Ponstan capsules and Ponstan forte tablets contain the active ingredient mefenamic acid, which is an anti-inflammatory painkiller.
What is it for?
Ponstan is used to relieve pain and inflammation in a wide range of musculoskeletal conditions, including those below. It can also be used to relieve some other types of pain, and to reduce blood loss in women with very heavy periods.
- Rheumatoid arthritis.
- Juvenile arthritis (Still's disease).
- Muscular pain.
- Pain and inflammation due to accidents, such as sprains, strains, fractures.
- Pain following surgery.
- Pain following childbirth.
- Painful periods (dysmenorrhoea).
- Abnormally heavy periods (menorrhagia).
How does Ponstan work?
- Ponstan and Ponstan forte contain the active ingredient mefenamic acid, which is a type of medicine called a non-steroidal anti-inflammatory drug (NSAID). NSAIDs are used to relieve pain and inflammation.
- Mefenamic acid works by blocking the action of a substance in the body called cyclo-oxygenase (COX). Cyclo-oxygenase is involved in the production of various chemicals in the body, some of which are known as prostaglandins. Prostaglandins are produced by the body in response to injury and certain diseases and conditions, and cause pain, swelling and inflammation. Mefenamic acid blocks the production of these prostaglandins and so reduces inflammation and pain.
- Mefenamic acid may also work by preventing the action of prostaglandins after they have already been formed.
- Mefenamic acid helps with heavy and painful menstrual periods because period pain cramps are caused by the production of prostaglandins in the lining of the womb. Prostaglandin production is also known to be increased in women who suffer from heavy periods. By opposing the production and action of prostaglandins, mefenamic acid relieves period pains and also reduces blood loss in women who have heavy periods.
How do I take Ponstan?
- Ponstan and Ponstan forte are usually taken three times a day. Follow the instructions given by your doctor regarding how much to take.
- Ponstan and Ponstan forte should preferably be taken with or after food to help avoid irritating the stomach.
- Try to space your doses evenly. If you forget to take a dose at your usual time take it as soon as you remember, unless it is nearly time for your next dose. In this case just leave out the forgotten dose and take the next dose as usual. Do not take a double dose to make up for a missed dose.
- Follow the instructions given by your doctor for how long to take this medicine for. For example, if you have been prescribed it to help with your periods you may just need to take it during your periods. If you are taking it for arthritis you may need to take it regularly all the time to keep your pain under control. If you are unsure about anything you should ask your pharmacist for advice.
Ponstan should be used with caution in
- Elderly people.
- People with a history of disorders affecting the stomach or intestines - see above.
- People with decreased liver or kidney function.
- People who are dehydrated.
- People with high blood pressure (hypertension).
- People with heart disease (see above), eg angina, history of heart attack, heart failure.
- People with a history of stroke or mini-stroke (TIA).
- People with poor blood circulation in the legs or feet (peripheral arterial disease).
- People with raised levels of fats such as cholesterol in the blood (hyperlipidaemia).
- People with a history of asthma or allergies.
- People with blood clotting disorders or taking anticoagulant medicines.
- People with diseases affecting connective tissue, eg systemic lupus erythematosus.
- Hereditary blood disorders called porphyrias.
Ponstan should not be used in
- People in whom aspirin or other NSAIDs, eg ibuprofen, cause allergic reactions such as asthma attacks, itchy rash (urticaria), nasal inflammation (rhinitis) or swelling of the lips, tongue and throat (angioedema).
- People with an active peptic ulcer or bleeding in the gut.
- People who have had recurrent peptic ulcers or bleeding in the gut (two or more episodes).
- People who have experienced bleeding or perforation in the gut as a result of previous treatment with an NSAID.
- Inflammatory bowel disease such as ulcerative colitis or Crohn's disease.
- People with severe heart failure.
- People with severe liver or kidney failure.
- Third trimester of pregnancy.
- Relieving pain following coronary artery bypass graft (CABG) surgery.
Rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption (Ponstan capsules and Ponstan forte tablets contain lactose).
This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Side effects of Ponstan
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Disturbances of the gut such as indigestion, diarrhoea, constipation, nausea, vomiting or abdominal pain (see important information above).
- Ulceration or bleeding in the stomach or intestines (see important information above).
- Skin reactions such as rashes or itching.
- Visual disturbances.
- Sensation of spinning (vertigo).
- Sensation of ringing, or other noise in the ears (tinnitus).
- Pins and needles sensations.
- Retention of fluid in the body tissues, resulting in swelling (oedema).
- Increased blood pressure.
- Awareness of your heartbeat (palpitations).
- Inflammation of the pancreas (pancreatitis).
- Allergic reactions such as severe skin rashes, swelling of the lips, tongue and throat (angioedema) or narrowing of the airways (bronchospasm).
- Kidney, liver or blood disorders.
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
If you think you have experienced a side effect from a medicine or vaccine you should check the patient information leaflet. This lists the known side effects and what to do if you get them. You can also get advice from your doctor, nurse or pharmacist. If they think it's necessary they'll report it for you.
Can I take ponstan with other medicines?
Mefenamic acid should not be used in combination with painkilling doses of aspirin or any other NSAID taken by mouth, eg ibuprofen, as this increases the risk of side effects on the stomach and intestines. Selective inhibitors of COX-2 such as celecoxib or etoricoxib should also be avoided for the same reason.
- There may be an increased risk of ulceration or bleeding in the gut if mefenamic acid is taken with corticosteroids such as prednisolone.
There may also be an increased risk of bleeding in the gut if mefenamic acid is taken with the following medicines:
- anti-blood-clotting (anticoagulant) medicines such as warfarin or heparin
- anti-platelet medicines to reduce the risk of blood clots or 'thin the blood', eg low-dose aspirin, clopidogrel, dipyridamole
- SSRI antidepressants, eg fluoxetine, paroxetine, citalopram
There may be an increased risk of side effects on the kidneys if mefenamic acid is used with any of the following medicines:
- ACE inhibitors, eg enalapril
- angiotensin II receptor antagonists such as losartan
- diuretics, eg furosemide
Mefenamic acid may oppose the blood pressure lowering effects of certain medicines to treat high blood pressure, including the following:
- ACE inhibitors such as captopril
- angiotensin II receptor antagonists such as losartan
- beta-blockers such as propranolol
- diuretics such as furosemide.
Mefenamic acid may reduce the removal of the following medicines from the body and so may increase the blood levels and risk of side effects of these medicines. People using mefenamic acid with any of these should be closely monitored by their doctor:
- If this medicine is used in combination with quinolone antibiotics, such as ciprofloxacin or norfloxacin there may be an increased risk of seizures (fits). This may occur in people with or without a previous history of epilepsy or convulsions.
Pregnancy and breastfeeding
- Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- This medicine is not recommended for use in pregnancy unless considered essential by your doctor. This is particularly important in the first and third trimesters. If taken in the third trimester it may delay labour, increase the length of labour and cause complications in the newborn baby. Some evidence suggests that NSAIDs should also be avoided by women attempting to conceive, as they may temporarily reduce female fertility during treatment and may also increase the risk of miscarriage or malformations. Seek medical advice from your doctor.
- This medicine may pass into breast milk in small amounts. The manufacturer states that it should not be used by breastfeeding mothers. Get advice from your doctor before taking this medicine if you are breastfeeding.
If you have any more questions please ask your Pharmacist.
Remember to keep all medicines out of reach of children
Please Note: We have made every effort to ensure that the content of this information sheet is correct at time of publish, but remember that information about drugs may change. This sheet does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet which comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects which may be relevant in your particular case.