Ponstel (Mefenamic Acid) vs Common NSAID Alternatives - Full Comparison

Anyone who’s ever dealt with a throbbing headache, menstrual cramps, or a sore back knows how frustrating it can be to find the right painkiller. Ponstel (the brand name for mefenamic acid) is one of the options doctors prescribe, but it isn’t the only game in town. This article breaks down how Ponstel stacks up against the most popular over‑the‑counter NSAIDs, so you can decide which one fits your needs without wading through endless pharmacy shelves.

Key Takeaways

• Ponstel is a prescription NSAID best for moderate to severe pain, especially menstrual cramps.
• Ibuprofen and naproxen are widely available OTC and work well for mild to moderate pain.
• Diclofenac offers strong anti‑inflammatory power but carries higher gastrointestinal risk.
• Celecoxib is a COX‑2‑selective NSAID, lowering stomach irritation but raising cardiovascular concerns.
• Cost, dosing frequency, and side‑effect profile vary considerably - choose based on your health history and how often you need relief.

What Is Ponstel (Mefenamic Acid)?

Ponstel (Mefenamic Acid) belongs to the anthranilic acid class of non‑steroidal anti‑inflammatory drugs (NSAIDs). It blocks cyclooxygenase enzymes (COX‑1 and COX‑2), which reduces the production of prostaglandins - the chemicals that cause pain, swelling, and fever. Ponstel is typically prescribed for:

• Severe menstrual cramps (dysmenorrhea)
• Post‑operative dental pain
• Musculoskeletal aches when other NSAIDs haven’t helped

Because it’s a prescription‑only drug in the UK, you’ll need a doctor’s approval before you can pick it up at a pharmacy.

How Do the Common NSAID Alternatives Work?

Below are the five most widely used NSAIDs you’ll find on pharmacy shelves. Each one blocks prostaglandin synthesis, but they differ in potency, half‑life, and side‑effect risk.

Ibuprofen is an oral NSAID that’s part of the propionic acid family. It’s the go‑to for headaches, minor injuries, and fever.

Naproxen offers a longer half‑life than ibuprofen, meaning you can take it twice a day instead of every 4‑6 hours. It’s favored for chronic conditions like arthritis.

Diclofenac is a potent NSAID often available as a gel for topical use. Systemic tablets provide fast, strong anti‑inflammatory action but can irritate the stomach.

Celecoxib is a COX‑2‑selective inhibitor, designed to spare the stomach lining while still easing pain. It’s prescription‑only in the UK.

Aspirin is the oldest NSAID, primarily used at low doses for heart protection. At higher doses it works as a pain reliever but carries a higher bleeding risk.

Side‑Effect Profile - What to Watch For

All NSAIDs share a core set of potential adverse effects, but the likelihood of each varies by drug.

• Gastrointestinal irritation: Ibuprofen, naproxen, and especially diclofenac can cause stomach ulcers or bleeding.
• Kidney function: Long‑term use of any NSAID may reduce renal clearance, which is a concern for people with chronic kidney disease.
• Cardiovascular risk: COX‑2‑selective drugs like celecoxib have been linked to higher rates of heart attack and stroke, particularly at high doses.
• Allergic reactions: Skin rash, hives, or asthma‑type symptoms can appear with any of these agents.

Ponstel sits in the middle - it can irritate the stomach, but its risk is not as high as diclofenac. People with a history of ulcers often avoid it.

Cost, Availability, and Dosing Convenience

Cost is often the deciding factor for over‑the‑counter (OTC) users. Below is a quick snapshot based on typical UK pharmacy pricing in 2025.

Choosing the Right Option for Your Situation

Below is a quick guide that maps common pain scenarios to the most suitable NSAID based on efficacy, safety, and convenience.

• Menstrual cramps that haven’t responded to ibuprofen: Ponstel is often the next step because it specifically targets uterine prostaglandins.
• Back pain after lifting something heavy: Naproxen’s longer duration can keep you pain‑free through the workday with only two doses.
• Arthritic joint pain that needs sustained relief: Diclofenac (especially topical gel) offers strong anti‑inflammation without swallowing a large amount of tablets.
• Patients with a history of stomach ulcers: Low‑dose celecoxib may be safer, but discuss cardiovascular risk with your doctor.
• Budget‑conscious everyday aches: Ibuprofen or aspirin remain the cheapest, widely available choices.

Potential Drug Interactions to Keep in Mind

All NSAIDs can interact with other medications. Here are the most common pairings you should double‑check with a pharmacist or GP:

• Anticoagulants (e.g., warfarin, apixaban): Adding any NSAID raises bleeding risk dramatically.
• SSRIs (e.g., fluoxetine, sertraline): Combined use can increase gastrointestinal bleeding.
• ACE inhibitors or ARBs: NSAIDs may blunt their blood‑pressure‑lowering effect and impair kidney function.
• Diuretics (e.g., furosemide): Risk of kidney stress goes up when paired with NSAIDs.

If you’re on any of these, a short consultation can help you pick the safest NSAID or decide on a non‑NSAID alternative like acetaminophen.

When to Avoid Ponstel Altogether

Even though Ponstel can be a solid choice for certain pain types, there are clear red flags:

• Active peptic ulcer disease or a history of GI bleeding.
• Severe heart failure or recent myocardial infarction - the combined COX inhibition can worsen fluid retention.
• Pregnancy after the first trimester - NSAIDs can affect fetal kidney development.
• Known hypersensitivity to anthranilic acid NSAIDs.

In any of these cases, discuss alternatives like acetaminophen, physical therapy, or even localized treatments (e.g., heat packs).

Frequently Asked Questions

Bottom Line

Choosing between Ponstel and its alternatives isn’t a one‑size‑fits‑all decision. If you need strong relief for menstrual pain and can handle a prescription, Ponstel is a solid option. For everyday aches, ibuprofen or naproxen usually get the job done with fewer hurdles. Patients with stomach or heart concerns should lean toward celecoxib (with caution) or topical diclofenac. Always factor in cost, dosing convenience, and any existing medical conditions before settling on a pill.

Remember, the safest pain‑relief plan combines the right medication with lifestyle tweaks - stay active, hydrate, and consider non‑drug methods like heat therapy or gentle stretching. When in doubt, a quick chat with your GP or pharmacist can clear up which NSAID aligns best with your health profile.