Medications and Drugs

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Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD

GENERIC NAME: etodolac

BRAND NAME: Lodine

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).

PRESCRIBED FOR: Etodolac is used for the treatment of inflammation and pain caused by osteoarthritis, rheumatoid arthritis, and juvenile rheumatoid arthritis. It is also used for treating soft tissue injuries, such as tendinitis and bursitis, and the treatment of menstrual cramps.

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.

SIDE EFFECTS: The most common side effects from etodolac are rash, ringing in the ears, headaches, dizziness, drowsiness, abdominal pain, nausea, diarrhea, constipation, heartburn, fluid retention and shortness of breath. NSAIDs reduce the ability of blood to clot and therefore increase bleeding after an injury. Etodolac also may cause stomach and intestinal bleeding and ulcers. Sometimes, stomach ulceration and intestinal bleeding can occur without any abdominal pain. Black, tarry stools, weakness, and dizziness upon standing may be the only signs of the bleeding. People who are allergic to other NSAIDs should not use etodolac. NSAIDs reduce the flow of blood to the kidneys and impair function of the kidneys. The impairment is most likely to occur in patients with impairment of kidney function or congestive heart failure, and treatment with NSAIDs in these patients should be done cautiously. Individuals with asthma are more likely to experience allergic reactions to etodolac and other NSAIDs. Fluid retention, blood clots, heart attacks, hypertension, and heart failure have also been associated with the use of NSAIDs.

Reference: FDA Prescribing Information

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