Etodolac Tablets and Capsules
Osteoarthritis, Rheumatoid Arthritis, Acute Pain
200mg · 300mg · 400mg
Designed to support physical comfort to manage articular joint swelling and alleviate acute structural pain.
From$1.51/ capsuleView
Etodolac
Etodolac is a nonsteroidal anti-inflammatory drug (NSAID). In animal models it has shown anti-inflammatory, analgesic and antipyretic activity, and its label indicates it for the management of acute pain. Anyone considering it is advised to weigh the potential benefits and risks against other treatment options before starting it.
Key points
- In man, etodolac’s elimination half-life averages seven hours.
- In patients also taking warfarin, prothrombin time testing showed no significant difference in warfarin’s effect whether or not etodolac was added.
How it works
All NSAIDs, etodolac included, work by inhibiting the formation of prostaglandins, and it is this action that accounts for both their therapeutic effects and some of their side effects. Etodolac’s mechanism has a distinguishing feature: as the EMC’s product information puts it, “the inhibition of prostaglandin synthesis observed with etodolac differs from that of other NSAIDs.” In-vitro studies consistent with this finding have found etodolac to be selective for cyclo-oxygenase 2 (COX-2, the enzyme associated with inflammation) over COX-1 (the enzyme that is cytoprotective).
Safety specific to etodolac
Etodolac’s US label carries a boxed warning covering cardiovascular thrombotic events and gastrointestinal risk.
On the cardiovascular side, nonsteroidal anti-inflammatory drugs, including etodolac, cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use. Etodolac is also contraindicated in the setting of coronary artery bypass graft (CABG) surgery.
On the gastrointestinal side, NSAIDs cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms, and elderly patients are at greater risk of serious gastrointestinal events.
Beyond the boxed warning, long-term administration of NSAIDs, etodolac included, has resulted in renal papillary necrosis and other renal injury. There is also a risk of premature closure of the fetal ductus arteriosus, and NSAIDs including etodolac should be avoided in pregnant women at about 30 weeks gestation and later.
When to seek urgent care
NSAIDs, including etodolac, can cause serious skin reactions such as exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis, which can be fatal. The advice is to stop taking etodolac at the first appearance of skin rash or any other sign of hypersensitivity. A related reaction, Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), has also been reported in patients taking NSAIDs such as etodolac. It typically, although not exclusively, presents with fever, rash, swollen glands and/or facial swelling, and fever or swollen glands can appear before any rash does.