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Although the absolute rate of death declined somewhat after the first year post-MI, vente Ponstel increased relative risk of death in NSAID users persisted over at least the next four years of follow-up. Avoid the use of Ponstel in patients with a recent MI unless the benefits are expected to outweigh the risk of recurrent CV thrombotic events. If Ponstel is used in patients with a recent MI, monitor patients for signs of cardiac ischemia. Gastrointestinal Bleeding, Ulceration, and Perforation NSAIDs, including mefenamic acid, cause serious gastrointestinal GI adverse events including inflammation, bleeding, ulceration, and perforation of the esophagus, stomach, small intestine, or large intestine, which can be fatal.
These serious adverse events can occur at any time, with or without warning symptoms, in patients treated with NSAIDs. Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy, concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors SSRIs ; smoking, use of alcohol, older age, and poor general health status. Most postmarketing reports of fatal GI events occurred in elderly or debilitated patients. Avoid use in patients at higher risk unless benefits are expected to outweigh the increased risk of bleeding. In addition, rare, sometimes fatal, cases of severe hepatic injury, including fulminant hepatitis, liver necrosis, and hepatic failure have been reported. Inform patients of the warning signs and symptoms of hepatotoxicity e.
If clinical signs and symptoms consistent with liver disease develop, or if systemic manifestations occur e.
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