Drug Detail:Etodolac (Etodolac [ ee-toe-doe-lak ])
Drug Class: Nonsteroidal anti-inflammatory drugs
1. How it works
- Etodolac helps to relieve pain and inflammation by possibly blocking the effects of cyclooxygenase (COX) enzymes. This prevents prostaglandin synthesis (prostaglandins elevate body temperature and make nerve endings more sensitive to pain transmission).
- Etodolac belongs to a class of medicines known as NSAIDs (nonsteroidal anti-inflammatory drugs).
2. Upsides
- Used to relieve mild-to-moderate acute pain or pain associated with osteoarthritis and rheumatoid arthritis.
- May also be used to relieve mild-to-moderate acute pain due to other causes.
- Etodolac is available as oral tablets, oral capsules, and extended-release tablets. Immediate-release forms are used to manage pain.
- Generic etodolac is available.
3. Downsides
If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:
- Stomach-related side effects such as indigestion, belching, heartburn, and bleeding. People of older age, taking other medicines that affect the stomach, or who drink more than 3 glasses of alcohol per day may be more at risk. Etodolac is more likely than ibuprofen to cause stomach-related side effects.
- Dizziness, edema, headaches, pruritis, and rashes are also reasonably common.
- Most NSAIDs have been associated with an increased risk of serious cardiovascular events including stroke or heart attack. The risk may be higher in patients with pre-existing cardiovascular conditions and with higher dosages. Etodolac is associated with a higher risk compared with other NSAIDs, such as ibuprofen.
- May affect kidney function and increase liver enzymes. Tinnitus (ringing in the ears) has also been reported.
- May increase bleeding time especially if given with other medicines that also delay blood clotting.
- May not be suitable for some people including those with kidney disease, a history of stomach ulcers or other gastrointestinal disorders, or with pre-existing cardiovascular disease. Should not be given during or following coronary artery bypass graft surgery.
- May interact with some other medicines such as warfarin, SSRIs, ACE inhibitors, and diuretics.
- Etodolac is only available on prescription, not over the counter.
- Not recommended for children.
- NSAIDs, such as etodolac, should not be used during the last three months of pregnancy because they can cause premature closure of the fetal ductus arteriosus. In addition, the use of NSAIDs at around 20 weeks gestation or later in pregnancy may cause fetal kidney problems leading to oligohydramnios (low amniotic fluid volume) and in some cases kidney impairment. If NSAID treatment is deemed necessary between 20 and 30 weeks of pregnancy, use the lowest effective dose for the shortest possible time. Avoid NSAIDs after 30 weeks gestation. It is not known if etodolac is excreted into breastmilk and use should be avoided.
Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects
4. Tips
- Always use etodolac at the lowest effective dose for the shortest possible time as directed by your doctor. Taking etodolac with food may decrease some of the gastrointestinal side effects.
- May make your skin more sensitive to the sun; wear sunblock SPF 30-50+ when outside; see a doctor as soon as possible if you develop a skin rash.
- Seniors may be especially sensitive to etodolac's side effects.
- Blood counts and liver enzymes may need monitoring periodically.
- Talk to your doctor if you are pregnant, intend to become pregnant, or breastfeeding. NSAIDs, such as etodolac should not be used in the last 3 months of pregnancy; always ask your doctor before using any medication during pregnancy.
- If you have experienced asthma-like symptoms, developed hives (urticaria), or other allergic-type reactions in the past after taking aspirin or other NSAIDs (like ibuprofen), do not take etodolac.
- Combining etodolac with alcohol may increase the risk of stomach ulcers or bleeding.
5. Response and effectiveness
- Peak plasma concentrations of etodolac are reached within 50 to 110 minutes after oral administration, and the peak analgesic effect occurs between one to two hours following a dose.
- Food does not affect the absorption of etodolac.
- The effects of etodolac usually last six to eight hours.
6. Interactions
Medicines that interact with etodolac may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with etodolac. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.
Common medications that may interact with etodolac include:
- ACE inhibitors such as benazepril, captopril, and enalapril
- apixaban
- aspirin
- corticosteroids, such as prednisone and methylprednisone
- dabigatran
- digoxin
- furosemide
- lithium
- methotrexate
- mifepristone
- NSAIDs, such as ibuprofen, diclofenac, and naproxen
- tetracyclines, such as doxycycline and minocycline
- tinzaparin
- warfarin.
In general, any medicine that can increase the risk of bleeding (such as clopidogrel, SSRI antidepressants [eg, citalopram, duloxetine, fluoxetine, venlafaxine], fish oils) may interact with etodolac.
Note that this list is not all-inclusive and includes only common medications that may interact with etodolac, You should refer to the prescribing information for etodolac for a complete list of interactions.