Etodolac

Indications

Etodolac is used for: Rheumatoid arthritis, Pain, Osetoarthritis

Adult Dose

Oral Osteoarthritis; Rheumatoid arthritis Adult: 600-1000 mg/day in divided doses adjusted according to response. Max: 1200 mg/day. ER tablet: Once daily Hepatic impairment: Dose adjustment not necessary

Child Dose

Juvenile Rheumatoid Arthritis <6 years Safety and efficacy not established 6-16 years 20-30 kg (extended release): 400 mg PO once daily 31-45 kg (extended release): 600 mg PO once daily 46-60 kg (extended release): 800 mg PO once daily >60 kg (extended release): 1000 mg PO once daily

Renal Dose

Mild-to-moderate renal impairment: Dose adjustment not necessary Severe renal impairment; Not recommended

Administration

Should be taken with food. Take w/ or immediately after meals.

Contra Indications

Peptic ulcer, hypersensitivity to etodolac/NSAIDs. Childn; pregnancy (3rd trimester) and lactation.

Precautions

CHF, dehydration, impaired renal, hepatic function, history of GI disease. Elderly, patients receiving anticoagulant. Lactation: Unknown whether drug is excreted in breast milk; not recommended

Pregnancy-Lactation

Pregnancy category: C; avoid in late pregnancy (may cause premature closure of ductus arteriosus) Lactation: Unknown whether drug is excreted in breast milk; not recommended

Interactions

Increased effect of warfarin, lithium, methotrexate, digoxin, cyclosporin, aspirin. Effect may be reduced with aspirin. Reduced effect of some diuretics and ?-blockers. Alcohol enhances gastric mucosal irritation.

Adverse Effects

Side effects of Etodolac : 1-10% Dyspepsia (10%), Dizziness (3-9%), Nervousness (1-3%), Pruritus (1-3%), Blurred vision (1-3%), Depression (1-3%), Chills/fever (1-3%) >1% Asthenia, malaise, Blurred vision, Bronchospasm, Dysuria, urinary frequency, Edema, Melena, Rash, Tinnitus Potentially Fatal: Acute renal failure; blood disorder; nephrotoxicity; angioedema, arrhythmia, bone marrow suppression, CHF, dyspnoea, erythema multiforme, exfoliative dermatitis, hepatitis, hypertension, peripheral neuropathy, Stevens-Johnson syndrome, syncope, tachycardia, toxic amblyopia, toxic epidermal necrolysis, urticaria.

Mechanism of Action

Etodolac is an NSAID derived from pyrano-indoleacetic acid, inhibits cyclooxygenase 2 (COX-2) resulting in decreased prostaglandin precursor formation.