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etodolac
Lodine, Lodine XL

Pregnancy Risk Category C

How supplied
Capsules:
200 mg, 300 mg
Tablets:
400 mg, 500 mg
Tablets (extended-release):
400 mg, 500 mg, 600 mg

Action
Unknown. Possibly related to inhibition of prostaglandin biosynthesis.

Indications & dosage
Acute pain--

Adults:
200 to 400 mg P.O. q 6 to 8 hours, p.r.n., not to exceed 1,200 mg daily. In patients weighing 60 kg (132 lb) or less, don't exceed total daily dose of 20 mg/kg.
Acute and chronic management of osteoarthritis and rheumatoid arthritis--

Adults:
600 to 1,000 mg P.O. daily, divided into two or three doses. Maximum dose is 1,200 mg/day. For extended-release product, 400 to 1,000 mg P.O. daily. Maximum dose is 1,000 mg/day.

Adverse reactions
CNS:
asthenia, malaise, dizziness, depression, drowsiness, nervousness, insomnia, syncope.
CV:
hypertension, heart failure, flushing, palpitations, edema, fluid retention.
EENT:
blurred vision, tinnitus, photophobia.
GI:
dyspepsia, flatulence, abdominal pain, diarrhea, nausea, constipation, gastritis, melena, vomiting, anorexia, peptic ulceration with or without GI bleeding or perforation, ulcerative stomatitis, thirst, dry mouth.
GU:
dysuria, urinary frequency, renal failure.
Hematologic:
anemia (rare), leukopenia, hemolytic anemia.
Hepatic:
hepatitis.
Metabolic:
weight gain.
Respiratory:
asthma.
Skin:
pruritus, rash, Stevens-Johnson syndrome.
Other:
chills, fever.

Interactions
Drug-drug.
Antacids: may decrease peak levels of drug. Monitor for decreased effect of etodolac.
Aspirin:
reduced protein-binding of etodolac without altering its clearance. Clinical significance unknown. May increase GI toxicity. Avoid concomitant use.
Beta blockers, diuretics:
effects may be blunted. Monitor closely.
Cyclosporine:
impaired elimination and increased risk of nephrotoxicity. Avoid concomitant use.
Digoxin, lithium, methotrexate:
etodolac may impair elimination of these drugs, resulting in increased levels and risk of toxicity. Monitor blood levels.
Phenytoin:
increased serum levels of phenytoin. Monitor for toxicity.
Warfarin:
etodolac decreases the protein-binding of warfarin but doesn't change its clearance. Although no dosage adjustment is needed, monitor INR closely and watch for bleeding.
Drug-lifestyle.
Alcohol use: increased chance of adverse effects. Avoid use.
Sun exposure:
photosensitivity reactions may occur; take precautions.

Effects on diagnostic tests
A false-positive test for urinary bilirubin may be caused by phenolic metabolites.

Contraindications
Contraindicated in patients with hypersensitivity to drug and in those with history of aspirin- or NSAID-induced asthma, rhinitis, urticaria, or other allergic reactions.

Nursing considerations

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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