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The elimination half-life of mefenamic acid is approximately two hoursHalf-lives of metabolites I and II have not been precisely reportedbut appear to be longer than the parent compoundThe metabolites may accumulate in patients with renal or hepatic failureThe mefenamic acid glucuronide may bind irreversibly to plasma proteinsBecause both renal and hepatic excretions are significant pathways of eliminationdosage adjustments in patients with renal or hepatic dysfunction may be necessaryPonstel should not be administered to patients with pre-existing renal disease or in patients with significantly impaired renal functionsee WARNINGSRenal Toxicity and Hyperkalemia

A subpopulation of patients with asthma may have aspirin-sensitive asthma which may include chronic rhinosinusitis complicated by nasal polypsseverepotentially fatal bronchospasmand/or intolerance to aspirin and other NSAIDsBecause cross-reactivity between aspirin and other NSAIDs has been reported in such aspirin-sensitive patientsPonstel is contraindicated in patients with this form of aspirin sensitivitysee CONTRAINDICATIONSWhen Ponstel is used in patients with pre-existing asthmawithout known aspirin sensitivitymonitor patients for changes in the signs and symptoms of asthma.

Mefenamic acid pharmacokinetics have not been studied in patients with hepatic dysfunctionAs hepatic metabolism is a significant pathway of mefenamic acid eliminationpatients with acute and chronic hepatic disease may require reduced doses of Ponstel compared to patients with normal hepatic functionsee WARNINGSHepatotoxicity

Before using this medicationwomen of childbearing age should talk with their doctor(sabout the benefits and riskssuch as miscarriagetrouble getting pregnantTell your doctor if you are pregnant or if you plan to become pregnantDuring pregnancythis medication should be used only when clearly neededIt 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.

Long-term administration of NSAIDs has resulted in renal papillary necrosis and other renal injury.

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