Yes

Nonsteroidal Anti-Inflammatory Agent (NSAID)

Dental: Management of postoperative pain

Medical: Acute and long-term use in the management of signs and symptoms of osteoarthritis and management of pain

Unapproved use: Rheumatoid arthritis

C (D if used in 3rd trimester)

Hypersensitivity to etodolac, aspirin, or other NSAIDs

Use with caution in patients with congestive heart failure, hypertension, decreased renal or hepatic function, history of GI disease, or those receiving anticoagulants

>10%:

Central nervous system: Dizziness

Dermatologic: Rash

Gastrointestinal: Abdominal cramps, heartburn, indigestion, nausea

1% to 10%:

Central nervous system: Headache, nervousness

Dermatologic: Itching

Endocrine & metabolic: Fluid retention

Gastrointestinal: Vomiting

Otic: Tinnitus

<1%: Congestive heart failure, hypertension, arrhythmia, tachycardia, confusion, hallucinations, aseptic meningitis, mental depression, drowsiness, insomnia, urticaria, erythema multiforme, toxic epidermal necrolysis, Stevens-Johnson syndrome, angioedema, polydipsia, hot flashes, gastritis, GI ulceration, cystitis, polyuria, agranulocytosis, anemia, hemolytic anemia, bone marrow suppression, leukopenia, thrombocytopenia, hepatitis, peripheral neuropathy, toxic amblyopia, blurred vision, conjunctivitis, dry eyes, decreased hearing, acute renal failure, allergic rhinitis, shortness of breath, epistaxis

Symptoms of overdose include acute renal failure, vomiting, drowsiness, leukocytes

Management of a nonsteroidal anti-inflammatory drug (NSAID) intoxication is primarily supportive and symptomatic. Fluid therapy is commonly effective in managing the hypotension that may occur following an acute NSAID overdose, except when this is due to an acute blood loss.

Decreased effect with aspirin

Increased effect/toxicity with aspirin (GI irritation), probenecid; increased effect/toxicity of lithium, methotrexate, digoxin, cyclosporin (nephrotoxicity), warfarin (bleeding)

Protect from moisture

Inhibits prostaglandin synthesis by decreasing the activity of the enzyme, cyclo-oxygenase, which results in decreased formation of prostaglandin precursors

Onset of effect: Analgesia: 2-4 hours; Anti-inflammatory: A few days

Absorption: Oral: Well absorbed

Distribution: V_d: 0.4 L/kg

Protein binding: High

Half-life: 7 hours

Time to peak serum concentration: 1 hour

Single dose of 76-100 mg is comparable to the analgesic effect of aspirin 650 mg; in patients greater than or equal to 65 years, no substantial differences in the pharmacokinetics or side-effects profile were seen compared with the general population

Acute pain: 200-400 mg every 6-8 hours, as needed, not to exceed total daily doses of 1200 mg; for patients weighing <60 kg, total daily dose should not exceed 20 mg/kg/day

Osteoarthritis: Initial: 800-1200 mg/day given in divided doses: 400 mg 2 or 3 times/day; 300 mg 2, 3 or 4 times/day; 200 mg 3 or 4 times/day; total daily dose should not exceed 1200 mg; for patients weighing <60 kg, total daily dose should not exceed 20 mg/kg/day

May be taken with food to decrease GI distress

Monitor CBC, liver enzymes; in patients receiving diuretics, monitor urine output and BUN/serum creatinine

False-positive for urinary bilirubin and ketone bleeding time

Dizziness is common; may cause nervousness; rarely produces confusion, depression, insomnia, or hallucinations

May rarely cause agranulocytosis; use caution with clozapine and carbamazepine; may decrease the clearance of lithium resulting in elevated serum levels and potential toxicity; monitor serum lithium levels

No information available to require special precautions

NSAID formulations are known to reversibly decrease platelet aggregation via mechanisms different than observed with aspirin. The dentist should be aware of the potential of abnormal coagulation. Caution should also be exercised in the use of NSAIDs in patients already on anticoagulant therapy with drugs such as warfarin (Coumadin®).

Take this medication exactly as directed; do not increase dose without consulting prescriber. Do not crush tablets or break capsules. Take with food or milk to reduce GI distress. Maintain adequate fluid intake (2-3 L/day of fluids unless instructed to restrict fluid intake). Do not use alcohol, aspirin, or aspirin-containing medication, and all other anti-inflammatory medications without consulting prescriber. You may experience anorexia, nausea, vomiting, or heartburn (frequent small meals, frequent mouth care, sucking lozenges, or chewing gum may help); drowsiness, dizziness, nervousness, or headache (use caution when driving or engaging in tasks requiring alertness until response to drug is known); fluid retention (weigh yourself weekly and report unusual (3-5 lb/week) weight gain). GI bleeding, ulceration, or perforation can occur with or without pain; discontinue medication and contact prescriber if persistent abdominal pain or cramping, or blood in stool occurs. Report breathlessness, difficulty breathing, or unusual cough; chest pain, rapid heartbeat, palpitations; unusual bruising/bleeding; blood in urine, stool, mouth, or vomitus; swollen extremities; skin rash or itching; acute fatigue; or changes in hearing or ringing in ears. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to be pregnant. Do not breast-feed.

Capsule: 200 mg, 300 mg

Lodine®: 200 mg, 300 mg

Tablet: 400 mg, 500 mg

Lodine®: 400 mg, 500 mg

Tablet, extended release (Lodine® XL): 400 mg, 500 mg, 600 mg

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