MEFENAMIC ACID

COMMON BRAND NAME(S): Ponstel

GENERIC NAME(S): MEFENAMIC ACID

 

Description: Mefenamic acid, an anthranilic acid derivative, is a prototypical NSAID. It reversibly inhibits the cyclooxygenase-1 and -2 (COX-1 and -2) enzymes, thus resulting in reduced synthesis of prostaglandin precursors. It has analgesic and antipyretic properties w/ minor anti-inflammatory activity.

Duration: ≤6 hr.

Pharmacokinetics:

Absorption: Rapidly absorbed from the GI tract. Time to peak plasma concentration: Approx 2-4 hr.

Distribution: Enters breast milk (small amounts). Volume of distribution: 1.06 L/kg. Plasma protein binding: >90%.

Metabolism: Metabolised by CYP2C9 isoenzyme to 3-hydroxymethyl mefenamic acid, which may then be oxidised to 3-carboxymefenamic acid.

Excretion: Via urine (approx 52%) as unchanged drug and metabolites; faeces (approx 20%). Elimination half-life: Approx 2-4 hr.

Mefenamic acid is used for the short-term treatment of mild to moderate pain from various conditions. It is also used to decrease pain and blood loss from menstrual periods.

Mefenamic acid is known as a nonsteroidal anti-inflammatory drug (NSAID).

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This medication may also be used to treat gout attacks.

How to use mefenamic acid

Read the Medication Guide provided by your pharmacist before you start using mefenamic acid and each time you get a refill. If you have any questions, consult your doctor or pharmacist.

Take this medication by mouth, usually 4 times a day with a full glass of water (8 ounces or 240 milliliters) or as directed by your doctor. Do not lie down for at least 10 minutes after taking this drug. If stomach upset occurs, take this medication with food or milk. Do not take mefenamic acid with antacids unless directed by your doctor. Certain antacids may change the amount of mefenamic acid absorbed by the body.

Dosage is based on your medical condition and response to therapy. To reduce your risk of stomach bleeding and other side effects, take this medication at the lowest effective dose for the shortest possible time. Do not increase your dose, take it more frequently, or take it for a longer time than prescribed. This medication usually should not be taken for more than 7 days at a time.

If you are taking this drug on an “as needed” basis (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the symptoms have worsened, the medicine may not work as well.

If you are using this medication for painful periods, take your first dose as soon as your period starts or pain begins. Usually, you will only need to take it for the first 2 to 3 days of your period.

Inform your doctor if your pain persists or worsens or if you develop new symptoms.

Nonsteroidal anti-inflammatory drugs (including mefenamic acid) may rarely increase the risk for a (sometimes fatal) heart attack or stroke. This effect does not apply to low-dose aspirin. (See Drug Interactions section.) The risk may be greater if you have heart disease or increased risk for heart disease (for example, due to smoking, family history of heart disease, or conditions such as high blood pressure or diabetes), or with longer use. This drug should not be taken right before or after heart bypass surgery (CABG). Also, this drug may infrequently cause serious (rarely fatal) bleeding from the stomach or intestines. This bleeding can occur without warning symptoms at any time during treatment.

Stop taking this medication and seek immediate medical attention if you notice any of the following rare but very serious side effects: chest pain, severe dizziness, trouble breathing, weakness on one side of the body, sudden vision changes, slurred speech, black stools, persistent stomach/abdominal pain, vomit that looks like coffee grounds. (See also Precautions section.)

Talk with your doctor or pharmacist about the risks and benefits of treatment with this medication.

See also Warning section.

Upset stomach, nausea, heartburn, dizziness, drowsiness, diarrhea, and headache may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

Tell your doctor immediately if any of these unlikely but serious side effects occur: fainting, persistent/severe headache, hearing changes (e.g., ringing in the ears), fast/pounding heartbeat, mental/mood changes, stomach pain, difficult/painful swallowing, swelling of the ankles/feet/hands, sudden/unexplained weight gain, vision changes, unusual tiredness.

Stop taking mefenamic acid and tell your doctor immediately if any of these rare but very serious side effects occur: easy bruising/bleeding, signs of infection (e.g., fever, persistent sore throat), unexplained stiff neck, change in the amount/color of urine.

This drug may rarely cause serious, possibly fatal liver disease. If you notice any of the following rare but very serious side effects, stop taking mefenamic acid and consult your doctor or pharmacist immediately: persistent nausea/vomiting, severe stomach/abdominal pain, weakness, dark urine, yellowing eyes/skin.

A very serious allergic reaction to this drug is rare. However, stop taking mefenamic acid and immediately seek medical attention if you notice any of the following symptoms of a serious allergic reaction: rash/blisters, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Before taking mefenamic acid, tell your doctor or pharmacist if you are allergic to it; or to aspirin or other NSAIDs (e.g., ibuprofen, naproxen, celecoxib); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: aspirin-sensitive asthma (a history of worsening breathing with runny/stuffy nose after taking aspirin or other NSAIDs, severe kidney disease, recent heart bypass surgery (CABG), active bleeding/sores in stomach/intestines (ulcer, gastrointestinal bleeding).

Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma, bleeding/clotting problems, blood disorders (e.g., anemia), high blood pressure, diabetes, heart disease (e.g., history of heart attack), liver disease, growths in the nose (nasal polyps), obesity, tobacco use, history of stomach/intestine/esophagus problems (e.g., bleeding, ulcers, recurring heartburn), stroke, swelling of the ankles/feet/hands.

Kidney problems can sometimes occur with the use of NSAID medications, including mefenamic acid. Problems are more likely to occur if you are dehydrated, have heart failure or kidney disease, are an older adult, or if you take certain medications (see also Drug Interactions section). Drink plenty of fluids as directed by your doctor to prevent dehydration and tell your doctor right away if you have any unusual change in the amount of urine.

Before having surgery, tell your doctor or dentist that you are using this medication.

This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid alcoholic beverages.

This medicine may cause stomach bleeding. Daily use of alcohol and tobacco, especially when combined with this medicine, may increase your risk for stomach bleeding. Limit alcohol and stop smoking. Consult your doctor or pharmacist for more information.

This medication may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths, or sunlamps. Use a sunscreen and wear protective clothing when outdoors.

Kidney function declines as you grow older. This medication is removed by the kidneys. Therefore, caution is advised when using this drug in the elderly because they may be more sensitive to its side effects, especially stomach bleeding and kidney problems.

Before using this medication, women of childbearing age should talk with their doctor(s) about the benefits and risks (such as miscarriage, trouble getting pregnant). Tell your doctor if you are pregnant or if you plan to become pregnant. During pregnancy, this medication should be used only when clearly needed. It is not recommended for use during the first and last trimesters of pregnancy due to possible harm to the unborn baby and interference with normal labor/delivery.

This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

 

Interactions:

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug include: aliskiren, ACE inhibitors (such as captopril, lisinopril), angiotensin II receptor blockers (such as valsartan, losartan), cidofovir, corticosteroids (e.g., prednisone), fluconazole, ketorolac, lithium, methotrexate, “water pills” (diuretics such as furosemide).

This medication may increase the risk of bleeding when taken with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, “blood thinners” such as dabigatran/enoxaparin/warfarin, among others.

Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as celecoxib or ibuprofen). These drugs are similar to mefenamic acid and may increase your risk of side effects if taken together. However, if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke (usually at dosages of 81-325 milligrams a day), you should continue taking the aspirin unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

This medication may interfere with certain laboratory tests (e.g., urine bile test), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

If overdose is suspected, contact a poison control center or emergency room immediately.

Notes

Do not share this drug with others.

Laboratory and/or medical tests (e.g., blood pressure, complete blood count, liver and kidney function tests) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Missed Dose

If you are taking this drug on a regular schedule (not “as needed”) and you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Brief storage between 59-86 degrees F (15-30 degrees C) is permitted. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

 

Brands:

Available Brands:

Acidan [ Ace ]                                                                       Afligec [ Filadams ]

Analcid [ Terramedic ]                                                       Arthran [ Biolink Pharma ]

Dolfenal [ Westmont ]                                                        Dolsten [ Medic+Aid ]

Fenamax [ CSPC Ouyi Pharma ]                                      Gardan [ sanofi-aventis ]

Gisfen [ S V More ]                                                              Istan [ Elin ]

Mefenax [ One Pharma ]                                                    Metaflam 250/500 [ Le Jumont ]

Pharex Mefenamic Acid [ Pascual ]                                  Ponser [ Medhaus ]

Ponstan/Ponstan SF [ Pfizer ]                                           Rhea Mefenamic Acid [ Pfizer ]

RiteMED Mefenamic Acid [ RiteMED ]                          Spegic Forte [ Pharma Dynamic ]

Stangesic [ GXI ]                                                                                                           Suprazen/Suprazen Forte [ Medi-Rx ]

Zestan [ AD-Drugstel ]

 

Also marketed as:

Algifort [ GPC ]                                                                    Almefen [ Lloyd ]

Analmin [ Flamingo ]                                                         Atmose [ Morishita-Seggs ]

Belfedane [ Novo Pharm Drug ]                                       Boie Mefenamic Acid [ Boie ]

Calibral [ Pharmacare ]                                                      Difenol [ Square Pharma ]

DLI-Mefenamic Acid [ DLI ]                                             Dolmetine [ CNN Generics ]

Eurostan [ Am-Europharma ]                                           Femacid [ Blue Sky ]

Fenexan [ Euro-Therapeutics ]                                         Finox [ Solvang ]

Fromefen [ Brymar Pharma ]                                            Hispen [ Genesis ]

Icelax [ Basic Pharma ]                                                        Inflasic [ Blue Sky ]

Isagesic [ Doctors ]                                                               Kramon [ Kramer ]

Lafayette Mefenamic Acid [ Lafayette ]                           Laffed [ Lafayette ]

Marfen [ Scheeling ]                                                             Mecid A [ Lewison ]

Medianon [ MedGen ]                                                          Mefan [ Lloyd ]

Mefril [ Brown & Burk Phils ]                                             MFE Capsule [ Morishita-Seggs ]

MFE Suspension [ La Croesus ]                                         Neostan [ Danlex ]

Penomor [ Blooming Fields ]                                              Ponsac Forte [ Brookes Pharma ]

Pontaser [ Roddensers ]                                                       Ralgec [ IAE ]

Remifein [ Pasteur Pharma ]                                               Revalan [ BioFemme ]

Selmac [ Heltker ]                                                                  Sindol [ Square Pharma ]

Totagesic [ Ashford ]                                                             Tynostan [ Gruppo Medica ]

Vandifen [ Crisdy-Na ]                                                          Zanovic [ Virgo ]

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