mefenamic acid (Oral route)

Pronunciation

mef-e-NAM-ik AS-id

Oral route(Capsule)

NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may be increased in patients with cardiovascular disease or risk factors for cardiovascular disease. Mefenamic acid is contraindicated for the treatment of perioperative pain in the setting of CABG surgery. NSAIDs can also cause an increased risk of serious gastrointestinal adverse events especially in the elderly, including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal .

Commonly used brand name(s)

In the U.S.

  • Ponstel

Available Dosage Forms:

  • Capsule

Therapeutic Class: Analgesic

Pharmacologic Class: NSAID

Chemical Class: Fenamate

Uses For mefenamic acid

Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) used to treat mild to moderate pain. mefenamic acid may also be used to treat menstrual cramps and other conditions as determined by your doctor.

Slideshow: 2014 Update: First Time Brand-to-Generic Switches

mefenamic acid is available only with your doctor's prescription.

Before Using mefenamic acid

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For mefenamic acid, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to mefenamic acid or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of mefenamic acid in children below 14 years of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of mefenamic acid in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require an adjustment in the dose for patients receiving mefenamic acid.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking mefenamic acid, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using mefenamic acid 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.

  • Ketorolac

Using mefenamic acid 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.

  • Abciximab
  • Apixaban
  • Ardeparin
  • Argatroban
  • Beta Glucan
  • Bivalirudin
  • Certoparin
  • Cilostazol
  • Citalopram
  • Clopidogrel
  • Clovoxamine
  • Cyclosporine
  • Dabigatran Etexilate
  • Dalteparin
  • Danaparoid
  • Desirudin
  • Dipyridamole
  • Duloxetine
  • Enoxaparin
  • Eptifibatide
  • Erlotinib
  • Escitalopram
  • Femoxetine
  • Feverfew
  • Flesinoxan
  • Fluoxetine
  • Fondaparinux
  • Ginkgo
  • Gossypol
  • Heparin
  • Lepirudin
  • Levomilnacipran
  • Meadowsweet
  • Methotrexate
  • Milnacipran
  • Nadroparin
  • Nefazodone
  • Parnaparin
  • Paroxetine
  • Pemetrexed
  • Pentosan Polysulfate Sodium
  • Pentoxifylline
  • Pralatrexate
  • Prasugrel
  • Protein C
  • Reviparin
  • Rivaroxaban
  • Sibutramine
  • Tacrolimus
  • Ticlopidine
  • Tinzaparin
  • Tirofiban
  • Venlafaxine
  • Vilazodone
  • Vortioxetine
  • Zimeldine

Using mefenamic acid 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.

  • Acebutolol
  • Acetohexamide
  • Alacepril
  • Alprenolol
  • Amiloride
  • Amlodipine
  • Arotinolol
  • Atenolol
  • Azilsartan Medoxomil
  • Azosemide
  • Befunolol
  • Bemetizide
  • Benazepril
  • Bendroflumethiazide
  • Benzthiazide
  • Bepridil
  • Betaxolol
  • Bevantolol
  • Bisoprolol
  • Bopindolol
  • Bucindolol
  • Bumetanide
  • Bupranolol
  • Buthiazide
  • Candesartan Cilexetil
  • Canrenoate
  • Captopril
  • Carteolol
  • Carvedilol
  • Celiprolol
  • Chlorothiazide
  • Chlorpropamide
  • Chlorthalidone
  • Cilazapril
  • Clopamide
  • Cyclopenthiazide
  • Delapril
  • Desvenlafaxine
  • Dilevalol
  • Diltiazem
  • Enalaprilat
  • Enalapril Maleate
  • Eprosartan
  • Esmolol
  • Ethacrynic Acid
  • Felodipine
  • Flunarizine
  • Fosinopril
  • Furosemide
  • Gallopamil
  • Gliclazide
  • Glimepiride
  • Glipizide
  • Gliquidone
  • Glyburide
  • Hydrochlorothiazide
  • Hydroflumethiazide
  • Imidapril
  • Indapamide
  • Irbesartan
  • Isradipine
  • Labetalol
  • Lacidipine
  • Landiolol
  • Levobunolol
  • Lidoflazine
  • Lisinopril
  • Lithium
  • Losartan
  • Manidipine
  • Mepindolol
  • Methyclothiazide
  • Metipranolol
  • Metolazone
  • Metoprolol
  • Moexipril
  • Nadolol
  • Nebivolol
  • Nicardipine
  • Nifedipine
  • Nilvadipine
  • Nimodipine
  • Nipradilol
  • Nisoldipine
  • Nitrendipine
  • Olmesartan Medoxomil
  • Oxprenolol
  • Penbutolol
  • Pentopril
  • Perindopril
  • Pindolol
  • Piretanide
  • Polythiazide
  • Pranidipine
  • Propranolol
  • Quinapril
  • Ramipril
  • Sotalol
  • Spirapril
  • Spironolactone
  • Talinolol
  • Tasosartan
  • Telmisartan
  • Temocapril
  • Tertatolol
  • Timolol
  • Tolazamide
  • Tolbutamide
  • Torsemide
  • Trandolapril
  • Triamterene
  • Trichlormethiazide
  • Valsartan
  • Verapamil
  • Xipamide
  • Zofenopril

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of mefenamic acid. Make sure you tell your doctor if you have any other medical problems, especially:

  • Anemia or
  • Asthma or
  • Bleeding problems or
  • Blood clots or
  • Edema (fluid retention or body swelling) or
  • Heart attack, history of or
  • Heart disease (e.g., congestive heart failure) or
  • Hypertension (high blood pressure) or
  • Kidney disease or
  • Liver disease (e.g., hepatitis) or
  • Stomach or intestinal ulcers or bleeding, history of or
  • Stroke, history of—Use with caution. mefenamic acid may make these conditions worse.
  • Aspirin-sensitive asthma or
  • Kidney disease, advanced or
  • Stomach ulcers, active—mefenamic acid should not be used in patients with these conditions.
  • Heart surgery (e.g., coronary artery bypass graft [CABG] surgery)—mefenamic acid should not be used to relieve pain right before or after the surgery.

Proper Use of mefenamic acid

For safe and effective use of mefenamic acid, do not take more of it, do not take it more often, and do not take it for a longer time than ordered by your doctor. Taking too much of mefenamic acid may increase the chance of unwanted effects, especially in elderly patients.

mefenamic acid should come with a medication guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

To lessen stomach upset, you may take mefenamic acid with food unless your doctor tells you otherwise.

Dosing

The dose of mefenamic acid will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of mefenamic acid. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (capsules):
    • For menstrual cramps:
      • Adults and children over 14 years of age—At first, 500 milligrams (mg), then 250 mg every six hours as needed, usually for up to two to three days.
      • Children up to 14 years of age—Use and dose must be determined by your doctor.
    • For mild to moderate pain:
      • Adults and children over 14 years of age—At first, 500 milligrams (mg), then 250 mg every six hours as needed, usually for not more than one week.
      • Children up to 14 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of mefenamic acid, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using mefenamic acid

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects.

mefenamic acid may raise your risk of having a heart attack or stroke. This is more likely in people who already have heart disease. People who use mefenamic acid for a long time might also have a higher risk.

mefenamic acid may cause bleeding in your stomach or intestines. These problems can happen without warning signs. This is more likely to occur if you have had a stomach ulcer in the past, if you smoke or drink alcohol regularly, if you are over 60 years of age, are in poor health, or if you are using certain other medicines (such as a steroid medicine or a blood thinner).

Liver problems may occur while you are using mefenamic acid. Stop using mefenamic acid and check with your doctor right away if you are having more than one of these symptoms: abdominal pain or tenderness; clay-colored stools; dark urine; decreased appetite; fever; headache; itching; loss of appetite; nausea and vomiting; skin rash; swelling of the feet or lower legs; unusual tiredness or weakness; or yellow eyes or skin.

Serious skin reactions can occur during treatment with mefenamic acid. Check with your doctor right away if you have any of the following symptoms while taking mefenamic acid: blistering, peeling, or loosening of the skin; chills; cough; diarrhea; fever; itching; joint or muscle pain; red skin lesions; sore throat; sores, ulcers, white spots in the mouth or on the lips; or unusual tiredness or weakness.

Possible warning signs of some serious side effects that can occur during treatment with mefenamic acid may include swelling of the face, fingers, feet, and/or lower legs; severe stomach pain, black, tarry stools, and/or vomiting of blood or material that looks like coffee grounds; unusual weight gain; yellow skin or eyes; decreased urination; bleeding or bruising; and/or skin rash. Also, signs of serious heart problems could occur such as chest pain, tightness in chest, fast or irregular heartbeat, unusual flushing or warmth of skin, weakness, or slurring of speech. Stop taking mefenamic acid and check with your doctor immediately if you notice any of these warning signs.

mefenamic acid may also cause a serious type of allergic reaction called anaphylaxis. Although this is rare, it may occur often in patients who are allergic to aspirin or other nonsteroidal anti-inflammatory drugs. Anaphylaxis requires immediate medical attention. The most serious signs of this reaction are very fast or irregular breathing, gasping for breath, wheezing, or fainting. Other signs may include changes in skin color of the face; very fast but irregular heartbeat or pulse; hive-like swellings on the skin; and puffiness or swelling of the eyelids or around the eyes. If these effects occur, get emergency help at once.

Using mefenamic acid while you are pregnant can harm your unborn baby. If you think you have become pregnant while using mefenamic acid, tell your doctor right away.

Tell your doctor if you have unexplained weight gain or edema (fluid retention or body swelling) with mefenamic acid.

Before having any kind of surgery or medical tests, tell your doctor that you are taking mefenamic acid. It may be necessary for you to stop treatment for a while, or to change to a different nonsteroidal anti-inflammatory drug before your procedure.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

mefenamic acid Side Effects

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
  • heartburn
  • increased bleeding time
  • increased blood pressure
  • increased thirst
  • indigestion
  • itching skin
  • loss of appetite
  • lower back or side pain
  • nausea
  • pale skin
  • rashes
  • severe abdominal pain, cramping, or burning
  • stomach bloating
  • swelling
  • 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
  • weight gain
  • weight loss
Less common
  • Bleeding gums
  • blood in vomit
  • blurred vision
  • burning feeling in the chest or stomach
  • chest pain
  • clay-colored stools
  • cloudy urine
  • confusion
  • constipation
  • 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 throat
  • pinpoint red or purple spots on the skin
  • pounding in the ears
  • rapid, slow breathing
  • redness, swelling, or soreness of tongue
  • severe or continuing stomach pain
  • shortness of breath
  • slow heartbeat
  • sore throat
  • 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
  • tremors
  • unpleasant breath odor
  • upper right abdominal pain
  • weight changes
  • wheezing
  • yellow eyes and skin
Rare
  • Blistering, peeling, or loosening of the skin
  • change in consciousness
  • chest discomfort
  • continuing vomiting
  • cracks in the skin
  • diarrhea
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • drowsiness
  • fever with or without chills
  • flushed, dry skin
  • fruit-like breath odor
  • general body swelling
  • general feeling of illness
  • high fever
  • hives
  • 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
  • scaly skin
  • seeing, hearing, or feeling things that are not there
  • seizures
  • severe headache
  • sneezing
  • sores, welting, or blisters
  • stiff neck and/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
  • Acid or sour stomach
  • belching
  • continuing ringing or buzzing or other unexplained noise in the ears
  • excess air or gas in the stomach or intestines
  • full feeling
  • hearing loss
  • passing gas
  • stomach discomfort
Less common
  • Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • discouragement
  • dry mouth
  • fear
  • feeling of constant movement of self or surroundings
  • feeling sad or empty
  • hair loss, thinning of the hair
  • increased sensitivity of 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
  • sleeplessness
  • trouble concentrating
  • trouble sleeping
  • unable to sleep
Rare
  • Appetite changes
  • burning, dry, or itching eyes
  • change in hearing
  • discharge, excessive tearing
  • redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid

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.

See also: Side effects (in more detail)

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