore throat or tongue
  • Stomach that is tender to the touch
  • Stools that look like clay
  • Swollen and painful glands
  • Tingling or pins and needles sensation
  • The urge to urinate more often than usual
  • Throwing up blood
  • Trouble swallowing
  • Ulcers in the mouth
  • Urine color that looks darker
  • Neck veins that appear to be swollen
  • Voice changes
  • Wheezing

In extreme cases, Mefenamic Acid may also cause patients to fall into a coma or show no vital signs, including a pulse, blood pressure, or breathing. In these cases, emergency medical help is required right away.

Dosage

When prescribing Mefenamic Acid, healthcare providers take into account several key factors for the patient's safety. As a result, the dosage amount should never be altered before first consulting with your healthcare provider. In addition, you should never share this drug with friends, family or loved ones.

Some of the main factors that are considered when prescribing Mefenamic Acid include:

  • The patient's pain levels
  • The strength of the medication
  • The patient's medical history, including any incidences of allergies
  • Current medications being used
  • The length that treatment is needed
  • The intermissions between each dose

The medication should be taken exactly as prescribed and for the length of time ordered. If your symptoms aren't alleviated, do not take more of Mefenamic Acid. Instead, consult your medical provider for help.

Gauging the level of pain

A healthcare provider generally assesses the patient's pain level using a pain scale. This pain scale helps healthcare providers get a better idea of that the patient is feeling and subsequently, what prescription strength to provide. For example, if a female patient sets up an appointment with a medical provider due to painful menses, she will likely be asked to rate her level of pain based on a scale of 1-10.

The cut-off points for mild to moderate pain vary by practice and region. However, Mefenamic Acid is generally indicated for mild to moderate levels of pain.

Mefenamic Acid is supplied in 250 mg capsules, that are ivory colored with a blue band.

Average Dose Amounts for Menstrual Cramps

  • Children 14 Years Old or Younger Varies based on a doctor's discretion
  • Children 14 Years Old and Older: Initial Dose: 500 mg | Follow Up With 250 mg Every 6 Hours (When Required) | for 2-3 Days
  • Adults: Initial Dose: 500 mg | Follow Up With 250 mg Every 6 Hours (When Required) | for 2-3 Days

Average Dose Amounts for Pain

  • Children 14 Years Old or Younger Varies based on a doctor's discretion
  • Children 14 Years Old and Older: Initial Dose: 500 mg | Follow Up With 250 mg Every 6 Hours (When Required) | Do Not Exceed 7 Days
  • Adults: Initial Dose: 500 mg | Follow Up With 250 mg Every 6 Hours (When Required) | Do Not Exceed 7 Days

Since Mefenamic Acid is generally taken on an as-needed basis for the short-term, prescribing doctors generally advise patients to:

1. Take the medicine at least one day before menstrual flow begins, or:
2. Take the medicine as soon as pain is felt

Waiting out the pain is usually a bad idea as the higher the pain scale, the higher the dose required. Nevertheless, you should never increase the dose of Mefenamic Acid without first consulting with your healthcare provider.

Pharmacists generally recommend taking this medicine with a full meal to reduce the chances of developing an upset stomach. The best practices also include taking the capsules with a full glass of water.

Patients are also advised to sit up for at least a few minutes after taking the medicine.

Mefenamic Acid doses should never be doubled. Therefore, if you forget to take your medicine, gauge if it's close to the time for the next scheduled dose. If only an hour or so has passed, it's generally okay to take the missed dose. If, however, the time is drawing near for the next scheduled dose, skip the missed dose altogether and go back to the normal schedule. If you have any questions while using this medicine, consult your local pharmacy.

An overdose of Mefenamic Acid is considered to be a medical emergency. If you or someone you know has taken too much of this medicine, call 911 immediately. The American Association of Poison Control Centers is also available by dialing 1-800-222-2222.

Interactions

NSAIDs, in general, may interact negatively with a host of other medicines. In medical studies, the following contraindications have been observed when Mefenamic Acid is used in conjunction with the following drugs:

  • Nadroparin
  • Piketoprofen
  • Ibuprofen
  • Enoxaparin
  • Tianeptine
  • Temocapril
  • Magnesium Oxide
  • Eprosartan
  • Azilsartan
  • Carteolol
  • Clopamide
  • Fluocortolone
  • Heparin
  • Captopril
  • Indomethacin
  • Tolmetin
  • Magaldrate
  • Mefenamic Acid
  • Oxprenolol
  • Cilazapril
  • Aluminum Phosphate
  • Donepezil
  • Parecoxib
  • Argatroban
  • Cyclopenthiazide
  • Proquazone
  • Enalapril
  • Ticlopidine
  • Valdecoxib
  • Polythiazide
  • Prasugrel
  • Amineptine
  • Amiloride
  • Salicylamide
  • Cortisone
  • Valsartan
  • Feverfew
  • Protein C
  • Benazepril
  • Pralatrexate
  • Eplerenone
  • Rofecoxib
  • Budesonide
  • Calcium Carbonate
  • Dipyridamole
  • Mesalamine
  • Reviparin
  • Moexipril
  • Aluminum Carbonate, Basic
  • Fepradinol
  • Lithium
  • Chlorothiazide
  • Tacrolimus
  • Metoprolol
  • Cangrelor
  • Imipramine
  • Floctafenine
  • Tolfenamic Acid
  • Desirudin
  • Propranolol
  • Prednisolone
  • Methylprednisolone
  • Phenyl Salicylate
  • Desvenlafaxine
  • Phenprocoumon
  • Morniflumate
  • Meloxicam
  • Spironolactone
  • Venlafaxine
  • Bumetanide
  • Naproxen
  • Balsalazide
  • Levomilnacipran
  • Dihydroxyaluminum Aminoacetate
  • Sotalol
  • Phenylbutazone
  • Deflazacort
  • Paramethasone
  • Penbutolol
  • Ramipril
  • Amitriptyline
  • Oxyphenbutazone
  • Cyclosporine
  • Magnesium Carbonate
  • Rivaroxaban
  • Dexibuprofen
  • Lumiracoxib
  • Pindolol
  • Flurbiprofen
  • Nimesulide Beta Cyclodextrin
  • Certoparin
  • Carvedilol
  • Telmisartan
  • Acemetacin
  • Gossypol
  • Niflumic Acid
  • Danaparoid
  • Felbinac
  • Levobunolol
  • Magnesium Hydroxide
  • Iloprost
  • Methyclothiazide
  • Reboxetine
  • Apixaban
  • Sertraline
  • Nebivolol
  • Lofepramine
  • Torsemide
  • Anagrelide
  • Melitracen
  • Delapril
  • Dihydroxyaluminum Sodium Carbonate
  • Aluminum Hydroxide
  • Treprostinil
  • Imidapril
  • Choline Magnesium Trisalicylate
  • Ardeparin
  • Aceclofenac
  • Pentoxifylline
  • Indapamide
  • Lornoxicam
  • Irbesartan
  • Propyphenazone
  • Labetalol
  • Etofenamate
  • Phenindione
  • Vorapaxar
  • Dabigatran Etexilate
  • Dalteparin
  • Perindopril
  • Ketoprofen
  • Diclofenac
  • Sodium Salicylate
  • Triamterene
  • Proglumetacin
  • Sibutramine
  • Celecoxib
  • Parnaparin
  • Bisoprolol
  • Methotrexate
  • Loxoprofen
  • Pemetrexed
  • Esmolol
  • Timolol
  • Tinzaparin
  • Vilazodone
  • Magnesium Salicylate
  • Enalaprilat
  • Dexketoprofen
  • Eptifibatide
  • Duloxetine
  • Nortriptyline
  • Nabumetone
  • Bromfenac
  • Metipranolol
  • Amitriptylinoxide
  • Clopidogrel
  • Clonixin
  • Aspirin
  • Tenoxicam
  • Opipramol
  • Paroxetine
  • Bufexamac
  • Nimesulide
  • Bivalirudin
  • Trichlormethiazide
  • Sulindac
  • Pentopril
  • Etoricoxib
  • Trolamine Salicylate
  • Azilsartan Medoxomil
  • Prednisone
  • Benzthiazide
  • Acenocoumarol
  • Abciximab
  • Celiprolol
  • Dibenzepin
  • Meadowsweet
  • Fluoxetine
  • Diazoxide
  • Nadolol
  • Edoxaban
  • Warfarin
  • Amoxapine
  • Hydrocortisone
  • Protriptyline
  • Candesartan
  • Fondaparinux
  • Trandolapril
  • Betaxolol
  • Salsalate
  • Feprazone
  • Hydrochlorothiazide
  • Digoxin
  • Epoprostenol
  • Pentosan Polysulfate Sodium
  • Lepirudin
  • Cilostazol
  • Trimipramine
  • Spirapril
  • Vortioxetine
  • Ethacrynic Acid
  • Dothiepin
  • Acebutolol
  • Doxepin
  • Atenolol
  • Hydroflumethiazide
  • Sodium Bicarbonate
  • Xipamide
  • Bendroflumethiazide
  • Practolol
  • Milnacipran
  • Beta Glucan
  • Losartan
  • Piroxicam
  • Magnesium Trisilicate
  • Furosemide
  • Bismuth Subsalicylate
  • Sulfasalazine
  • Ticagrelor
  • Tiaprofenic Acid
  • Fluvoxamine
  • Droxicam
  • Salicylic Acid
  • Etodolac
  • Diflunisal
  • Ketorolac
  • Betamethasone
  • Alacepril
  • Meclofenamate
  • Nefazodone
  • Zofenopril
  • Dexamethasone
  • Oxaprozin
  • Metolazone
  • Escitalopram
  • Fenoprofen
  • Amtolmetin Guacil
  • Citalopram
  • Bemiparin
  • Quinapril
  • Clomipramine
  • Fosinopril
  • Ginkgo
  • Dipyrone
  • Chlorthalidone
  • Desipramine
  • Flufenamic Acid
  • Olmesartan
  • Nepafenac
  • Olsalazine
  • Lisinopril
  • Choline Salicylate
  • Tirofiban

Pre-existing conditions

Patients who have certain underlying conditions may be at an increased risk of side effects while taking Mefenamic Acid. This drug may also cause some conditions to get worse. As a result, patients should always inform their medical provider of any pre-existing conditions before using Mefenamic Acid. Some examples of medical conditions that have been studied to adversely interact with this drug include:

  • Hemorrhaging or bleeding disorders
  • Blood clots
  • Asthma
  • Heart conditions
  • High blood pressure
  • Anemia
  • Kidney disorders
  • Liver conditions
  • Stomach conditions, including ulcers
  • Stroke

Warnings

For the safety of patients, a leaflet is provided with precautions for use when the prescription is filled at a local pharmacy. An information sheet is also provided by healthcare providers prescribing this medication. Read through these precautions in full to lower the risk of side effects.

Progress checks

Healthcare providers generally schedule follow-up visits after prescribing certain medications like Mefenamic Acid. This is done to measure if any improvements are observed. Additionally, lab work is done to determine if any unwanted side effects have developed. Keep all progress checks with your medical provider to help keep you safe.

Worsening symptoms

If you do not feel better after taking this medication, inform your doctor.

Alcohol

Limit alcohol use when undergoing treatment with Mefenamic Acid as negative interactions are likely when both are used at the same time. Namely, upset stomach, nausea, and changes in stool color are likely. Patients who drink alcohol concomitantly while using Mefenamic Acid may also experience severe drowsiness, confusion or fainting.

OTCs
There is a lengthy list of common over the counter medicines that may interact negatively with Mefenamic Acid. Some examples include:

  • OTC pain medications
  • OTC migraine or headache medications
  • OTC sinus medicines
  • OTC arthritis medicines

Stroke and heart attack risk

In some cases, Mefenamic Acid may increase patients' risk of developing a stroke or heart attack, both serious and potentially life-threatening conditions.

Patients who use this medicine for prolonged periods of time and those who suffer from pre-existing heart disease are at an increased risk of developing a stroke or heart attack. Be sure to never use more of this medication or for longer than it is prescribed. Also, if you have heart disease, inform your doctor before taking Mefenamic Acid.

Intestinal bleeding

Another serious risk associated with Mefenamic Acid is sudden intestinal or stomach bleeds. This side effect requires immediate medical intervention. Certain patients using this treatment are more predisposed to intestinal bleeding, including:

  • Patients using blood thinners
  • People who drink
  • People who have ulcers
  • People who smoke
  • People who use steroids
  • Senior patients

Again, it's important to discuss any underlying conditions, medications used, and lifestyle habits such as drinking or smoking with your medical provider.

It should also be noted that intestinal bleeding can occur without warning.

Liver issues

Mefenamic Acid may affect liver function. Discontinue using this medication and consult your healthcare provider immediately if the following side effects develop:

  • Appetite loss
  • Stomach pain
  • Tenderness in the abdominal region
  • Changes in stool color
  • Urine that looks visibly darker than before
  • A headache
  • A high temperature
  • Edema or swelling in the legs or feet
  • Jaundice or yellowish skin and eyes
  • Feeling nauseous
  • Lethargy
  • Feeling weak

These symptoms point to liver dysfunction and medical help is required immediately if these symptoms are noticed.

A common side effect of Mefenamic Acid is the development of skin sensitivities, some more serious than others. Some examples of when you need to call a doctor include if your skin peels or blisters, whether it's accompanied by:

  • White marks in the mouth area
  • Extreme drowsiness or lethargy
  • Runny stools or diarrhea
  • Coughing
  • A high temperature
  • Severe itching
  • Pain in the muscles and/or joints
  • Lesions on the skin
  • Coughing, sore throat, and other flu-like symptoms

Allergies

In some cases, Mefenamic Acid may cause patients to develop and allergic reaction. An allergic reaction is generally characterized by patients exhibiting one or more of the following symptoms:

  • Trouble breathing
  • Chest tightness
  • Abnormal heartbeat
  • Swelling or puffiness around the eyelids or facial area
  • Hives, welts, and other rashes on the skin
  • Fainting or lightheadedness

To lower the risk of an allergic reaction, tell your doctor if you have a history of allergies to any medicines, foods, dyes, preservatives, or other substances.

Severe side effects and when to call a doctor
In addition to the above precautions, it may be necessary to call the doctor if you are experience a severe negative reaction to this drug, including for:

  • Unexplained weight gain
  • Severe abdominal pain
  • Edema or swelling in any area of the body
  • Changes in stool color
  • Throwing up a coffee-ground like texture
  • Skin that bruises easily
  • Unexplained bleeding
  • Yellowish looking eyes or skin
  • An abnormal heartbeat
  • Changes in speech
  • Pain in the chest

Signs of an Overdose

Some of the main telltale signs that a patient has overdosed on Mefenamic Acid include:

  • Extreme fatigue or drowsiness
  • Regurgitation
  • High blood pressure
  • Pain in the stomach
  • Nausea

In the event of an overdose, call 911 immediately as well as the American Association of Poison Control Centers at 1-800-222-2222.

Medical I.D. bracelet

Due to the serious potential risks associated with Mefenamic Acid, patients are advised to wear a medical ID bracelet at all times. This bracelet provides critical information for first aid responders.

Pregnancy

Mefenamic Acid should be used with caution in expecting mothers, as it is proven to cause harm to developing fetuses. If you get pregnant during the course of treatment, discontinue the therapy and consult your healthcare provider immediately.

Nursing

Medical studies depict a slight risk to nursing infants whose mothers take this medication. Research findings reveal this medicine excretes into breastmilk. Your healthcare provider can discuss the possible side effects of use during breastfeeding and make an informed decision about whether to prescribe Mefenamic Acid.

Upcoming surgeries and medical tests

If you have a medical procedure or exam scheduled, inform your healthcare provider about your current treatment with Mefenamic Acid. This is especially true if you have a heart bypass surgery planned. In some cases, it may be necessary to discontinue the treatment or switch to another NSAID.

Storage

Store Mefenamic Acid in the original bottle and at a controlled room temperature of 20- 25°C (68- 77°F). Do not store in heat, moisture, or direct sunlight. As a rule of thumb, Mefenamic Acid, along with other medications, should be kept out of the reach of children and pets. Additionally, leftover or expired capsules should be safely discarded. One option is to return any unused portions of this medicine to a local pharmacy.

Summary

Ponstel, the brand name for Mefenamic Acid, is a fast-acting NSAID available by prescription only. It has analgesic and anti-inflammatory properties, which subsequently work to alleviate pain and discomfort linked to menstruation or arthritis.

This medication is not recommended for children under the age of 14, pregnant or nursing mothers, and individuals with certain types of pre-existing conditions such as asthma or heart disease.

A simple explanation of Ponstel's mechanisms of action is that it reduces hormones in the body that are in charge of regulating pain and inflammation. Unlike other pain management treatments, Mefenamic Acid isn't intended for long-term use, as doing so increases the risk of serious side effects.

A black box warning is marked on the label, which cautions users about the possible risk of developing a stroke, heart attack, or intestinal bleed. In addition to prolonged use, patients are more predisposed to these risks if they are over the age of 60, smoke, drink, or are taking blood thinners at the same time with Mefenamic Acid.

To reduce the risks of side effects, patients are advised to create a complete list of all medications being taken; including prescription and over-the-counter drugs. You should also note any pre-existing conditions, allergies, or lifestyle habits such as drinking or smoking, which could interact negatively with this medicine. Mefenamic Acid may also cause some conditions to get worse, including asthma, anemia, or liver disease, for example.

The dosage amount for Mefenamic Acid varies from one patient to another and is based on medical history, the strength of the medicine, the age of the patient, and more.

Treatment with Ponstel typically last 2-3 days depending on the condition being treated. However, the dose should not exceed 7 days. Not only will healthcare providers limit the timeline of treatment with Ponstel. In most cases, the lowest dose amount is generally recommended.

Generally, a higher dose amount is prescribed at the start of treatment, followed by a 50% reduction in the medication strength for as-needed pain relief. To decrease the risk of heartburn, indigestion, or upset stomach, Ponstel should be taken with a full meal.

Patients are moreover advised to read through the precaution label in detail to determine when it's necessary to call a doctor. Some examples include if the patient experiences Anaphylaxis shock, a heart attack, stroke, serious skin irritations, and more. Weight gain and swelling of the hands or feet are also cause for concern and emergency medical intervention.

Generally speaking, Mefenamic Acid is well-tolerated by most patients who use it, as medical providers assess if this is an appropriate treatment before prescribing. Patients who have mild to moderate or short-term pain, for example, have shown favorable responses to the medicine.