Etodolac

Brand Names: Lodine

Drug Class: Nonsteroidal Anti-inflammatory Drug (NSAID)

Overview

Etodolac is a nonsteroidal anti-inflammatory drug (NSAID) used for the management of osteoarthritis, rheumatoid arthritis, and acute pain. It works by inhibiting prostaglandin synthesis, providing anti-inflammatory, analgesic, and antipyretic effects. Treatment should use the lowest effective dose for the shortest duration to minimize cardiovascular and gastrointestinal risks.

Mechanism of Action

Etodolac is a nonsteroidal anti-inflammatory drug that inhibits cyclooxygenase (COX) enzymes, reducing prostaglandin synthesis. This inhibition provides anti-inflammatory, analgesic, and antipyretic effects through decreased production of inflammatory mediators.

Indications

  • Management of signs and symptoms of osteoarthritis
  • Management of signs and symptoms of rheumatoid arthritis
  • Management of acute pain

Common Doses

  • 200 mg
  • 300 mg
  • 400 mg
  • 500 mg

Dosage

For acute pain: 200-400 mg every 6-8 hours, up to 1000 mg daily. For osteoarthritis/rheumatoid arthritis: Starting dose of 300 mg twice daily, three times daily, or 400-500 mg twice daily. Maintenance dose may be reduced to 600 mg daily. Use lowest effective dose for shortest duration.

Contraindications

  • Known hypersensitivity to etodolac or any component
  • History of asthma, urticaria, or allergic reactions after aspirin or other NSAIDs
  • Coronary artery bypass graft (CABG) surgery

Side Effects

  • Common: Dyspepsia (10%), abdominal pain, diarrhea, nausea, flatulence, dizziness
  • Serious: GI ulceration/bleeding, hypertension, congestive heart failure, renal impairment, hepatic toxicity
  • Other: Headache, edema, rash, pruritus, tinnitus, elevated liver enzymes
  • Rare: Anaphylaxis, Stevens-Johnson Syndrome, toxic epidermal necrolysis, blood dyscrasias

Interactions

  • Warfarin: Increased risk of GI bleeding (monitor prothrombin time)
  • Aspirin: Increased adverse effects, not recommended for concomitant use
  • ACE inhibitors/ARBs: Reduced antihypertensive effect, increased renal risk
  • Diuretics: Reduced natriuretic effect, possible loss of blood pressure control
  • Lithium: Increased lithium levels and toxicity risk
  • Methotrexate: Increased methotrexate toxicity
  • Cyclosporine: Increased nephrotoxicity risk

Counseling Points

  • Take with food or milk to minimize gastrointestinal upset
  • Report any signs of GI bleeding (black/tarry stools, vomiting blood)
  • Seek immediate medical attention for chest pain, shortness of breath, weakness, or slurred speech
  • Avoid alcohol consumption during treatment
  • Discontinue and contact provider for skin rash, itching, or allergic reactions
  • Use lowest effective dose for shortest duration possible