Ponstel (mefenamic acid) is a prescription nonsteroidal anti-inflammatory drug (NSAID) specifically indicated for the relief of moderate pain and the treatment of primary dysmenorrhea. It belongs to the fenamate class of NSAIDs and works by inhibiting the body’s production of prostaglandins, hormone-like substances that cause pain, inflammation, and uterine contractions. This targeted mechanism makes it a potent option for managing acute, short-term pain associated with menstrual cycles. As with all NSAIDs, it requires careful medical supervision to maximize benefits and minimize potential risks.

Features

• Active Ingredient: Mefenamic acid (500 mg per capsule).
• Drug Class: Nonsteroidal anti-inflammatory drug (NSAID) of the fenamate group.
• Mechanism of Action: Potent inhibitor of cyclooxygenase (COX-1 and COX-2) enzymes, reducing the synthesis of prostaglandins.
• Administration: Oral capsule.
• Prescription Status: Available by prescription only.
• Standard Packaging: Bottles or blister packs, typically in quantities of 30 or 60 capsules.

Benefits

• Provides effective and targeted relief from moderate pain, particularly menstrual cramps (dysmenorrhea).
• Reduces inflammation at the source by blocking the production of pain- and inflammation-causing prostaglandins.
• Offers a specific therapeutic option for short-term analgesic needs, often showing effect within a few hours.
• Can improve quality of life and functional capacity during painful menstrual periods.
• Serves as an alternative for patients who may not achieve sufficient relief from other NSAIDs or analgesics.

Common use

Ponstel is primarily prescribed for the short-term relief of moderate pain. Its most common and well-established use is in the management of primary dysmenorrhea, the medical term for painful menstrual cramps caused by uterine contractions. It is highly effective at alleviating the associated pain, lower backache, and headache that often accompany menstruation. It may also be used for other types of acute, mild to moderate pain, such as musculoskeletal pain, but its use is generally limited to short durations, typically not exceeding one week for pain or 2-3 days for fever, as directed by a physician.

Dosage and direction

Ponstel dosage must be individualized under the direct supervision of a healthcare provider. The following represents common dosing guidelines for adults.

• For mild to moderate pain: The recommended initial adult dose is 500 mg.
• Subsequent Dosing: Following the initial dose, 250 mg every 6 hours as needed for pain relief.
• For primary dysmenorrhea: The recommended dosage is 500 mg as an initial dose, followed by 250 mg every 6 hours, starting with the onset of bleeding and associated cramping. Treatment should be initiated upon the onset of menses and typically should not exceed 2-3 days.
• Administration: Ponstel capsules should be taken with a full glass of water and with food, milk, or an antacid to minimize the potential for stomach upset.
• Duration of Therapy: Treatment should be for the shortest duration consistent with individual patient treatment goals. Long-term continuous therapy is not recommended.

Precautions

Prior to and during treatment with Ponstel, patients and prescribers must consider several important precautions.

• Cardiovascular Risk: NSAIDs, including Ponstel, may increase the risk of serious and sometimes fatal cardiovascular thrombotic events, such as myocardial infarction and stroke. This risk may increase with duration of use and in patients with cardiovascular disease or risk factors for cardiovascular disease.
• Gastrointestinal Risk: NSAIDs cause an increased risk of serious gastrointestinal adverse events, including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk.
• Renal Effects: Long-term administration of NSAIDs has resulted in renal injury, including renal papillary necrosis. Use with caution in patients with impaired renal function, heart failure, liver dysfunction, those taking diuretics or ACE inhibitors, and the elderly.
• Hepatic Effects: Borderline elevations of liver tests may occur in up to 15% of patients. Rare cases of severe hepatic reactions have been reported.
• Preexisting Conditions: Use with extreme caution in patients with a history of ulcer disease or gastrointestinal bleeding, hypertension, fluid retention, heart failure, asthma, and bleeding disorders.
• Pregnancy: Avoid use in late pregnancy (starting at 30 weeks) as it may cause premature closure of the fetal ductus arteriosus.

Contraindications

Ponstel is contraindicated and must not be used in patients with the following conditions:

• Known hypersensitivity (e.g., anaphylactic reactions, serious skin reactions) to mefenamic acid, aspirin, or other NSAIDs.
• History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Severe, sometimes fatal, anaphylactic reactions to NSAIDs have been reported in such patients.
• In the setting of coronary artery bypass graft (CABG) surgery.
• Patients with active peptic ulcer disease or a history of recurrent ulceration or gastrointestinal bleeding.

Possible side effect

Like all medications, Ponstel can cause side effects, although not everybody gets them. Side effects can range from common and mild to rare and severe.

• Common (>1%): Gastrointestinal disturbances are most frequent and include dyspepsia (indigestion), heartburn, nausea, vomiting, abdominal pain, constipation, diarrhea, and flatulence. Dizziness and headache are also commonly reported.
• Less Common: Rash, drowsiness, nervousness, tinnitus (ringing in the ears), blurred vision, and fluid retention presenting as edema.
• Serious (Seek immediate medical attention):
  • Signs of gastrointestinal bleeding (e.g., black, tarry stools; vomiting blood or material that looks like coffee grounds).
  • Signs of liver problems (e.g., nausea, fatigue, lethargy, itching, jaundice, right upper quadrant tenderness, “flu-like” symptoms).
  • Signs of heart problems (e.g., shortness of breath, chest pain, weakness in one part or side of the body, slurred speech).
  • Signs of an allergic reaction (e.g., skin rash, hives, swelling of the face/tongue/throat, severe dizziness, trouble breathing).
  • Signs of skin reactions (e.g., skin reddening, blisters, rash).
  • Unexplained weight gain or swelling.

Drug interaction

Ponstel has the potential to interact with many other medications, which can alter its effects or increase the risk of serious side effects.

• Anticoagulants (e.g., Warfarin): NSAIDs may enhance the effects of anticoagulants, increasing the risk of serious bleeding.
• Aspirin: Concomitant use with aspirin is not recommended as it may decrease Ponstel levels and increase the risk of GI adverse effects.
• Other NSAIDs: Concurrent use with other NSAIDs (e.g., ibuprofen, naproxen, celecoxib) or salicylates is not recommended due to additive side effects.
• ACE Inhibitors/ARBs/Diuretics: NSAIDs may diminish the antihypertensive effect of ACE inhibitors and angiotensin II receptor blockers (ARBs) and reduce the natriuretic effect of diuretics. This combination can also increase the risk of renal impairment.
• Lithium: NSAIDs may decrease lithium clearance, leading to increased plasma lithium levels and potential lithium toxicity.
• Methotrexate: NSAIDs may reduce the tubular secretion of methotrexate, potentially increasing methotrexate plasma levels and its toxicity.
• Cyclosporine: Concurrent use may increase the risk of cyclosporine-induced nephrotoxicity.
• Corticosteroids: Increases the risk of GI ulceration or bleeding.

Missed dose

Due to its typical “as-needed” dosing schedule for pain, a missed dose of Ponstel is generally not a critical issue. If you are on a scheduled regimen and remember within a reasonable time, take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and resume your usual dosing schedule. Do not take a double dose to make up for a missed one. Always follow the specific instructions provided by your doctor or pharmacist.

Overdose

Overdose of Ponstel can be very serious and requires immediate medical attention. Symptoms may be mild and limited to lethargy, drowsiness, nausea, vomiting, and epigastric pain, or they may be more severe, including gastrointestinal bleeding, coma, metabolic acidosis, hypertension, acute renal failure, and respiratory depression. There is no specific antidote. Management is supportive and symptomatic, including gastric lavage or activated charcoal (if presented early), and careful monitoring of vital organ function. Forced diuresis, alkalinization of the urine, or hemodialysis are unlikely to be beneficial due to Ponstel’s high protein binding.

Storage

Store Ponstel capsules at room temperature, between 20°C to 25°C (68°F to 77°F), in a tightly closed container. Excursions are permitted between 15°C to 30°C (59°F to 86°F). Keep the medication in its original container, away from light, excess heat, and moisture (i.e., not in a bathroom medicine cabinet). Keep all medications out of the reach of children and pets.

Disclaimer

This information is for educational and informational purposes only and does not constitute medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Never disregard professional medical advice or delay in seeking it because of something you have read here. The content has not been evaluated by all regulatory bodies and is intended for a U.S. audience. Drug information may change. Always refer to the official FDA-approved Prescribing Information for the most complete and up-to-date guidance.

Reviews

• Clinical Efficacy (4.5/5): Numerous clinical studies and patient reports consistently highlight Ponstel’s high efficacy in managing the acute pain of dysmenorrhea, often providing relief superior to placebo and comparable to other NSAIDs. Its targeted mechanism is frequently praised.
• Tolerability (3/5): Reviews often note a higher incidence of gastrointestinal side effects (e.g., nausea, stomach pain) compared to some other pain relievers, which can limit its use for some patients. Taking it with food is almost universally recommended.
• Speed of Onset (4/5): Many users report a relatively rapid onset of action, often within 1-2 hours of the initial dose, which is critical for managing acute menstrual pain.
• Overall Satisfaction: Patients for whom it is effective and well-tolerated often describe it as a “lifesaver” for managing difficult menstrual cycles. However, its side effect profile means it is not suitable for everyone, and satisfaction is highly individual. It is consistently regarded by healthcare professionals as a valuable, specific tool in the management of dysmenorrhea when used appropriately under medical guidance.