Adult Dosing
Analgesia
- Acute pain: 200-400 mg PO q6-8 hrs; Max: 1000 mg/day
Osteoarthritis and rheumatoid arthritis
- 300 mg PO bid-tid, 400 mg bid, 500 mg bid
- Maintenance dose: 600 mg/day
- Max: 1000 mg/day
Note:
- Use the lowest effective dose for the shortest duration possible with individual patient treatment goals
Pediatric Dosing
- Safety and effectiveness in pediatric patients <6 yrs of age have not been established
Juvenile rheumatoid arthritis (ETABS)
Children 6-16 yrs of age
- 20-30 kg: 400 mg PO qd
- 31-45 kg: 600 mg PO qd
- 46-60 kg: 800 mg PO qd
- >60 kg: 1000 mg PO qd
Note:
- Use the lowest effective dose for the shortest duration possible with individual patient treatment goals
[Outline]
- NSAIDs may increase the risk of serious and potentially fatal cardiovascular thrombotic events, MI, and stroke. Risk further increases with duration of use and with the presence of cardiovascular disease/risk factors for CV disease [US Black Box Warning]
- Use the lowest effective dose for the shortest duration possible in patients with known CV disease or risk factors for CV disease
- Etodolac may cause potentially fatal GI adverse events such as inflammation, bleeding, ulceration, and perforation of the stomach, small intestine or large intestine. Restrict use in patients with a prior history of peptic ulcer disease and/or gastrointestinal bleeding
- If a serious GI adverse event is suspected, discontinue the therapy and promptly institute an alternative therapy
- Factors that increase the risk for GI bleeding in patients with NSAID therapy include concomitant use of oral corticosteroids or anticoagulants, longer duration NSAID therapy, smoking, alcohol, older age, and poor general health status
- Severe hepatotoxicity can occur any time during treatment; closely monitor ALT and AST levels periodically. Avoid concomitant use of hepatotoxic drugs. Use the lowest effective dose for the shortest duration possible to minimize the potential risk of hepatotoxicity
- Should be used with caution in patients with hypertension. May cause onset of new hypertension or worsening of preexisting hypertension, either of which may contribute to increased risk of CV events
- Use with caution in patients taking thiazides or loop diuretics as it may hamper the therapeutic response of these agents. Closely monitor BP during the initiation and throughout the course of therapy
- Use cautiously in patients with heart failure, as it may cause fluid retention and edema
- Monitor for renal toxicity including renal papillary necrosis and other renal injury during long-term treatment. Patients at greater risk of this reaction are those with impaired renal function, heart failure, liver dysfunction, those taking diuretics and ACE inhibitors, and the elderly
- Contraindicated in advanced renal disease
- Restrict administration in patients with aspirin triad, which occurs typically in asthmatic patients who experience rhinitis with or without nasal polyps, or in patients who exhibit potentially fatal bronchospasm after taking aspirin or other NSAIDs
- Discontinue the treatment at the first appearance of skin rash or any other sign of hypersensitivity like exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis
- Do not administer in pregnant women after 30 weeks as it causes premature closure of the ductus arteriosus in the fetus
- Check hematologic profile at regular intervals in patients on long-term treatment with NSAIDs as it may cause anemia due to fluid retention, occult or gross GI blood loss
- Etodolac inhibits platelet aggregation and prolongs bleeding time in some patients; closely monitor patients with coagulation disorders or those receiving anticoagulants
- Monitor for signs of GI bleeding. Perform CBC and other blood chemistries, liver function and renal function tests periodically
- Etodolac cannot be used to treat corticosteroid insufficiency or to substitute for corticosteroids
- Use with caution in older age, poor general health status, debilitated patients
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Preexisting kidney disease
- Preexisting asthma
- Dehydration
Pregnancy Category:C (caution in 3rd trimester)
Breastfeeding: Due to no information available, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 7 March 2011).
Pricing data from www.DrugStore.com in U.S.A.
- Etodolac 400 MG TABS [Bottle] (ACTAVIS ELIZABETH)
60 mg = $38.99
180 mg = $100.98 - Etodolac 500 MG TABS [Bottle] (APOTEX)
60 mg = $75.99
180 mg = $205.97 - Etodolac 300 MG CAPS [Bottle] (TARO)
60 mg = $35.99
180 mg = $85.97
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
