Mefenamic acid (Ponstel) is a prescription non-steroidal anti-inflammatory drug (NSAID). It's used to treat mild-to-moderate pain, including pain from menstrual periods by people ages 14 years and older. Mefenamic acid (Ponstel) is taken by mouth every 6 hours. Treatment can last up to 1 week. Possible side effects of this medication include stomach pain, heartburn, and dizziness. Brand name medication Ponstel has been discontinued.
Treatment of general, mild-to-moderate pain
Treatment of pain from menstrual cramps
Mefenamic acid (Ponstel) is a non-steroidal anti-inflammatory drug (NSAID). It lowers inflammation, pain, and swelling by blocking proteins in your body called cyclooxygenase or COX.
Source:Â DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Bloody urine
bloody, black, or tarry stools
decreased frequency or amount of urine
increased bleeding time
increased blood pressure
increased thirst
indigestion
itching skin
loss of appetite
lower back or side pain
pale skin
rashes
severe abdominal pain, cramping, or burning
stomach bloating
swelling of the face, fingers, feet, or lower legs
trouble breathing with or without exertion
unusual bleeding or bruising
unusual tiredness or weakness
vomiting
vomiting of material that looks like coffee grounds, severe and continuing
Less common
Bleeding gums
blood in vomit
blurred vision
burning feeling in the chest or stomach
clay-colored stools
cloudy urine
confusion
cough or hoarseness
dark urine
difficult or labored breathing
difficult, burning, or painful urination
difficulty in swallowing
dilated neck veins
dizziness
extreme fatigue
fainting
fast, pounding, or irregular heartbeat or pulse
fever or chills
frequent urge to urinate
headache
increased volume of pale, dilute urine
irregular breathing
irregular heartbeat
large, flat, blue, or purplish patches in the skin
light-colored stools
lightheadedness
nervousness
noisy breathing
pain or burning feeling in the throat
pinpoint red or purple spots on the skin
pounding in the ears
rapid, slow breathing
redness, swelling, or soreness of the tongue
severe or continuing stomach pain
slow heartbeat
sores, ulcers, or white spots on the lips or tongue or inside the mouth
stomach upset
swelling or inflammation of the mouth
swollen glands
tenderness in the stomach area
tightness in the chest
unpleasant breath odor
upper right stomach pain
yellow eyes and skin
Rare
Blistering, peeling, or loosening of the skin
change in consciousness
chest discomfort
continuing vomiting
cracks in the skin
dizziness, faintness, or lightheadedness when suddenly getting up from a lying or sitting position
drowsiness
fever with or without chills
flushed, dry skin
fruit-like breath odor
general body swelling
general feeling of illness
high fever
increased hunger
irregular, fast or slow, or shallow breathing
joint or muscle pain
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
leg pain
loss of consciousness
loss of heat from the body
no blood pressure
no breathing
no pulse
nosebleeds
painful glands
pain or discomfort in the arms, jaw, back, or neck
pains in the stomach, side, or abdomen, possibly radiating to the back
pale or blue lips, fingernails, or skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
racing heartbeat or pulse
red skin lesions, often with a purple center
red, irritated eyes
red, swollen skin
redness or soreness of the skin
seeing, hearing, or feeling things that are not there
seizures
severe headache
sores, welting, or blisters
stiff neck or back
sweating
swollen, painful, or tender lymph glands in the neck, armpit, or groin
unexplained weight loss
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Continuing ringing or buzzing or other unexplained noise in the ears
excess air or gas in the stomach or intestines
feeling of fullness
hearing loss
passing gas
stomach discomfort
Less common
Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
discouragement
fear
feeling of constant movement of self or surroundings
feeling sad or empty
hair loss, thinning of the hair
increased sensitivity of the skin to sunlight
irritability
lack of appetite
lack of interest or pleasure
lack or loss of strength
redness or other discoloration of the skin
sensation of spinning
severe sunburn
sleepiness
trouble concentrating
trouble sleeping
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Works well to relieve menstrual cramps and pain
Can be used in children ages 14 years or older
Lower-cost generic is available
Can only use for up to 1 week
Can potentially cause serious side effects (e.g., stomach bleeding, kidney problems)
Might need to be taken multiple times per day
Mefenamic acid (Ponstel) shouldn't be used for longer than 7 days. If you're using it for menstrual pain or cramps, your symptoms should get better within 2 to 3 days. Contact your healthcare provider if you're still having symptoms after using mefenamic acid (Ponstel) for 7 days.
Take mefenamic acid (Ponstel) with or without food. But taking it with food or milk can help prevent getting an upset stomach.
Don't crush, chew, or open the mefenamic acid (Ponstel) capsules. If you're having trouble swallowing the capsules, contact your provider. You might need to be switched to a different medication.
Don't take mefenamic acid (Ponstel) with other NSAIDs, such as ibuprofen (Motrin, Advil). Doing so puts you at higher risk for stomach bleeds. NSAIDs are commonly found in over-the-counter pain and cold medications. Talk with your healthcare provider or pharmacist if you're not sure whether you're already taking an NSAID.
Mefenamic acid (Ponstel) can make your skin more sensitive to the sun or ultraviolet (UV) light. This means you can get more sunburns than usual. To protect your skin, make sure to wear sunscreen when going outside and wear long-sleeved clothing. Also avoid being exposed to light or sun for a long time.
Store mefenamic acid (Ponstel) up and away from children and pets so they're less likely to reach and accidentally take the medication. If you think your child accidentally took the medication, call a Poison Control Center right away at 1-800-222-1222.
Mefenamic acid (Ponstel) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: History of heart problems, including heart attack | Taking high doses of mefenamic acid (Ponstel) | Taking mefenamic acid (Ponstel) for a long time | History of heart bypass surgery
Mefenamic acid (Ponstel) can raise your risk of having blood clots, heart attacks, or strokes. That’s why your pain specialist will recommend that you take it for the shortest possible time. If you have heart problems, talk to your care before starting this medication. Don't take mefenamic acid (Ponstel) if you've had or will be having heart bypass surgery. Call 911 or get immediate medical help if you experience chest pain, trouble breathing, weakness on one side of your body, or trouble speaking or walking.
Risk factors: History of stomach bleeding or ulcers | Older adults | Taking other medications that raises the risk of bleeds | Drinking alcohol | Smoking | Having poor health | Bleeding problems | Liver problems
Mefenamic acid (Ponstel) can cause stomach bleeding and ulcers, which can be dangerous. There are many conditions and medications that raise your risk of this problem, so speak with your provider before starting this medication. Stomach bleeding and ulcers can occur without warning or symptoms, so it's best to take the lowest possible dose for the shortest possible time to minimize your risk. If you notice blood in your vomit, stool that looks like black coffee grounds, or if you have pain in your stomach that doesn't go away, stop taking mefenamic acid (Ponstel) and talk to your care team right away.
Risk factors: History of liver damage | Taking other medications that can cause liver damage
Very rarely, mefenamic acid (Ponstel) can cause life-threatening liver damage. Your risk is higher if you take mefenamic acid (Ponstel) with other medications that can also cause liver damage, such as acetaminophen (Tylenol). Liver damage can happen with or without symptoms. Stop mefenamic acid (Ponstel) and talk to your healthcare provider right away if you experience symptoms, such as fever, chills, fatigue, nausea, vomiting, yellowing of the skin or whites of the eyes, clay-colored stool, and dark urine.
Risk factors: Heart problems
Mefenamic acid (Ponstel) can cause your body to hold onto extra fluid, which can raise your blood pressure or put you at risk for heart failure. Tell your provider if you have a history of heart problems or are taking blood pressure medications before starting mefenamic acid (Ponstel) to make sure it's safe for you. Your provider will check for heart problems before they prescribe this medication to you. If you experience unexplained fainting, chest pain with physical activity, or irregular heartbeat while taking mefenamic acid (Ponstel), contact your care team.
Risk factors: Kidney or liver problems | Heart failure | Taking other medications that can cause kidney problems| Older adults | Loss of body fluid through conditions such as severe vomiting, bleeding, or diarrhea
Mefenamic acid (Ponstel) can damage your kidneys by slowing down blood flow to the kidneys. The risk is higher if you're taking certain blood pressure medications (like ACE inhibitors, ARBs, or water pills), or have certain conditions (like kidney or liver problems and heart failure). Kidney damage is usually reversible once you stop taking mefenamic acid (Ponstel). This medication isn't recommended if you have very severe kidney problems, so discuss the risks and benefits of taking it with your pain specialist. Let your care team know if you notice a change in how often you urinate after starting mefenamic acid (Ponstel) as this can be a sign of kidney damage.
In addition, kidney damage from mefenamic acid (Ponstel) can also lead to high potassium levels. Sometimes, this medication can cause high potassium levels even in people with normal kidneys. If you experience signs of high potassium levels, such as nausea, muscle weakness, or tingling sensations in your muscles, tell your care team right away because it might be dangerous.
Risk factors: Asthma and stuffy nose with or without nasal polyps | Allergic reaction to aspirin or other NSAIDs
Mefenamic acid (Ponstel) can cause your airways to tighten, which might lead to severe asthma attacks. Be careful using this medication if you have asthma. People who've experienced asthma attacks triggered by aspirin (Aspir-Low) or other NSAIDs in the past should avoid mefenamic acid (Ponstel). Get medical help right away if your throat tightens and you can't breathe.
Risk factors: Aspirin allergy | NSAID allergy
Severe allergic reactions to mefenamic acid (Ponstel) are possible, including life-threatening reactions like facial swelling, shock, and anaphylaxis. Let your provider know if you have an allergy to aspirin or other NSAIDs before starting mefenamic acid (Ponstel). If you notice hives, rash, red skin, swelling of the lips or tongue, or difficulty breathing after using mefenamic acid (Ponstel), call for medical help as soon as possible.
Although rare, mefenamic acid (Ponstel) can cause serious skin reactions, such as rash, blisters, skin reddening, or skin peeling. If you notice changes in your skin, stop using mefenamic acid (Ponstel) and get medical attention right away.
If you're pregnant or breastfeeding, talk to your obstetrician or pain specialist first about the risk and benefits of mefenamic acid (Ponstel) before using this medication. Mefenamic acid (Ponstel) can cause harm to your unborn baby or complications during delivery, especially if taken during the second half of pregnancy.
Risk factors: Taking with other blood thinners (e.g. aspirin, warfarin) | Taking with selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs)
Mefenamic acid (Ponstel) can raise your risk of bleeding, especially if you take other medications that cause bleeding. This can lead to anemia (low red blood cells). If you experience fatigue, weakness, pale skin, shortness of breath, or dizziness after taking this medication, let your care team know.
| Dosage | Quantity | Price as low as | Price per unit | 
|---|---|---|---|
| 250mg | 30 capsules | $42.08 | $1.40 | 
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Allergy to other NSAIDs
History of asthma, hives, or other allergic reactions after taking aspirin or another NSAID
Use of mefenamic acid (Ponstel) after coronary artery bypass graft surgery (CABG)
Treatment of general, mild-to-moderate pain
Treatment of pain from menstrual cramps
Fever in adults
Mild-to-moderate pain in adults
Pain from menstrual cramps
Juvenile arthritis
Rheumatoid arthritis
Osteoarthritis
Ankylosing spondylitis
Tendinitis and bursitis
Gout
Short-term relief of minor aches and pains due to headache, muscle aches, minor arthritis pain, toothache, backache, the common cold, or menstrual cramps
Fever
Mild-to-moderate pain
Pain from rheumatoid arthritis (RA) or osteoarthritis (OA)
Pain from menstrual cramps
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American Kidney Fund. (2024). High potassium (hyperkalemia): Causes, prevention, and treatment.
Lupin Pharmaceuticals, Inc. (2024). Mefenamic acid capsule [package insert]. DailyMed.
Moll, R., et al. (2011). Single dose oral mefenamic acid for acute postoperative pain in adults. The Cochrane Database of Systematic Reviews.
National Heart, Lung, and Blood Institute. (2022). What is anemia?
National Heart, Lung, and Blood Institute. (2022). What is coronary artery bypass grafting?
U.S. Food and Drug Administration. (2020). Nonsteroidal anti-inflammatory drugs (NSAIDs): Drug Safety Communication - Avoid use of NSAIDs in pregnancy at 20 weeks or later.
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