Etodolac

LODINE

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What it isNSAID inhibiting COX-2 more than COX-1; osteoarthritis and rheumatoid arthritis.

Why this oneIts COX-2 preference may reduce GI injury versus fully nonselective NSAIDs, but fades as exposure rises.

What limits itRenal and cardiovascular toxicity persist, and it can raise lithium levels.

FDA-approved for

arthritis (1991)

FDA label

Read the full label on DailyMed ↗

BOXED WARNING NSAID: increased risk of serious CV thrombotic events (MI, stroke); contraindicated in CABG surgery setting. Increased risk of serious GI bleeding, ulceration, perforation.

FDA dosing	Population	Start	Target	Max
Acute pain / analgesia	adult	200-400 mg q6-8h	up to 1000 mg/day	1000 mg/day
Osteoarthritis / rheumatoid arthritis	adult	300 mg BID/TID or 400 mg BID or 500 mg BID	600 mg/day may suffice long-term	1000 mg/day

Renal No adjustment needed in mild-moderate impairment (use with caution)

Hepatic Undefined

Instructions

Use lowest effective dose for shortest duration

Contraindications

History of asthma, urticaria, or allergic-type reaction to aspirin or other NSAIDs
Coronary artery bypass graft (CABG) surgery setting

Cautions

CV thrombotic events (MI, stroke)
GI bleeding, ulceration, perforation
Renal effects — may worsen renal function
Anaphylactoid reactions
Hepatotoxicity (elevated LFTs)
Hypertension, edema
Fetal toxicity in later pregnancy

Adverse reactions

Dyspepsia, abdominal pain, diarrhea, nausea, flatulence, constipation
GI ulcers / bleeding, melena
Dizziness, headache, asthenia
Rash, pruritus
Edema, elevated liver enzymes, tinnitus, blurred vision

Pregnancy Avoid at ~30 weeks and later (premature closure of fetal ductus arteriosus); limit dose/duration ~20-30 weeks (oligohydramnios/neonatal renal impairment).

Lactation Undefined

⚠ BOXED WARNINGS

Cardiovascular thrombotic events
Gastrointestinal bleeding, ulceration and perforation

Cost, est. cash$5–$150/month

Generic entry1997

Classes and tags

Clinical profile

Therapeutic safety burden2 / 4

Overdose danger3 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk3 / 4

Legacy pregnancy categoryMultiple / indication-, trimester- or formulation-dependent

Defining liabilityGI bleeding, kidney injury, hypertension and fluid retention; many agents increase lithium concentrations.

Mechanism of action: Etodolac ballicule

Etodolac ballicule: receptor binding, kinetics and half-life diagram

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Memory aids: mascots and interaction avatars

Etodolac LODINE mascot mnemonic cartoon — **“A total lack (of) Loading”**
“The N said... NSAID”
Rapid onset 30–60 minutes (actually fast “loading”)

Box: minimal PK interactions

Open Etodolac in the interactive console ↗