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If you have any of these other conditionsyou may need a dose adjustment or special tests to safely use this medication:

This medication should not be used if you have certain medical conditionsBefore using this medicineconsult your doctor or pharmacist if you haveaspirin-sensitive asthmaa history of worsening breathing with runny/stuffy nose after taking aspirin or other NSAIDssevere kidney diseaserecent heart bypass surgeryCABGactive bleeding/sores in stomach/intestinesulcergastrointestinal bleeding

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusionIn these patientsadministration of an NSAID may cause a dose-dependent reduction in prostaglandin formation andsecondarilyin renal blood flowwhich may precipitate overt renal decompensationPatients at greatest risk of this reaction are those with impaired renal functiondehydrationhypovolemiaheart failureliver Buy actoplus medication dysfunctionthose taking diuretics and ACE inhibitors or ARBsand the elderlyDiscontinuation of NSAID therapy is usually followed by recovery to the pretreatment state.

This medicine can increase your risk of life-threatening heart or circulation problemsincluding heart attack or strokeDo not use this medicine just before or after having heart bypass surgeryalso called coronary artery bypass graftor CABG

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

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