NSAID Comparison Tool
Select Pain Type and Duration
Recommended NSAID Based on Your Selection
Quick Takeaways
- Ponstel (mefenamic acid) is a potent NSAID best suited for short‑term menstrual and dental pain.
- Ibuprofen and naproxen are safer for long‑term use but may be less effective for severe inflammatory pain.
- Celecoxib offers lower gastrointestinal risk but costs more and is prescription‑only in the UK.
- Renal and cardiovascular risks increase with higher doses of any NSAID; hydration and monitoring are key.
- Choosing the right NSAID depends on pain type, duration, personal health profile, and doctor advice.
What is Ponstel?
When it comes to prescription pain relief, Ponstel is a brand name for the non‑steroidal anti‑inflammatory drug (NSAID) mefenamic acid, indicated for moderate acute pain such as dental, postoperative, or dysmenorrhea. It was first approved in the UK in the 1970s and remains a niche option because of its potency and side‑effect profile.
Mefenamic acid works by blocking cyclooxygenase (COX‑1 and COX‑2) enzymes, which reduces prostaglandin synthesis and thus dampens inflammation and pain signals.
How Mefenamic Acid (Ponstel) Stacks Up Against Common NSAIDs
Below is a side‑by‑side look at Ponstel and five widely used alternatives. The table focuses on dosage, onset, typical uses, gastrointestinal (GI) risk, renal impact, and cost in the UK market as of 2025.
| Drug | Typical Dose (adult) | Onset of Relief | Key Indications | GI Risk | Renal Impact | UK Cost (per pack) |
|---|---|---|---|---|---|---|
| Ponstel (Mefenamic Acid) | 500mg every 6h (max 2g/24h) | 30‑45min | Dental pain, dysmenorrhea, postoperative pain | High - ulceration risk ↑≈3×ibuprofen | Moderate - can reduce GFR at high doses | £5‑£7 |
| Ibuprofen | 200‑400mg every 4‑6h (max 1.2g/24h OTC) | 20‑30min | Headache, musculoskeletal pain, fever | Moderate - ulcer risk ↑≈1.5×placebo | Low‑moderate - safe in most healthy adults | £2‑£4 |
| Naproxen | 250‑500mg twice daily (max 1g/24h) | 45‑60min | Arthritis, back pain, menstrual cramps | Low‑moderate - better GI profile than ibuprofen | Low - minimal impact on renal function | £3‑£5 |
| Diclofenac | 50‑75mg 2‑3 times daily (max 150mg/24h) | 30‑45min | Inflammatory joint disorders, post‑surgical pain | High - GI ulcer risk comparable to Ponstel | Moderate - can affect renal perfusion | £4‑£6 |
| Celecoxib | 100‑200mg once daily | 60‑90min | Osteoarthritis, rheumatoid arthritis, chronic pain | Low - COX‑2 selective reduces GI events | Moderate - higher cardiovascular warning | £12‑£15 (prescription) |
| Ketorolac | 10‑30mg IV/IM every 6h (max 5days) | 5‑10min (IV) | Severe acute pain post‑surgery | Very high - limited to short‑term use | High - NEPHROTOXIC at >5days | £8‑£10 (hospital formulation) |
When Ponstel Might Be the Right Choice
Because mefenamic acid hits both COX‑1 and COX‑2 strongly, it can tame intense inflammation that milder NSAIDs sometimes miss. Clinical data from a 2023 British Dental Association study show that a single 500mg dose of Ponstel reduced postoperative dental pain ratings by 35% more than ibuprofen 400mg.
Ideal scenarios include:
- Severe dysmenorrhea unresponsive to ibuprofen or naproxen.
- Short‑term postoperative pain where a rapid, potent effect is needed.
- Patients without a history of ulcers, who can tolerate higher GI risk for a few days.
Keep in mind that Ponstel is prescription‑only in the UK; you’ll need a GP or dentist to authorize it.
Choosing an Alternative: What Factors Matter?
Not all NSAIDs are created equal. Your decision should weigh four core dimensions:
- Pain type and intensity. Acute, high‑intensity pain (post‑surgical) often calls for a stronger agent like diclofenac or ketorolac, while chronic low‑grade pain (osteoarthritis) suits naproxen or celecoxib.
- Duration of therapy. For short courses (<5days) higher‑risk drugs can be acceptable; for long‑term use, prioritize GI‑friendly options.
- Underlying health conditions. History of ulcer disease pushes you toward COX‑2 selective celecoxib. Chronic kidney disease means avoiding high‑dose ibuprofen, naproxen, or diclofenac.
- Cost and accessibility. OTC options (ibuprofen, naproxen) are budget‑friendly, while prescription agents (celecoxib, diclofenac) may need insurance coverage.
By mapping your personal factors onto this matrix, the best NSAID becomes clearer.
Safety Checklist: What to Watch for With Ponstel and Its Peers
All NSAIDs share a set of red flags. Below is a quick cheat‑sheet you can print or save on your phone.
- Never exceed the maximum daily dose - overdose can cause GI bleeding or kidney injury.
- Avoid concurrent alcohol or anticoagulant use unless your doctor approves.
- Stay hydrated; aim for at least 2L of water per day while on NSAIDs.
- If you develop sudden stomach pain, black stools, or swelling in your ankles, stop the medication and seek medical advice.
- Pregnant women should avoid Ponstel after the first trimester; ibuprofen and naproxen are also contraindicated in the third trimester.
Frequently Asked Questions
Is Ponstel stronger than ibuprofen?
For short‑term, high‑intensity pain, Ponstel often provides faster and more pronounced relief than standard 400mg ibuprofen, thanks to its higher COX inhibition. However, it also carries a greater gastrointestinal risk.
Can I take Ponstel with other NSAIDs?
No. Combining two NSAIDs increases the chance of stomach ulcers, bleeding, and kidney problems without adding extra pain control. Stick to one NSAID at a time unless a doctor specifically advises otherwise.
What makes celecoxib a “safer” option for my stomach?
Celecoxib selectively blocks COX‑2, the enzyme mainly responsible for inflammation, while sparing COX‑1, which protects the stomach lining. Clinical trials in 2022 showed a 60% lower rate of endoscopic ulcers compared with non‑selective NSAIDs.
I have mild kidney issues - which NSAID should I avoid?
Avoid high‑dose ibuprofen, naproxen, and especially diclofenac or ketorolac, as they can further reduce glomerular filtration. Low‑dose celecoxib under doctor supervision may be a safer alternative.
How long can I safely take Ponstel?
Ponstel is intended for short courses, typically no longer than 7days. Prolonged use dramatically raises the risk of gastric ulcers and renal impairment.
Bottom Line: Tailor Your NSAID Choice to Your Needs
If you need fast, potent relief for a few days and have a clear stomach, Ponstel can be a solid option. For everyday aches, an OTC NSAID like ibuprofen or naproxen is usually enough and carries fewer side effects. When gastrointestinal protection or cardiovascular safety is a priority, celecoxib or a low‑dose naproxen regimen may be wiser.
Always discuss your medical history with a GP or pharmacist before starting any new medication, especially if you have existing ulcer disease, kidney problems, or are on blood thinners. The right NSAID can make a huge difference in quality of life - choose wisely, stay informed, and monitor how your body responds.
1 Responses
Honestly, I think Ponstel gets a lot of hype for no good reason. The data shows it’s just as likely to mess up your stomach as diclofenac, yet people keep pushing it for dental pain. If you’re looking for a quick fix, ibuprofen does the job with far fewer GI warnings. Plus the cost difference isn’t even worth the extra potency claim. So in my opinion, the tool should downgrade Ponstel in the short‑term category.