Ponstel (mefenamic acid) is a prescription nonsteroidal anti-inflammatory drug (NSAID) specifically formulated to provide effective relief from menstrual pain and inflammation. As a member of the fenamate class, it works by inhibiting the production of prostaglandins, hormone-like substances that cause pain, fever, and inflammation. This targeted mechanism offers a potent option for managing primary dysmenorrhea and acute pain, with a well-established efficacy and safety profile when used as directed under medical supervision. It is intended for short-term use and requires a healthcare provider’s prescription to ensure appropriate patient selection and monitoring.

Features

• Active Ingredient: Mefenamic acid (250 mg per capsule)
• Drug Class: Nonsteroidal anti-inflammatory drug (NSAID), fenamate derivative
• Indication: Relief of mild to moderate pain; treatment of primary dysmenorrhea
• Mechanism of Action: Cyclooxygenase (COX-1 and COX-2) enzyme inhibition, reducing prostaglandin synthesis
• Onset of Action: Typically within 1–2 hours after administration
• Duration: Dosing usually every 6 hours as needed for pain
• Formulation: Oral capsules
• Prescription Status: Rx-only in most jurisdictions

Benefits

• Provides rapid and effective relief from menstrual cramps and associated pain
• Reduces uterine inflammation and prostaglandin-induced smooth muscle contractions
• Offers an alternative for patients who do not respond adequately to other NSAIDs or analgesics
• Allows for improved daily functioning and quality of life during menstrual periods
• Short-term use minimizes potential for long-term systemic side effects when used appropriately
• Well-studied efficacy in clinical settings for dysmenorrhea and acute pain management

Common use

Ponstel is most commonly prescribed for the treatment of primary dysmenorrhea, a condition characterized by painful menstrual cramps resulting from uterine contractions and inflammation. It is also indicated for the relief of mild to moderate pain, including musculoskeletal pain, dental pain, and postoperative discomfort. Its use is generally reserved for short-term management rather than chronic conditions, typically not exceeding one week for dysmenorrhea or a few days for general pain relief unless specifically directed by a physician. Patients often begin taking Ponstel at the onset of menstrual symptoms for optimal effectiveness.

Dosage and direction

For the treatment of primary dysmenorrhea, the recommended dosage is 500 mg as an initial dose, followed by 250 mg every 6 hours as needed, usually not to exceed one week. For other mild to moderate pain, the typical adult dosage is 500 mg initially, then 250 mg every 6 hours as needed. Ponstel should be taken with food or milk to minimize gastrointestinal upset. It is important to use the lowest effective dose for the shortest duration necessary to control symptoms. Dosage adjustments may be necessary for elderly patients or those with renal impairment. Do not crush or chew capsules; swallow whole with a full glass of water.

Precautions

Patients should be aware that NSAIDs, including Ponstel, may increase the risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use and in patients with cardiovascular disease or risk factors. Ponstel is contraindicated in the setting of coronary artery bypass graft (CABG) surgery. NSAIDs also increase the risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events. Use with caution in patients with fluid retention, hypertension, or heart failure. Periodic monitoring of blood counts, renal function, and liver function may be advisable during prolonged therapy.

Contraindications

Ponstel is contraindicated in patients with known hypersensitivity to mefenamic acid, aspirin, or other NSAIDs. It should not be used in patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. Severe, sometimes fatal, anaphylactic reactions to NSAIDs have been reported in such patients. Contraindications also include: in the setting of coronary artery bypass graft (CABG) surgery; history of gastrointestinal bleeding or perforation with previous NSAID therapy; active peptic ulcer disease or gastrointestinal bleeding; severe heart failure; advanced renal disease; third trimester of pregnancy; and concomitant use with other NSAIDs including COX-2 inhibitors.

Possible side effect

Common side effects may include gastrointestinal symptoms such as dyspepsia, nausea, vomiting, diarrhea, constipation, abdominal pain, and flatulence. Central nervous system effects may include dizziness, headache, nervousness, and drowsiness. Dermatological reactions such as rash, pruritus, and photosensitivity may occur. Less frequently, patients may experience tinnitus, visual disturbances, edema, palpitations, and elevated blood pressure. Serious but rare adverse effects include gastrointestinal ulceration or bleeding, hepatotoxicity, renal impairment, anemia, thrombocytopenia, neutropenia, agranulocytosis, aseptic meningitis, and severe skin reactions such as Stevens-Johnson syndrome. Patients should seek immediate medical attention for signs of allergic reactions, chest pain, shortness of breath, weakness on one side of the body, slurred speech, black or bloody stools, or unusual weight gain.

Drug interaction

Ponstel may interact with several medication classes. Concomitant use with other NSAIDs or salicylates may increase the risk of gastrointestinal toxicity. It may reduce the antihypertensive effect of ACE inhibitors, angiotensin II receptor blockers, and beta-blockers. Concurrent use with diuretics may impair renal function. Ponstel may increase lithium levels and methotrexate toxicity. It can potentiate the effects of warfarin and other anticoagulants, increasing bleeding risk. Corticosteroids may increase the risk of gastrointestinal ulceration. Ponstel may decrease the effectiveness of aspirin for cardioprotection. Concomitant use with SSRIs or SNRIs may increase bleeding risk. Always inform your healthcare provider of all medications, including over-the-counter drugs and supplements.

Missed dose

If a dose is missed, take it as soon as remembered unless it is almost time for the next scheduled dose. Do not double the dose to make up for a missed one. Ponstel is typically taken on an as-needed basis for pain relief rather than on a fixed schedule, so the concept of “missed dose” applies primarily when used for dysmenorrhea with scheduled dosing. If using for menstrual cramps, take at the first sign of pain or cramping rather than waiting for symptoms to worsen.

Overdose

Symptoms of overdose may include drowsiness, nausea, vomiting, epigastric pain, gastrointestinal bleeding, coma, hypotension, acute renal failure, respiratory depression, and convulsions. In case of suspected overdose, seek immediate medical attention or contact a poison control center. Management is supportive and symptomatic with emphasis on maintaining adequate renal function. There is no specific antidote. Gastric lavage or activated charcoal may be considered if presented soon after ingestion. Forced diuresis, alkalinization of urine, hemodialysis, or hemoperfusion are unlikely to be beneficial due to high protein binding.

Storage

Store Ponstel capsules at room temperature between 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). Keep in the original container, tightly closed, and protect from light and moisture. Do not store in the bathroom or near sinks. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Properly discard any unused medication after the treatment course is completed; do not flush down the toilet or pour into drains unless instructed to do so.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Ponstel is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual results may vary. Always follow your healthcare provider’s instructions regarding dosage and duration of treatment. Do not use this medication for conditions other than those for which it was prescribed. Report any side effects to your healthcare provider promptly. This information is not exhaustive; consult the full prescribing information and discuss with your healthcare provider for complete information about this medication.

Reviews

Clinical studies and patient reports generally indicate that Ponstel is effective for menstrual pain relief, with many users reporting significant reduction in cramping within a few hours of the first dose. Some patients note better efficacy compared to other NSAIDs for dysmenorrhea specifically. Common feedback includes appreciation for its targeted action but also mentions of gastrointestinal side effects, particularly when taken without food. Healthcare providers often consider it a valuable option for patients with prostaglandin-mediated menstrual pain who haven’t responded adequately to first-line treatments. Long-term user satisfaction tends to be good when used appropriately for indicated conditions under medical supervision.