NSAIDs include-
Propionic acid- Fenoprofen, Flurbiprofen, Ibuprofen, Ketoprofen, Naproxen, Naproxen Sodium, Oxaprozin
Acetic acids-  Diclofenac sodium, Etodolac, Indomethicin, Ketorolac, Nabumetone, Sulindac, Tolmetin
Fenamates (anthralic acids) - Meclofenamate, Mefenamic acxid
Oxicams- Piroxicam
Refer- Ibuprofen
 

ACE inhibitors-

reports suggest NSAIDs may diminish the antihypertensive effect of ACE- inhibitors

Antacids-

Concomittant use has no apparent effect on the extent of absorption of Etodolac

Aspirin-

When Etodolac is administerd with Aspirin, its protein binding is reduced although clearance of Etodoac is not affected.
Concomittant administration of Etodolac and aspirin is not generally recomended due to potential adverse effects,

Cyclosporine,Digoxoin, Methotrexate- 

 Etodolac may cause changes in elimination of these drugs leading to elevated serum levels of cyclosporine, digoxin, methotrexate and increased toxicity

Diuretics-

Etodolac has no apparent pharmacokinetic interaction when administred with Furosemide or Hydrochlothiazide

Glyburide, phenytoin-
No apparent pharmacokinetic interactin when administerd with Glyburide.

Lithium-
NSAIDs have produced an elevation of plasma levels and a reduction in Lithium clearance. When administerd concomittantly subjects should be observed carefuly.

Phenylbutazone-
Phenylbutazone causes incease in free fraction of todolac. Co-adminstration not recommended

Warfarin-
Effects of Warfarin and NSAIDs are synergistic. Caution should be excercised with patients  receiving concomittant therapy

Mifepristone-
NSAIDs should not be used for 8-12 days after Mifepristone admin as NSAIDs can reduce the effect of Mifepristone

Corticosteroids-
Concomittant admin can result in increased risk of gastrointestinal bleeding.

Quinolone antibiotics-
Animal studies indicate that NSAIDs can increase the risk of convulsions

Other Analgesics-
Avoid concomittant use

Drug/Lab Interactions-

Urine of patients who take Etodolac can give a false -positive reaction for urinary
 bilirubin due to presence of phenolic metabolites of Etodolac.


 


 

Gastrointestinal experiences-
Abdominal pain, constipation, diarhea, dyspepsia,flatulance, gross bleeding/perforation,
heartburn, nausea, gI ulcers, vomiting

Others-
Abnormal renal function, anemia, dizzines, edema, elevated liver enzymes, headaches,
increased bleeding time

Digestive system- yspepsia, abdominal pain

Nervous system- Asthena/malaise, dizziness, depression, nervousness

Skin and appendages- pruritus, rash

Special senses-
blurred vision. tinnitus

Urogenital dysuria, urinary frequency

 

Contraindicated-

Patients hypersentive to Etodolac
Patients who have experienced Asthma, urticaria, orothevallergic reactions-

Treatment of post-operative pain in coronary artery bypass graft surgery

Patients with active peptic ulcers

Warnings-
Cardiovascular thrombotic events
Lowest dose of Etiodolac should be used for the shortest duration possible

Hypertension-
NSAIDs To be used with caution

Congestive Heart failure and Edema-
Etodolac to be used with caution in patients withfluid retension or heart failure

GI effect- Etodolac to be used with lowest dose and shortest duration

Renal effects-
Patients at greater risk.
Discontiuation of Etodolac is usally followed by recovery .

Anaphylactoid reactions-
Emergency help should be sought in cases where an anaphylactoid reaction occurs.

Skin reactions-
Etodolac should be discontinued at first appearance of skin rash or any sign of hypersensitivity

 

Indication-

Acute Pain-

Dosage-

200-400mg BID to TID
 maximum upto 1200mg/day

OA & RA-  400mg twice daily

JRA -6 to 16 years- 13.3 to 21.3mg/kg body weight

 

Refer- Ibuprofen

Clinical Pharmacology-
Etodolac is NSAID drug that ekhibits anti-inflammatory, analgesics and antipyretic activities.
Mechanism of action is like any other NSAIDs.

Pharmacokinetics-
Etodolac is extensively metabolised in the liver.approximately 1% of a Etodolac dose
is excreted unchanged inte urine with 72% of the dose excreted into urine as parent drug metabolite,

 

Pregnancy-
Etodolac should be used in pregnancy only if the potential benefit justifies the risk to the fetus.

Lactation-
Decison to be taken whether to discontue nursing or to discontinue drug taking
into account the importance to the mother.

Use in Geritrics-
Because elderly patients are more likely to have ddecreaed renal function,
care should be taken in dose selection. It may be yuseful to monitor renal function.

Use in Children-
Safety and efectiveness in pediatric patients below the age of 18 years have not been established.