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mefenamic acid

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Brand names: Ponstel

Nonsteroidal Anti-Inflammatory Drug (NSAID) Rx

Mefenamic acid is a medicine used to treat mild to moderate pain and menstrual cramps. It is a type of nonsteroidal anti-inflammatory drug (NSAID).

Drug Pricing (NADAC)

Generic Price

$0.98/unit

Generic Available

Yes (3 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Mefenamic acid is used to relieve mild to moderate pain in people 14 years and older.

Common side effects

Abdominal pain, Constipation, Diarrhea

Key warnings

Mefenamic acid may increase the risk of serious heart problems, including heart attack and stroke, which can be fatal.

How It Works

Mefenamic acid reduces pain and inflammation in the body. It does this by blocking substances in the body that cause pain and swelling. This medicine helps to reduce pain and discomfort.

How to Take It

Take mefenamic acid exactly as your doctor tells you. For pain, the usual starting dose is 500 mg, followed by 250 mg every 6 hours as needed. Do not take it for more than one week. For menstrual cramps, the usual starting dose is 500 mg, followed by 250 mg every 6 hours, starting when bleeding and symptoms begin. You should not need to take it for more than 2 to 3 days.

Pregnancy & Breastfeeding

Tell your doctor if you are pregnant or plan to become pregnant. Mefenamic acid may harm your unborn baby. It is not known if mefenamic acid passes into breast milk. Talk to your doctor before breastfeeding.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.

Storage

Store at room temperature, away from heat and moisture.

Side Effects (from patient reports)

Based on 2,101 FDA adverse event reports.

The medicine did not work
352
Feeling sick to your stomach
296
Feeling tired
253
Head pain
227
General pain
202
Feeling lightheaded
177
Feeling unwell
170
Joint pain
152
Pain in your arms or legs
139
Throwing up
133

FDA Adverse Event Report Analysis

Detailed analysis of 2,104 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.

Total Reports

2,104

Death-Related Reports

81

Hospitalization Reports

707

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 1,507 (78%)
Male 427 (22%)

Age Distribution

0–17 133
18–44 668
45–64 538
65–74 112
75+ 88

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 DRUG INEFFECTIVE 352
2 NAUSEA 296
3 FATIGUE 253
4 HEADACHE 227
5 PAIN 202
6 DIZZINESS 177
7 MALAISE 170
8 ARTHRALGIA 152
9 PAIN IN EXTREMITY 139
10 VOMITING 133
11 STRESS 130
12 DIARRHOEA 129
13 DRUG INTOLERANCE 127
14 DYSPNOEA 121
15 RHEUMATOID ARTHRITIS 120

Reactions in Death Reports

CONDITION AGGRAVATED 8
DEATH 8
DECREASED APPETITE 8
DIZZINESS 8
ARTHRALGIA 7
DIARRHOEA 7
OVERDOSE 7
SEPTIC SHOCK 7
ABDOMINAL PAIN UPPER 6
ADJUSTMENT DISORDER WITH DEPRESSED MOOD 6

Reactions in Hospitalization Reports

VOMITING 80
NAUSEA 60
DIZZINESS 51
HEADACHE 51
DIARRHOEA 47
DRUG INTERACTION 46
DRUG INEFFECTIVE 42
PYREXIA 40
RENAL FAILURE ACUTE 37
DYSPNOEA 35

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Mefenamic acid may increase the risk of serious heart problems, including heart attack and stroke, which can be fatal. This risk may occur early in treatment and may increase with longer use. You should not take this medicine if you are having heart bypass surgery. Mefenamic acid can also increase the risk of serious stomach and intestinal problems, including bleeding, ulcers, and holes, which can be fatal. These problems can occur without warning. The elderly and those with a history of stomach ulcers or bleeding are at higher risk.

Known Drug Interactions

Methotrexate Clinical Impact: Concomitant use of NSAIDs and methotrexate may increase the risk for methotrexate toxicity (e.g., neutropenia, thrombocytopenia, renal dysfunction). Intervention: During concomitant use of mefenamic acid and methotrexate, monitor patients for methotrexate toxicity.

Mechanism: This pain medicine can prevent your body from clearing out methotrexate, which can lead to toxic levels in your system.

What to do: Your doctor should monitor you for signs of toxicity, such as kidney issues or changes in your blood cell counts.

moderate diflunisal

NSAIDs and Salicylates Clinical Impact: Concomitant use of mefenamic acid with other NSAIDs or salicylates (e.g., diflunisal, salsalate) increases the risk of GI toxicity, with little or no increase in efficacy (see Warnings ; Gastrointestinal Bleeding, Ulceration and Perforation ).

Mechanism: Taking these two drugs together increases the risk of stomach bleeding and ulcers without providing extra relief. Both drugs are similar and can irritate the lining of your digestive system.

What to do: Avoid taking these two medications at the same time. Your doctor should help you choose just one of these drugs to manage your symptoms safely.

moderate warfarin

Table 3: Drugs that Can Increase the Risk of Bleeding Drug Class Specific Drugs Anticoagulants argatroban, dabigatran, bivalirudin, desirudin, heparin, lepirudin Antiplatelet Agents aspirin, cilostazol, clopidogrel, dipyridamole, prasugrel, ticlopidine Non-steroidal Anti-Inflammatory Agents celecoxib, diclofenac, diflunisal, fenoprofen, ibuprofen, indomethacin, ketoprofen, ketorolac, mefenamic acid, naproxen, oxaprozin, piroxicam, sulindac Serotonin Reuptake Inhibitors citalopram, desvenlafaxine, duloxetine, escitalopram, fluoxetine, fluvoxamine, milnacipran, paroxetine, sertraline, venlafa...

Mechanism: Mefenamic acid can increase the risk of bleeding when used with warfarin. These drugs work together to slow down blood clotting more than usual.

What to do: Use this combination with caution and under a doctor's supervision. Your healthcare provider may need to change your medication plan.

In the absence of data regarding potential interaction between pemetrexed and NSAIDs with longer half-lives (e.g., meloxicam, nabumetone), patients taking these NSAIDs should interrupt dosing for at least five days before, the day of, and two days following pemetrexed administration.

Mechanism: Both of these drugs are NSAIDs that work in the same way, so taking them together increases the risk of stomach issues without helping more with pain.

What to do: Do not take these two medications together unless your doctor specifically tells you to.

Diuretics Clinical Impact: Clinical studies, as well as post-marketing observations, showed that NSAIDs reduced the natriuretic effect of loop diuretics (e.g., furosemide) and thiazide diuretics in some patients.

Mechanism: Mefenamic acid can block the effects of furosemide, making it harder for your body to remove extra salt and water through your urine.

What to do: Your doctor may need to check your blood pressure and fluid levels more often while you are taking both drugs.

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Common Questions

Can I take mefenamic acid with aspirin?
It is generally not recommended to take mefenamic acid with aspirin due to the increased risk of bleeding.
Can mefenamic acid affect my blood pressure?
Yes, mefenamic acid may increase your blood pressure. Your doctor should monitor your blood pressure during treatment.
Can I take mefenamic acid if I have kidney problems?
Talk to your doctor before taking mefenamic acid if you have kidney problems. It may worsen your condition.
Can mefenamic acid cause liver problems?
Yes, mefenamic acid can cause liver problems. Your doctor may check your liver function during treatment.
How quickly does mefenamic acid work?
Mefenamic acid typically starts to work within an hour to relieve pain and menstrual cramps.
Can I drink alcohol while taking mefenamic acid?
It is best to avoid alcohol while taking mefenamic acid, as it can increase the risk of stomach bleeding.
Can mefenamic acid interact with other medications?
Yes, mefenamic acid can interact with several medications, including blood thinners, aspirin, and some blood pressure medicines. Tell your doctor about all the medicines you take.
What should I do if I experience severe side effects?
If you experience severe side effects, such as chest pain, shortness of breath, or severe stomach pain, seek medical attention immediately.
Can I use mefenamic acid for long-term pain relief?
No, mefenamic acid is not meant for long-term use. It is typically used for short-term pain relief (no more than 7 days).
Is it okay to take mefenamic acid on an empty stomach?
You can take mefenamic acid with or without food. Taking it with food may help prevent stomach upset.
What are the common side effects of mefenamic acid?
The most commonly reported side effects of mefenamic acid include Abdominal pain, Constipation, Diarrhea, Upset stomach, Gas. Based on 2,101 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does mefenamic acid interact with other medications?
Yes, mefenamic acid has 15 known drug interactions. Notable interactions include methotrexate, diflunisal, warfarin. Always inform your doctor about all medications you are taking.
What drug class is mefenamic acid?
mefenamic acid belongs to the Nonsteroidal Anti-Inflammatory Drug (NSAID) drug class. It requires a prescription (Rx). Mefenamic acid is used to relieve mild to moderate pain in people 14 years and older.
Is mefenamic acid safe during pregnancy?
Tell your doctor if you are pregnant or plan to become pregnant. Mefenamic acid may harm your unborn baby. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

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What the FDA Data Shows for mefenamic acid

The FDA label for mefenamic acid (sold under brand names such as Ponstel) classifies it as a prescription-only medication in the Nonsteroidal Anti-Inflammatory Drug (NSAID) class. Mefenamic acid is used to relieve mild to moderate pain in people 14 years and older. Official labeling lists 11 commonly reported side effects, including Abdominal pain, Constipation, Diarrhea.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 2,101 voluntary reports. The database also lists 15 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS shows a generic unit cost of $0.98.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: July 19, 2024

All federal data sources used on this page