What to Know About Etodolac

Etodolac is a nonsteroidal anti-inflammatory drug (NSAID) used for short and long-term pain relief. Etodolac works by blocking the production of certain naturally-occurring substances that cause inflammation in the body to relieve pain, reduce swelling, tenderness and stiffness in joints, and reduce inflammation.

For this reason, it is most often prescribed to relieve the symptoms of rheumatoid arthritis and osteoarthritis. The FDA approved etodolac for use in 1991. It is available in oral tablets and capsules.

Etodolac—like all NSAIDs—has a black box warning from the Food and Drug Administration (FDA) related to cardiovascular thrombotic events and gastrointestinal risks. Black box warnings alert patients and healthcare providers to potentially dangerous side effects caused by a medication.

Uses

Etodolac is used to relieve joint pain and inflammation pain caused by various conditions, particularly arthritis. It reduces pain, joint stiffness, and swelling.

NSAIDs like etodolac are used to help manage mild to moderate pain and inflammation. They reduce the levels of prostaglandins in the body—chemicals that can cause tenderness and pain that occur with inflammation.

If you are prescribed etodolac to treat a chronic condition such as arthritis, it may take up to two weeks to see the full benefits of this medication once you begin taking it. Etodolac is not a cure for arthritis and will only help alleviate symptoms while you are taking it. 

Off-Label Uses

Etodolac is most often prescribed to individuals living with arthritis, including osteoarthritis and rheumatoid arthritis. It is generally not prescribed by healthcare providers for other uses but may be prescribed if you are experiencing joint pain (not caused by arthritis) that other NSAIDs do not provide relief for. It is sometimes prescribed for gout attacks.

Before Taking 

When deciding to use etodolac to treat pain, it is important to weigh the risks vs. benefits with your healthcare provider. When prescribed this medication to manage pain, it is important to take it exactly as prescribed in order for it to help relieve your symptoms.

Precautions and Contraindications

Before taking etodolac, the following should be considered:

• Allergies: If you’ve ever had an allergic reaction to other medications—particularly NSAIDs—talk to your healthcare provider before taking this medication. 
• Pediatric patients: No studies have been conducted on the efficacy and safety of etodolac use in children ages 18 and under. 
• Older adults: Older adults may be more likely to be sensitive to the effects of etodolac, and are more likely to experience unwanted side effects. 
• Breastfeeding: Because etodolac is passed through breast milk and could be potentially harmful to the baby, nursing while taking the medication isn't recommended. Talk to your healthcare provider about whether you should stop taking etodolac or avoid breastfeeding.
• Pregnancy: There are no good human studies of etodolac use during pregnancy, but animal studies suggest possible risks for the unborn baby. It is not currently recommended for use during pregnancy, particularly for those who are over 20 weeks pregnant.
• Coronary artery bypass graft (CABG) surgery: Etodolac is contraindicated for people who will be having CABG surgery.

Other NSAIDs

Etodolac belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Other medications that fall under this class of drugs include over-the-counter medications such as Advil (ibuprofen) and prescription NSAIDs, such as Indocin (indomethacin), Relafen (nabumetone), and others.

Etodolac should not be taken with other NSAIDs, as this may increase the risk of serious side effects. 

Dosage

Many factors can affect the dose of etodolac that a person needs, including body weight and age, other medications currently taken, and other medical conditions.  All listed dosages are according to the drug manufacturer. Check your prescription and talk to your healthcare provider to make sure you are taking the right dose for you.

Most common dosage recommendations for adults are as follows:

• For acute pain: Oral dosage form (capsules or tablets): 200-400 milligrams (mg) every 6–8 hours, not to exceed 1,000 mg/day. 
• For rheumatoid arthritis and osteoarthritis: Oral dosage form (capsules or tablets): 300 mg 2–3 times a day, or 400–500 mg twice a day. If you are taking this medication on a long-term basis, your healthcare provider may prescribe 600 mg once a day.

If your healthcare provider has recommended a dose not listed here, do not change the amount of medication you take or the way you are taking it without first discussing it with your healthcare provider. It is important to take etodolac exactly as prescribed by your healthcare provider.

How to Take and Store 

Take this medication orally as directed by your healthcare provider, typically two to three times a day with a full glass of water (8 ounces). To prevent stomach upset and heartburn, take this medication with food, milk, or an antacid. Do not lie down for 10 minutes after taking your dose.

Continue to take as directed by your healthcare providerr. If you are taking etodolac “as needed” (for acute pain), remember that pain medications work best when taken at the first sign of pain. If you wait until the pain has worsened, it may take longer to feel the effects of the drug.

If you miss a dose, take it as soon as possible. If it is almost time for your second dose, do not take a double dose, skip the missed dose and then continue with your regular dosing schedule. If you are unsure what to do after missing a dose, talk with your pharmacist or healthcare provider to discuss. 

Store etodolac in a closed container at room temperature, away from moisture, direct light, and heat. Do not keep or take outdated medicine or medicine you no longer need. Ask your healthcare provider or pharmacist how to dispose of any medicine that you do not use. Keep out of reach of children. 

Side Effects 

Some side effects may occur as a result of taking etodolac. Side effects may be mild, moderate, or severe. However, many are mild and do not need medical attention; they typically go away once your body adjusts to the medication. The side effects listed below are not experienced by everyone who takes etodolac.

Common

Common side effects may include:

• Blurred vision 
• Bloating 
• Constipation
• Diarrhea
• Dizziness
• Gas/bloating
• Headache
• Loss of appetite
• Runny nose
• Sneezing 
• Stomach pain 
• Swelling

Severe   

Talk with your healthcare provider if you are experiencing serious side effects of Etodolac, including:

• Changes in the amount or color of urine
• Difficult or painful swallowing
• Fast heartbeat
• Hearing problems
• Mood changes 
• Rash and/or hives
• Signs of depression (e.g., changes in sleep, decreased interest in activities, thoughts of self-harm)
• Swelling in the feet or legs
• Symptoms of liver damage (e.g., yellow skin or eyes, abdominal pain, dark urine, pale stools, loss of appetite, nausea, and vomiting, or itching)
• Unexpected weight changes
• Vision changes

Stop taking the medication and seek immediate medical attention if you experience any of the following: 

• Signs of a severe allergic reaction (e.g., hives, difficulty breathing, swelling of the face, tongue, or throat)
• Symptoms of a stomach ulcer (e.g., black tarry stools, blood in the stool, vomiting up of blood or material that looks like coffee grounds)
• Severe skin rash (e.g., blistering, peeling, rash all over the body or spreads quickly, rash accompanying a fever) 
• Unusual or persistent bruising or bleeding

If you are concerned with the side effects, discuss the risks and benefits with your healthcare provider or pharmacist. You may also report side effects to the FDA at 1-800-FDA-1088.

Warnings and Interactions 

Before taking etodolac, talk to your healthcare provider about all current medications you are taking, including prescription and non-prescription medications, herbal supplements, and vitamins. It is very important to tell your healthcare provider if you are currently taking:

• ACE inhibitors
• Antidepressants (SSRIs, SNRIs)
• Aspirin 
• Blood thinners
• Diuretics (water pills)
• Heart or blood pressure medication
• Lithium
• Methotrexate
• Steroids
• Warfarin

This list is not complete. Other medications may also affect etodolac or the way your body processes the medications(s). Ask your healthcare provider or pharmacist for more information.

Do not take etodolac with other NSAIDs—including those available over-the-counter (e.g., ibuprofen) as it may increase your risk of stomach bleeding or other serious side effects.