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etodolac (Rx)Brand and Other Names:Lodine

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 400mg
  • 500mg

capsule

  • 200mg
  • 300mg

tablet, extended-release

  • 400mg
  • 500mg
  • 600mg
more...

Pain

Immediate release: 200-400 mg PO q6-8hr; not to exceed 1000 mg/day (not evaluated)

Osteoarthritis

Immediate release: 600-1000 mg/day PO divided q8-12hr or 900 mg/day PO divided q8hr; doses >1000 mg/day not evaluated

Extended release: 400-1000 mg PO once daily; not to exceed 1200 mg/day (not evaluated)

Rheumatoid Arthritis

Immediate release: 600-1000 mg/day PO divided q8-12hr or 900 mg/day PO divided q8hr; doses >1000 mg/day not evaluated

Extended release: 400-1000 mg PO once daily; not to exceed 1200 mg/day (not evaluated)

Dosing Considerations

Take with food or 8-12 oz of water to avoid gastrointestinal (GI) effects

<60 kg: Not to exceed 20 mg/kg PO  

Mild-to-moderate renal impairment: Dose adjustment not necessary

Severe renal impairment; Not recommended

Hepatic impairment: Dose adjustment not necessary

Malignant Glioma (Orphan)

Orphan designation for treatment of malignant glioma (plus propranolol)

Sponsor

  • Vicus Therapeutics, LLC; 55 Madison Avenue, Suite 400; Morristown, NJ 07960

Dosage Forms & Strengths

tablet, extended-release

  • 400mg
  • 500mg
  • 600mg
more...

Juvenile Rheumatoid Arthritis

<6 years

  • Safety and efficacy not established

6-16 years

  • 20-30 kg (extended release): 400 mg PO once daily
  • 31-45 kg (extended release): 600 mg PO once daily
  • 46-60 kg (extended release): 800 mg PO once daily
  • >60 kg (extended release): 1000 mg PO once daily

Dosing considerations

  • Safety and effectiveness of conventional tablets for juvenile rheumatoid arthritis not established
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Interactions

Interaction Checker

etodolac and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            Sort by :  
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            Adverse Effects

            1-10%

            Dyspepsia (10%)

            Dizziness (3-9%)

            Nervousness (1-3%)

            Pruritus (1-3%)

            Blurred vision (1-3%)

            Depression (1-3%)

            Chills/fever (1-3%)

            >1%

            Asthenia, malaise

            Blurred vision

            Bronchospasm

            Dysuria, urinary frequency

            Edema

            Melena

            Rash

            Tinnitus

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            Warnings

            Black Box Warnings

            Cardiovascular risk

            • Nonsteroidal anti-inflammatory drugs (NSAIDs) may increase risk of serious cardiovascular thrombotic events, myocardial infarction (MI), and stroke, which can be fatal
            • Risk may increase with duration of use
            • Patients with risk factors for or existing cardiovascular disease may be at greater risk
            • NSAIDs are contraindicated for perioperative pain in setting of coronary artery bypass graft (CABG) surgery

            Gastrointestinal risk

            • NSAIDs increase risk of serious GI adverse events, including bleeding, ulceration, and gastric or intestinal perforation, which can be fatal
            • GI adverse events may occur at any time during use and without warning symptoms
            • Elderly patients are at greater risk for serious GI events

            Contraindications

            Absolute

            • Aspirin allergy
            • Perioperative pain associated with coronary artery bypass graft
            • Previous allergic reactions or asthma after taking aspirin or other NSAIDs

            Relative

            Cautions

            Use caution in patients with history of asthma (bronchial)

            Caution in bleeding disorder, duodenal/gastric/peptic ulcer, stomatitis, systemic lupus erythematosus, ulcerative colitis, upper GI disease, late pregnancy (may cause premature closure of ductus arteriosus)

            Use with caution in cardiac disease, hepatic and renal impairment

            Long-term administration of NSAIDs may result in renal papillary necrosis and other renal injury; patients at greatest risk include elderly individuals; those with impaired renal function, hypovolemia, heart failure, liver dysfunction, or salt depletion; and those taking diuretics, angiotensin-converting enzyme inhibitors, or angiotensin-receptor blockers

            Advanced renal disease: Monitor closely

            Risk of severe GI toxicities, including inflammation, ulcers, bleeding, and perforation

            Increased risk of serious cardiovascular thrombotic events, MI, and stroke

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            Pregnancy & Lactation

            Pregnancy category: C; avoid in late pregnancy (may cause premature closure of ductus arteriosus)

            Quebec Pregnancy Registry identified 4705 women who had a spontaneous abortion by 20 weeks' gestation; each case was matched to 10 control subjects (n=47,050) who had not had a spontaneous abortion; exposure to nonaspirin NSAIDs during pregnancy was documented in approximately 7.5% of cases of spontaneous abortion and approximately 2.6% of controls

            Lactation: Unknown whether drug is excreted in breast milk; not recommended

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Pharmacology

            Mechanism of Action

            Inhibits synthesis of prostaglandins in body tissues by inhibiting at least 2 cyclo-oxygenase (COX) isoenzymes, COX-1 and COX-2

            May inhibit chemotaxis, alter lymphocyte activity, decrease proinflammatory cytokine activity, and inhibit neutrophil aggregation; these effects may contribute to anti-inflammatory activity

            Absorption

            Bioavailability: 80-100%

            Onset: 2-4 hr

            Duration: 4-6 hr

            Peak plasma time: Immediate release, 1-2 hr (adults); extended release, 5-7 hr (children)

            Distribution

            Protein bound: ≥99%

            Vd: 0.4 L/kg (Immediate release); 0.57 L/kg (adults; extended release) or 0.08 L/kg (children; extended release)

            Metabolism

            Hepatic

            Metabolites: Hydroxylated metabolites (6-, 7-, 8-OH), hydroxylated metabolite glucuronides, unidentified metabolites (33%)

            Elimination

            Half-life: Immediate release, 5-8 hr (adults); extended release, 12 hr (children)

            Dialyzable: No

            Excretion: Urine (73%), feces (16%)

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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            • View the formulary and any restrictions for each plan.
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            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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