Classifications: analgesic, nonsteroidal antiinflammatory agent (nsaid); antipyretic; Therapeutic:nsaid, analgesic; antipyretic
Pregnancy Category: C
400, 500 mg tablets; 200 mg, 300 mg capsules; 400, 500 mg, 600 mg sustained release tablets
Inhibits cyclooxygenase (COX-1 and COX-2) enzyme activity and prostaglandin synthesis. NSAIDs may also suppress production
of rheumatoid factor.
Produces analgesic and antiinflammatory effects of an NSAID.
Osteoarthritis and acute pain, rheumatoid arthritis.
Hypersensitivity to NSAIDS, salicylates; ulceration or inflammation; perioperative CABG pain; pregnancy (category C), lactation. Safety and efficacy
in children <6 y are not established.
Renal impairment, liver function impairment, GI disorders; cardiac disorders; dehydration; diabetes mellitus; patients over
65 y, and lactation.
Route & Dosage
Adult: PO 200400 mg q68h prn
Adult: PO 6001200 mg/d in 24 divided doses, (max: 1200 mg/d or 20 mg/kg for patients ?60 kg; Lodine XL 4001000 mg
Adult: PO 500 mg b.i.d.
- Give with food or antacid to reduce risk of GI ulceration.
- Ensure that sustained release form of drug is not chewed or crushed. It must be swallowed whole.
- Store at 15°25° C (59°77° F); tablets and capsules in bottles; sustained release capsules
in unit-dose packages. Protect all forms from moisture.
Adverse Effects (≥1%)CV:
Fluid retention, edema. CNS:
Dizziness, headache, drowsiness, insomnia
. GI: Dyspepsia, nausea, vomiting, diarrhea, indigestion
, heartburn, abdominal pain, constipation
, flatulence, gastritis
, melena, peptic ulcer
, GI bleeding. Hematologic:
Thrombocytopenia, increased bleeding time. Skin:
Rash, pruritus. Urogenital:
Urinary frequency. Metabolic:
Hepatotoxicity. Special Senses:
Blurred vision; tinnitus. Respiratory: Asthma
Diagnostic Test Interference
May cause a false-positive urinary bilirubin test and a false-positive ketone test done with the dipstick method. May cause a small decrease (1 to 2 mg/dL) in serum uric acid levels.
May reduce effects of diuretics
and antihypertensive effects of beta blockers
and other antihypertensive medications
. May increase digoxin
levels and nephrotoxicity due to cyclosporine. Herbal: Feverfew, garlic, ginger, ginkgo
may increase bleeding.
Readily from GI tract. Onset:
30 min. Peak:
12 h. Duration:
412 h. Distribution:
Widely distributed; 99% protein bound; not known if crosses placenta or if distributed into breast milk. Metabolism:
Extensively in liver. Elimination:
72% in urine, 16% in feces. Half-Life:
Assessment & Drug Effects
- Assess for signs of GI ulceration and bleeding. Risk factors include high doses of etodolac, history of peptic ulcer disease,
alcohol use, smoking, and concomitant use of aspirin.
- Assess carefully for fluid retention by monitoring weight and observing for edema in patients with a history of CHF.
- Monitor for decreased BP control in hypertensive patients.
- Lab tests: Periodic CBC and kidney and liver function.
- Monitor for drug toxicity when used concurrently with either digoxin or lithium.
- Monitor for rhinitis, urticaria, or other signs of allergic reactions. Discontinue drug and notify physician when present.
- Monitor carefully increases in etodolac dosage with older adult patients; adverse effects are more pronounced.
- Monitor for headaches, especially at high doses. Discontinuation of therapy may be indicated.
Patient & Family Education
- Learn S&S of GI ulceration. Stop medication in presence of bleeding and contact the physician immediately.
- Do not take aspirin, which may potentiate ulcerogenic effects.