Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Etodolac belongs to a class of drugs called
nonsteroidal anti-inflammatory drugs (NSAIDs). Other members of this class
include ibuprofen (Motrin, Advil, Nuprin, etc.), naproxen (Aleve, Naprosyn),
indomethacin (Indocin), nabumetone (Relafen) and numerous others. These drugs
are used for the management of mild to moderate pain, fever, and inflammation.
They work by reducing the levels of prostaglandins, which are chemicals that are
responsible for pain and the fever and tenderness that occur with inflammation.
Etodolac blocks the enzyme that makes prostaglandins (cyclooxygenase), resulting
in lower concentrations of prostaglandins. As a consequence, inflammation, pain
and fever are reduced. The FDA approved etodolac in January 1991.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS:
Capsules: 200 and 300 mg;
Tablets: 400 and 500 mg;
Extended Release: 400, 500 and 600 mg.
STORAGE: Capsules and tablets of etodolac should be stored at room
temperature, between 15-30 C (59-86 F).
DOSING: The recommended doses for general pain relief when using
immediate release capsules or tablets are 200-400 mg every 6-8 hours. Arthritis
is managed with 600-1000 mg given in 2 or 3 divided doses daily. The maximum
recommended dose is 1000 mg daily. Total daily doses exceeding 1000 mg have not
been adequately evaluated; however, some patients may benefit from a total daily
dose of 1200 mg. The recommended dose when using extended relief tablets is
400-1000 mg once daily. Doses above 1200 mg have not been evaluated.
DRUG INTERACTIONS: Etodolac is associated with several suspected or
probable interactions that affect the action of other drugs. The following
examples are the most common suspected interactions.
Etodolac may increase the blood levels of lithium (Eskalith) by reducing the
elimination of lithium from the body by the kidneys. Increased levels of lithium
may lead to lithium toxicity.
Etodolac may reduce the blood pressure lowering effects of blood pressure
medications. This may occur because prostaglandins play a role in the regulation
(lowering) of blood pressure.
When etodolac is used in combination with aminoglycosides (for example,
gentamicin) the blood levels of the aminoglycoside may increase, presumably
because the elimination of aminoglycosides from the body is reduced. This may
lead to more aminoglycoside-related side effects.
Individuals taking oral blood thinners or anticoagulants [for example,
warfarin (Coumadin)] should avoid etodolac because etodolac also thins the blood, and
excessive blood thinning may lead to bleeding.
PREGNANCY: There are no adequate studies of etodolac in
pregnant women. NSAIDs may cause adverse cardiovascular effects in the fetus during late
pregnancy.
NURSING MOTHERS: It is not known whether etodolac is excreted in
human
milk.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
The knee joint is composed of three compartments and ligaments which stabilize the joint. Causes of knee pain may include injury, degeneration, infrequently infection and rarely bone tumors. Although routine x-rays do not revel meniscus tears, they can be used to exclude other problems of the bones and tissues. The knee joint is the most commonly involved joint in rheumatic disease, as well as immune diseases that affect various tissues of the body.
Menstrual cramps (pain in the belly and pelvic area) are experienced by women as a result of menses. Menstrual cramps are not the same as premenstrual syndrome (PMS). Menstrual cramps are common, and may be accompanied by headache, nausea, vomiting, constipation, or diarrhea. Severity of menstrual cramp pain varies from woman to woman. Treatment includes OTC or prescription pain relief medication.
Elbow pain is most often the result of tendinitis, which can affect the inner or outer elbow. Treatment includes ice, rest, and medication for inflammation. Inflammation, redness, warmth, swelling, tenderness, and decreased range of motion are other symptoms associated with elbow pain. Treatment for elbow pain depends upon the nature of the patient's underlying disease or condition.
Ankle pain is commonly due to a sprain or tendinitis. The severity of ankle sprains ranges from mild (which can resolve within 24 hours) to severe (which can require surgical repair). Tendinitis of the ankle can be caused by trauma or inflammation.
Osteoarthritis is a type of arthritis caused by inflammation, breakdown, and eventual loss of
cartilage in the joints. Also known as degenerative arthritis. Osteoarthritis
can be caused by aging, heredity, and injury from trauma or disease.
Bursitis is inflammation of a bursa. A bursa is a tiny fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. There are 160 bursae in the body. The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees.
Bursitis of the knee results when any of the three fluid-filled sacs (bursae) become inflamed due to injury or strain. Symptoms include pain, swelling, warmth, tenderness, and redness. Treatment of knee bursitis depends on whether infection is involved. If the knee bursa is not infected, knee bursitis may be treated with ice compresses, rest, and antiinflammatory and pain medications.
Pain management and treatment can be simple or complex, according to its cause. There are two basic types of pain, nociceptive pain and neuropathic pain. Some causes of neuropathic pain includes: complex regional pain syndrome, interstitial cystitis, and irritable bowel syndrome. There are a variety of methods to treat chronic pain, which are dependant on the type of pain experienced.
Chronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
Juvenile arthritis (juvenile rheumatoid arthritis or JRA) annually affects one child in every thousand. There are three types of JRA: pauciarticular (less than four joints affected), polyarticular (more than four joints affected), and systemic-onset (inflamed joints with high fevers and rash). Treatment of juvenile arthritis depends upon the type the child has and should focus on treating the symptoms that manifest.
Menstruation (menstrual cycle) is also referred to as a "period." When a woman menstruates, the lining of the uterus is shed. This shedding of the uterine linking is the menstrual blood flow. The average menstrual cycle is 28 days. There can be problems with a woman's period, including heavy bleeding, pain, or skipped periods. Causes of these problems may be amenorrhea (lack fo a period), menstrual cramps (dysmenorrhea), or abnormal vaginal or uterine bleeding. There are a variety of situations in which a girl or woman should see a doctor about her menstrual cycle.
Menstrual cramps and premenstrual syndrome (PMS) symptoms include abdominal cramping, bloating, a feeling of fullness, abdominal pain, mood swings, anxiety and more. Treatment for menstrual cramps and premenstrual syndrome (PMS) symptoms include regular sleep, exercise, smoking cessation, diet changes, and OTC or prescription medication depending on the severity of the condition.
Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
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