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Mefenamic Acid

1. Generic Name & Brand Names

  • Generic Name: Mefenamic Acid

  • Common Brand Names (Varies by Country):

    • Ponstel® (USA, Canada)

    • Ponstan® (UK, Australia, Europe, Asia)

    • Meftal® (India, Middle East)

    • Parkemed®

    • Generic/store brands (e.g., "Mefenamic Acid")

2. Dosage Forms

  • Oral Capsules (250 mg, 500 mg)

  • Oral Suspension/Syrup (50 mg/mL, pediatric use)

  • Tablets (250 mg, 500 mg in some regions)

3. Drug Class

  • NSAID (Non-Steroidal Anti-Inflammatory Drug)

  • Analgesic (Pain Reliever)

  • Anti-inflammatory

4. Uses

  • Primary Dysmenorrhea: Moderate-to-severe menstrual pain/cramps.

  • Mild-to-Moderate Pain:

    • Headaches, dental pain, muscle aches.

    • Post-surgical pain (short-term).

  • Not typically used for fever or chronic inflammation (e.g., arthritis).

5. Side Effects

  • Common:

    • Diarrhea (may be severe), nausea, vomiting

    • Stomach pain, indigestion, heartburn

    • Dizziness, headache

  • Serious (Require Immediate Medical Attention):

    • GI Bleeding/Ulcers: Black/tarry stools, vomiting blood.

    • Kidney Problems: Reduced urine, swelling (feet/ankles).

    • Liver Toxicity: Yellow skin/eyes (jaundice), dark urine.

    • Severe Skin Reactions: SJS/TEN (blistering rash).

    • Anemia/Pancytopenia: Unusual fatigue, pale skin, infections.

    • Seizures (rare, linked to overdose).

6. Warnings Before Taking

  • Black Box Warning (USA): ↑ Risk of cardiovascular events (heart attack/stroke) and GI bleeding/ulcers (may be fatal).

  • Contraindications:

    • Allergy to NSAIDs/mefenamic acid.

    • Active stomach ulcers or GI bleeding.

    • Severe kidney/heart/liver disease.

    • 3rd trimester pregnancy.

    • Inflammatory bowel disease (IBD).

  • Use with Extreme Caution If:

    65 years old, history of ulcers, asthma, bleeding disorders, or hypertension.

  • Drug Interactions:

    • Blood thinners (warfarin), SSRIs (fluoxetine), diuretics (furosemide), lithium.

  • Pregnancy: Avoid in 3rd trimester; not recommended in 1st/2nd trimesters without doctor approval.

7. How to Take It

  • For Menstrual Pain:

    • Start at pain onset: 500 mg initial dose, then 250 mg every 6 hours.

    • Max Daily Dose: 1,000 mg (4 doses of 250 mg).

  • With Food/Milk: Always take with food to reduce stomach upset.

  • Duration: Do not exceed 2–3 days for menstrual pain.

  • Never crush or chew capsules.

8. Uses in Adults

  • Exclusively short-term:

    • Menstrual cramps (max 2–3 days per cycle).

    • Other acute pain (≤7 days unless directed).

  • Not for chronic pain or inflammation.

9. Missed Dose

  • As-Needed Use: Take when pain recurs (wait ≥6 hours after last dose).

  • Scheduled Use (rare): Skip missed dose if close to next dose. Never double dose.

10. Overdose

  • Symptoms:

    • Severe vomiting/diarrhea, stomach pain, seizures.

    • Drowsiness, kidney failure, coma.

  • Action: Call emergency services/poison control immediately.

    Note: Overdose may cause seizures within hours.

11. Avoid While Taking

  • Other NSAIDs: Ibuprofen, naproxen, aspirin (↑ bleeding risk).

  • Alcohol: ↑ Risk of stomach ulcers/bleeding.

  • Corticosteroids (e.g., prednisone): ↑ GI bleeding risk.

  • Anticoagulants (warfarin, apixaban): ↑ Bleeding risk.

12. Storage

  • Temperature: Room temperature (15–30°C / 59–86°F).

  • Moisture: Keep container tightly closed (capsules degrade in humidity).

  • Light: Store in original packaging.

  • Safety: Keep away from children/pets (overdose risk is high).

Critical Safety Notes:

⚠️ Short-Term Use Only: Never use >7 days due to high GI/renal toxicity.
⚠️ Diarrhea Warning: Discontinue immediately if severe diarrhea occurs (may indicate colitis).
⚠️ Menstrual-Specific Dosing: Start at first sign of cramps; limit to 2–3 days monthly.
⚠️ Cardiovascular Risk: Higher in patients with heart disease/hypertension.

Consult your doctor before use – mefenamic acid requires a prescription in many countries and is not first-line for menstrual pain (ibuprofen/naproxen are often preferred)

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