Ponstel

Generic Name: mefenamic acid (Oral route)

mef-e-NAM-ik AS-id

Commonly used brand name(s):

In the U.S.

• Ponstel

Available Dosage Forms:

• Capsule

Therapeutic Class: Analgesic

Pharmacologic Class: NSAID

Chemical Class: Fenamate

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Uses For Ponstel

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

This medicine is available only with your doctor's prescription .

Before Using Ponstel

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 this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine 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 geriatrics-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 adjustment of dosage in patients receiving mefenamic acid .

Pregnancy

Breast Feeding

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

Interactions with Medicines

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.

• Ketorolac

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.

• Ardeparin
• Beta Glucan
• Certoparin
• Dalteparin
• Danaparoid
• Enoxaparin
• Ginkgo
• Methotrexate
• Nadroparin
• Parnaparin
• Pemetrexed
• Reviparin
• Tacrolimus
• Tinzaparin

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.

• Acetohexamide
• Alacepril
• Amiloride
• Azosemide
• Bemetizide
• Benazepril
• Bendroflumethiazide
• Benzthiazide
• Bumetanide
• Buthiazide
• Candesartan Cilexetil
• Canrenoate
• Captopril
• Chlorothiazide
• Chlorpropamide
• Chlorthalidone
• Cilazapril
• Citalopram
• Clopamide
• Clopidogrel
• Clovoxamine
• Cyclopenthiazide
• Cyclosporine
• Cyclothiazide
• Delapril
• Desvenlafaxine
• Duloxetine
• Enalaprilat
• Enalapril Maleate
• Eprosartan
• Escitalopram
• Ethacrynic Acid
• Femoxetine
• Flesinoxan
• Fluoxetine
• Fluvoxamine
• Fosinopril
• Furosemide
• Gliclazide
• Glimepiride
• Glipizide
• Gliquidone
• Glyburide
• Hydrochlorothiazide
• Hydroflumethiazide
• Imidapril
• Indapamide
• Irbesartan
• Lisinopril
• Lithium
• Losartan
• Methyclothiazide
• Metolazone
• Milnacipran
• Moexipril
• Nefazodone
• Olmesartan Medoxomil
• Paroxetine
• Pentopril
• Perindopril
• Piretanide
• Polythiazide
• Quinapril
• Quinethazone
• Ramipril
• Sertraline
• Spirapril
• Spironolactone
• Tasosartan
• Telmisartan
• Temocapril
• Tolazamide
• Tolbutamide
• Torsemide
• Trandolapril
• Triamterene
• Trichlormethiazide
• Valsartan
• Venlafaxine
• Xipamide
• Zimeldine
• 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 this medicine. 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
• High blood pressure or
• Kidney disease or
• Liver disease (e.g., hepatitis) or
• Stomach or intestinal ulcers or bleeding or
• Stroke, history of—Use with caution. This medicine may make these conditions worse .

• Aspirin sensitivity, history of—This medicine should NOT be used in patients with this condition .

• Heart surgery (e.g., coronary artery bypass graft [CABG] surgery)—This medicine should NOT be used to relieve pain right before or after the surgery .

Proper Use of Ponstel

For safe and effective use of this medicine, 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 this medicine may increase the chance of unwanted effects, especially in elderly patients .

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

Dosing

The dose of this medicine 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 this medicine. 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 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 .
  • 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 .

Missed Dose

If you miss a dose of this medicine, 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.

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

Do not keep outdated medicine or medicine no longer needed.

Keep out of the reach of children.

Precautions While Using Ponstel

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 .

This medicine 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 this medicine for a long time might also have a higher risk .

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

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

Possible warning signs of some serious side effects that can occur during treatment with this medicine 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 this medicine and check with your doctor immediately if you notice any of these warning signs .

This medicine 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 this medicine while you are pregnant can harm your unborn baby. If you think you have become pregnant while using this medicine, tell your doctor right away .

Before having any kind of surgery or medical tests, tell your doctor that you are taking this medicine. 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 .

Ponstel 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:

• 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
• lab results that show problems with liver
• loss of appetite
• lower back or side pain
• nausea
• pale skin
• rashes
• severe abdominal pain, cramping, or burning
• stomach bloating
• swelling
• swelling of 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

• Bleeding gums
• blood in vomit
• blurred vision
• burning feeling in 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 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 lips or tongue or inside the mouth
• stomach upset
• swelling or inflammation of the mouth
• swollen glands
• tenderness in stomach area
• tightness in chest
• tremors
• unpleasant breath odor
• upper right abdominal pain
• weight changes
• wheezing
• yellow eyes and skin

• Blistering, peeling, loosening of 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 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 arms, jaw, back, or neck
• pains in 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 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 neck, armpit, or groin
• unexplained weight loss

• 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:

• Acid or sour stomach
• belching
• continuing ringing or buzzing or other unexplained noise in ears
• excess air or gas in stomach or intestines
• full feeling
• hearing loss
• passing gas
• stomach discomfort

• 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 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 skin
• sensation of spinning
• severe sunburn
• sleepiness
• sleeplessness
• trouble concentrating
• trouble sleeping
• unable to sleep

• Appetite changes
• burning, dry, or itching eyes
• change in hearing
• discharge, excessive tearing
• redness, pain, swelling of eye, eyelid, or inner lining of eyelid

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

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