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
Central nervous system: Dizziness
Gastrointestinal: Abdominal cramps, heartburn, indigestion, nausea
1% to 10%:
Central nervous system: Headache, nervousness
Endocrine & metabolic: Fluid retention
<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,
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),
Protect from moisture
Inhibits prostaglandin synthesis by decreasing the activity of the enzyme,
cyclo-oxygenase, which results in decreased formation of prostaglandin
Onset of effect: Analgesia: 2-4 hours; Anti-inflammatory: A few days
Absorption: Oral: Well absorbed
Distribution: Vd: 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
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
|Mental Health: Effects
on Mental Status|
Dizziness is common; may cause nervousness; rarely produces confusion,
depression, insomnia, or hallucinations
Effects on Psychiatric
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
|Dental Health: Local
No information available to require special precautions
Effects on Dental Treatment|
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
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
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,
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