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Advise patients to be alert for the symptoms of cardiovascular thrombotic eventsincluding chest painshortness of breathweaknessor slurring of speechand to report any of these symptoms to their healthcare provider immediatelysee WARNINGSCardiovascular Thrombotic Events

Take the missed dose as soon as you rememberIf it is almost time for your next doseskip the missed dose and take the medicine at your next regularly scheduled timeDo not take extra medicine to make up the missed dose.

Upset stomachmild heartburn or stomach paindiarrheaconstipationbloatinggasdizzinessheadachenervousnessskin itching or rashdry mouthincreased sweatingrunny noseblurred visionor ringing in your ears.

NSAIDs cause an increased risk of serious gastrointestinalGIadverse events including bleedingulcerationand perforation of the stomach or intestineswhich can be fatalThese events can occur at any time during use and without warning symptomsElderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI eventssee WARNINGS

Advise patients to be alert for the symptoms of cardiovascular thrombotic eventsincluding chest painshortness of breathweaknessor slurring of speechand to report any of these symptoms to their healthcare provider immediatelysee WARNINGSCardiovascular Thrombotic Events

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acute hyper- ponstel exhibit potency and side effects similar to sensitivity to ibuprofen has been reported in patients those of other nonsalicylate nsaids.

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These are not all of the side effects that may occurIf you have questions about side effectscall your doctorCall your doctor for medical advice about side effects.

Based on its physical and chemical propertiesPonstel is expected to be excreted in human breast milksee PRECAUTIONSNursing Mothers

Advise the patient to read the FDA-approved patient labelingMedication Guidethat accompanies each prescription dispensedInform patientsfamilies and their caregivers of the following information before initiating therapy with Ponstel and periodically during the course of ongoing therapy.

NSAIDsincluding Ponstelcan lead to new onset of hypertension or worsening of pre-existing hypertensioneither of which may contribute to the increased incidence of CV eventsPatients taking angiotensin converting enzymeACEinhibitorsthiazides diureticsor loop diuretics may have impaired response to these therapies when taking NSAIDssee PRECAUTIONSDrug Interactions

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Tell your doctor if you are taking an antidepressant such as citalopramCelexaduloxetineCymbaltaescitalopramLexaprofluoxetineProzacSarafemSymbyaxfluvoxamineLuvoxparoxetinePaxilsertralineZoloftor venlafaxineEffexorTaking any of these drugs with mefenamic acid may cause you to bruise or bleed easily.

Belly pain or heartburnUpset stomach or throwing upLoose stoolsdiarrheaHard stoolsconstipationGasDizzinessHeadache.

A blood thinner such as warfarinCoumadina diureticwater pillsuch as furosemideLasixcyclosporineGengrafNeoralSandimmunelithiumEskalithLithobidmethotrexateRheumatrexTrexallsteroidsprednisone and othersor aspirin or NSAIDsnon-steroidal anti-inflammatory drugssuch as diclofenacVoltarenetodolacLodinefenoprofenNalfonflurbiprofenAnsaidibuprofenAdvilMotrinindomethacinIndocinketoprofenOrudisketorolacToradolmeclofenamateMeclomenmeloxicamMobicnabumetoneRelafennaproxenAleveNaprosynpiroxicamFeldeneand others.

Stop taking this medication and seek immediate medical attention if you notice any of the following rare but very serious side effectschest painsevere dizzinesstrouble breathingweakness on one side of the bodysudden vision changesslurred speechblack stoolspersistent stomach/abdominal painvomit that looks like coffee groundsSee also Precautions section

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