Mefenamic Acid and Paracetamol Suspension: Uses, Dose, Side Effects (2026)

• Updated 23 October 2026
• Reviewed by Sudhanshu Singhal
• 21 min read
• 33 sources

Prices are as shown by the e-pharmacy Tata 1mg on 23 October 2026; prices change from time to time, and the MRP printed on the pack governs.

What is mefenamic acid + paracetamol?

It is a fixed-dose combination of two pain-relieving drugs, the NSAID mefenamic acid and paracetamol, packed together in one suspension, syrup or tablet.

The US label for mefenamic acid says its active moiety "is a member of the fenamate group of nonsteroidal anti-inflammatory drugs (NSAIDs)" and that it "has analgesic, anti-inflammatory, and antipyretic properties", meaning pain-relieving, anti-inflammatory and fever-lowering. Its action involves inhibition of cyclooxygenase (COX-1 and COX-2), although the US label says the mechanism "is not completely understood". The UK SmPC adds that mefenamic acid inhibits prostaglandin synthetase (cyclo-oxygenase) and also appears to inhibit prostaglandin action after it has been formed.

Paracetamol, which is the same drug as acetaminophen, is described in a UK SmPC as "a mild analgesic and antipyretic". Its mechanism "is not fully understood"; it may act mainly by inhibiting prostaglandin synthesis in the central nervous system, its fever effect is probably central, and it "has only weak anti-inflammatory properties".

What each partner adds: mefenamic acid supplies the anti-inflammatory action as well as pain and fever relief, while paracetamol adds pain relief and fever reduction with only a weak anti-inflammatory effect. Mefenamic acid is absorbed rapidly, reaches a peak blood level in 2 to 4 hours, has an elimination half-life of about 2 hours, and is broken down in the liver by the enzyme CYP2C9 (US label).

Forms and strengths sold in India

Indian listings show three forms of the combination, and the strengths below are as listed by the e-pharmacy Tata 1mg.

"DS" (double strength) carries twice the milligrams per 5 ml of the 50 mg + 125 mg suspension, so the same spoon volume gives twice the dose; never use a volume meant for the 50/125 strength with a DS bottle.

Do not confuse it with mefenamic acid alone

Some familiar names are not the combination at all. Meftal-P Suspension (Blue Cross, 60 ml) and Mefkind-P Suspension (Mankind, 60 ml) are mefenamic acid 100 mg per 5 ml only, with no paracetamol in them.

The Blue Cross products that do contain the combination are Meftagesic-P, Meftagesic Syrup, Meftagesic-DS and Meftal-Forte. No product called "Meftal-DS" was found on Tata 1mg.

What is it used for?

An Indian manufacturer page for a 50 mg + 125 mg per 5 ml suspension says it is "indicated for fever and pain", and secondary e-pharmacy listings describe the combination brands for pain and fever; the exact wording of each source is named below.

The US FDA label for mefenamic acid (PONSTEL capsules) states two indications: "management of mild to moderate pain in adults and pediatric patients 14 years of age and older, when therapy will not exceed one week (7 days)", and treatment of primary dysmenorrhea. The US generic label carries the same two indications. Fever is not listed as an indication in the US label, although the label does name antipyretic properties.

The UK SmPC for mefenamic acid 50 mg/5 ml suspension lists "post-operative and post-partum pain, pyrexia in children" and "Primary dysmenorrhoea in older children", among others. The UK SmPC for Ponstan Forte 500 mg tablets lists rheumatoid arthritis (including Still's Disease), osteoarthritis, muscular, traumatic and dental pain, headaches, post-operative and post-partum pain, primary dysmenorrhoea, and menorrhagia of certain causes.

India's drug-safety regulator, the IPC, describes the indications of mefenamic acid as rheumatoid arthritis, osteoarthritis, dysmenorrhoea, mild to moderate pain, inflammation, fever and dental pain. The Indian manufacturer page for Zuventus Mefast P Suspension (50 mg + 125 mg per 5 ml) says the product is "indicated for fever and pain", and its leaflet lists inflammation symptoms, arthritis and muscular pain, headache, toothache, post-operative and trauma pain, fever in children, and painful or heavy periods in girls.

Indian product listings describe the combination brands: Meftagesic-P Suspension is described for pain from headache, migraine, nerve pain, toothache and sore throat and for reducing fever; Meftagesic-DS Suspension for pain such as headache, body ache, muscle pain and toothache and for fever such as flu, viral infections and post-vaccination reactions; and Meftal-Forte Tablet for pain such as headache, body ache, muscle pain, toothache, menstrual cramps and minor injuries, and for fever. For paracetamol alone, a UK SmPC lists mild to moderate pain (headache, migraine, neuralgia, toothache, sore throat, period pains) and reduction of fever, and the NHS lists children's uses as aches, teething, earache, sore throat, cold or flu pain and discomfort from a high temperature.

Dose as stated in the labels

Each label states its own dose regimen, quoted below for information only; these are not personal dose instructions, and all of these medicines must be taken only as prescribed by a doctor.

Adults

The usual adult dose stated in the US label (PONSTEL, mefenamic acid capsules) for mild to moderate pain is 500 mg by mouth as an initial dose, then 250 mg every 6 hours as needed, with pain use "not to exceed one week (7 days)". For primary dysmenorrhea the label states 500 mg as an initial dose and then 250 mg every 6 hours, starting with the onset of bleeding and associated symptoms.

The usual adult dose stated in the UK label for Ponstan Forte 500 mg tablets is "1 tablet (500 mg) three times daily", taken "preferably with or after food"; for elderly patients the dose is the same as for adults, using the lowest effective dose for the shortest time. The UK label for Ponstan 250 mg capsules states 2 capsules (500 mg) three times daily, preferably with or after food, and says that children under 12 years "should be given Mefenamic Acid Suspension (50 mg/5ml)".

For the Indian combination tablets of 500 mg + 325 mg, product listings say to follow the doctor's dose and to take the tablet with or after food. The age limit in the US label is also worth noting: safety and effectiveness for pain "have not been established" in patients under 14 years.

Children

The only Indian leaflet-style dosing table read is on the Zuventus page for Mefast P Suspension (mefenamic acid 50 mg + paracetamol 125 mg per 5 ml), given "up to three times daily, usually not to exceed one week".

Two more points from those sources: the Zuventus leaflet says do not take mefenamic acid for more than 7 days unless the doctor advises, and adults should consult a doctor for dosage; the UK suspension label says that, apart from Still's Disease, therapy "should not be continued for longer than 7 days in children" and to give it "preferably with or after food". The UK label also gives an alternative by body weight for infants over 6 months: 25 mg/kg of bodyweight daily in divided doses.

These volumes are for the 50 mg + 125 mg per 5 ml strength only; for the DS strength and the tablets the doctor prescribes the dose by age and weight. Never adjust a spoon volume yourself; the doctor prescribes the volume and the number of doses for the child's weight and age.

Paracetamol part

The Indian Academy of Pediatrics (IAP) states a paracetamol dose of 15 mg/kg body weight, repeated after 4-6 hours if required, and warns that brands differ in strength, so the strength must be confirmed with the pharmacist. For adults the NHS states 500 mg tablets, 1 or 2 per dose, at least 4 hours apart, to a maximum of 8 tablets in 24 hours, and not for more than 3 days unless a doctor says so; the FDA says the total acetaminophen from all products in 24 hours should not exceed 4,000 mg for adults and children 12 and older.

Side effects

Common side effects mostly involve the stomach and gut, while the serious ones described in the labels are bleeding or ulceration of the stomach or intestine, heart and stroke events, liver and kidney problems, and severe skin reactions.

Common side effects

The US label lists reactions seen in about 1 to 10% of patients: abdominal pain, constipation, diarrhoea, dyspepsia, flatulence, heartburn, nausea, vomiting, GI ulcers and bleeding, abnormal renal function, anaemia, dizziness, oedema, raised liver enzymes, headache, increased bleeding time, itching, rashes and tinnitus. The UK SmPC for Ponstan Forte says the most frequent side effects "involve the gastrointestinal tract", namely nausea, vomiting, diarrhoea and dyspepsia.

MedlinePlus lists diarrhoea, constipation, gas, headache, dizziness, nervousness and ringing in the ears as common, and advises calling a doctor for blurred vision, swelling or weight gain, fever with rash or hives, facial swelling, yellow skin or eyes, and bloody or cloudy urine. E-pharmacy listings for the combination brands name skin rash, nausea, diarrhoea, indigestion, loss of appetite, heartburn and hypersensitivity.

Serious side effects that need urgent medical help

The US label carries a boxed warning that NSAIDs "cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal", and that the risk "may occur early in treatment and may increase with duration of use". A second boxed warning says NSAIDs cause serious stomach and gut events "including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal", and that these "can occur at any time during use and without warning symptoms".

The label also warns about hepatotoxicity, hypertension, heart failure and oedema, renal toxicity and raised potassium, anaphylactic reactions, aspirin-sensitive asthma, serious skin reactions including Stevens-Johnson syndrome and toxic epidermal necrolysis, blood toxicity, and masking of inflammation and fever. Mefenamic acid "should be stopped at the first appearance of skin rash" or any sign of hypersensitivity (UK SmPC).

DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) is named in both the US label and an Indian safety alert. India's IPC/PvPI Monthly Drug Safety Alert dated 30 November 2023, from a preliminary analysis of the PvPI database, links mefenamic acid to DRESS Syndrome, and asks health professionals and patients to "closely monitor the possibility" of this reaction and to report suspected cases to NCC-PvPI through the form on ipc.gov.in, the Android app "ADR PvPI" or the PvPI Helpline 1800-180-3024.

In children

The UK suspension SmPC says the gastrointestinal tract is most affected, that diarrhoea occurs occasionally, and that "Hypothermia has been reported in association with mefenamic acid, predominantly in paediatric patients". The same label advises caution in epilepsy and notes that bilirubin displacement "may increase neonatal jaundice".

Overdose is an emergency: the UK SmPC says mefenamic acid "has a tendency to induce tonic-clonic (grand mal) convulsions in overdose", and significant poisoning can cause acute renal failure and liver damage. For the paracetamol part, the US label warns of severe liver damage above 4,000 mg of acetaminophen in 24 hours or with three or more alcoholic drinks a day, and the FDA describes rare but serious skin reactions such as Stevens-Johnson syndrome and toxic epidermal necrolysis; the Zuventus leaflet states that Fixed Drug Eruption has been associated with paracetamol use.

Who should not take it, and interactions

It should not be taken by people with a known allergy to mefenamic acid, paracetamol or NSAIDs, by patients with active stomach ulcers or a history of NSAID-related gut bleeding, or by patients with severe heart, liver or kidney failure, and it is contraindicated for pain after coronary artery bypass graft surgery.

Contraindications

The US label lists known hypersensitivity to mefenamic acid; a history of asthma, urticaria or other allergic-type reactions after aspirin or other NSAIDs; and the setting of coronary artery bypass graft (CABG) surgery. The UK SmPC for Ponstan Forte adds inflammatory bowel disease, GI bleeding or perforation linked to earlier NSAID use, active or recurrent peptic ulcer or haemorrhage, severe heart, liver or kidney failure, and the last trimester of pregnancy.

The Indian manufacturer page for the combination lists hypersensitivity to mefenamic acid, paracetamol or excipients; NSAID-triggered asthma, urticaria or allergy; pain after CABG; active GI ulceration or chronic GI inflammation; pre-existing renal disease; and severe hepatic impairment. The UK label says "Caution is required" in patients with bronchial asthma or a history of it, and that renal function should be monitored in people with kidney, heart or liver impairment, those on diuretics, and elderly patients.

Interactions

The US label warns of increased bleeding risk with anticoagulants such as warfarin, aspirin, SSRIs and SNRIs, says that other NSAIDs and salicylates are "not recommended", and lists ACE inhibitors, ARBs, beta-blockers, diuretics, digoxin, lithium, methotrexate, cyclosporine and pemetrexed as needing monitoring. The UK SmPC states that "It is considered unsafe to take NSAIDs in combination with warfarin or heparin unless under direct medical supervision."

For paracetamol, the labels say not to take it with any other paracetamol-containing product, and to count paracetamol from all medicines when checking the daily total.

Pregnancy, breastfeeding, alcohol and children

The US label says to avoid NSAIDs "at about 30 weeks gestation and later", and that use at about 20 weeks or later may cause fetal kidney dysfunction leading to low amniotic fluid; between about 20 and 30 weeks the dose should be the lowest effective one for the shortest time. The FDA's October 2020 safety communication says NSAIDs from 20 weeks "may cause rare but serious kidney problems in an unborn baby", and names acetaminophen as an alternative chosen with a clinician.

The UK SmPC contraindicates the last trimester and says that from the 20th week mefenamic acid "may cause oligohydramnios"; MedlinePlus says "Do not take mefenamic acid around or after 20 weeks of pregnancy" unless the doctor says otherwise. The Zuventus leaflet for the combination says it "should not be used in late pregnancy" and not in the last three months, and not while breastfeeding unless a doctor advises.

For breastfeeding, the US label says mefenamic acid "is present in human milk in low amounts and may be transferred to breastfed infants", while the UK suspension SmPC says "mefenamic acid should not be taken by nursing mothers". On alcohol, the US paracetamol label warns of severe liver damage if you take more than 4,000 mg of acetaminophen in 24 hours, take it with other acetaminophen products, or have "3 or more alcoholic drinks a day".

For children, the US label does not establish safety for pain under 14 years, and the UK labels point under-12s to the 50 mg/5 ml suspension from 6 months and for no more than 7 days; in children use it only as a paediatrician prescribes.

Rules in India

Under the Drugs and Cosmetics Rules, 1945, as amended up to 30 September 2020, mefenamic acid is listed as item 302 of Schedule H ("Prescription Drugs"), so products containing it carry the Rx label warning "To be sold by retail on the prescription of a Registered Medical Practitioner only".

Under Rule 97(1)(b) the label must carry the symbol Rx and the words "Schedule H drug - Warning: To be sold by retail on the prescription of a Registered Medical Practitioner only", and preparations containing the listed substances, other than topical ones, are also covered. Paracetamol appears in the same Rules text only in Schedule K as "Paracetamol Tablets" (household remedy), not in Schedule H or G.

On the National List of Essential Medicines (NLEM 2022), notified by Gazette of India Extraordinary on 11 November 2022, mefenamic acid is item 2.1.4 (levels P,S,T) with a 250 mg tablet and a 100 mg/5 mL oral liquid, and paracetamol is item 2.1.5 with tablets, oral liquids, injection and suppositories. The mefenamic acid + paracetamol combination is not listed in NLEM 2022.

On prices, the NPPA ceiling prices reported for single-ingredient mefenamic acid in an aggregator page are ₹0.57 per ml for the 100 mg/5 ml oral liquid and ₹2.16 per tablet for the 250 mg tablet, shown under an order dated 25 March 2026. No NPPA ceiling price was found for the combination, which is consistent with its absence from NLEM 2022; what we did find are company-specific retail prices fixed under the DPCO, including ₹2.76 per tablet and ₹0.63 per ml reported in 2019 and ₹0.77 per unit excluding GST for a 50 mg + 125 mg per 5 ml paediatric suspension computed in November 2025.

Top brands in India

The table near the top of this page lists the mefenamic acid + paracetamol brands found on the Indian e-pharmacy Tata 1mg, grouped by strength, with prices as shown on 23 October 2026.

No published sales source ranking these brands was found, so no rank or "best" claim is made here; the list is by composition only, and all of them are shown by the e-pharmacy as prescription-required.

The Vibcare range

Vibcare supplies 12 products in this combination across four divisions: DS suspensions of 100 mg + 250 mg per 5 ml in 60 ml packs (Mefojem P DS, Mefolam P DS, Mefomol P DS, Mefovas P DS), tablets of 500 mg + 325 mg in 10x2x10 blister packs (Mefojem P, Mefolam P, Mefomol P, Mefovas P), and paediatric suspensions of 50 mg + 125 mg per 5 ml in 60 ml packs (Mefojem P, Mefolam P, Mefomol P, Mefovas P).

These products are supplied to PCD franchise partners district by district, one partner per district, with monopoly rights confirmed in writing; see our Paediatric PCD franchise and PCD pharma franchise pages.

Frequently asked questions

Sources

Related reading

• PCD pharma franchise with Vibcare
• Vibcare Pharma manufacturing
• About Vibcare Pharma