Etodolac
Etodolac is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain, swelling, stiffness, and inflammation. It belongs to the pyranocarboxylic acid group of NSAIDs.
Mechanism of Action: Etodolac works by inhibiting cyclooxygenase (COX) enzymes, specifically COX-1 and COX-2. These enzymes are responsible for the production of prostaglandins, which are involved in the inflammatory response. By reducing prostaglandin production, etodolac helps to alleviate pain and inflammation. Etodolac exhibits some COX-2 selectivity, meaning it preferentially inhibits COX-2, which is thought to be responsible for inflammation and pain, over COX-1, which is involved in protecting the stomach lining.
Indications: Etodolac is commonly prescribed for the following conditions:
- Osteoarthritis
- Rheumatoid arthritis
- Acute pain management
Dosage and Administration: Etodolac is available in oral formulations, including capsules and tablets. Dosage varies depending on the condition being treated and the individual patient. It is typically taken with food to minimize gastrointestinal side effects. Extended-release formulations are available for once-daily dosing.
Contraindications: Etodolac is contraindicated in patients with known hypersensitivity to etodolac or other NSAIDs. It is also generally avoided in patients with a history of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. Caution is advised in patients with peptic ulcer disease, gastrointestinal bleeding, or renal impairment. It is generally avoided late in pregnancy due to the risk of premature closure of the ductus arteriosus.
Side Effects: Common side effects of etodolac include:
- Gastrointestinal disturbances (e.g., nausea, dyspepsia, diarrhea, constipation, abdominal pain)
- Headache
- Dizziness
More serious side effects, though less common, include:
- Gastrointestinal ulceration and bleeding
- Renal toxicity
- Liver toxicity
- Cardiovascular events (e.g., heart attack, stroke)
Drug Interactions: Etodolac can interact with other medications, including:
- Aspirin and other NSAIDs (increased risk of gastrointestinal bleeding)
- Warfarin and other anticoagulants (increased risk of bleeding)
- ACE inhibitors and angiotensin receptor blockers (ARBs) (decreased antihypertensive effect and increased risk of renal impairment)
- Lithium (increased lithium levels)
- Diuretics (decreased diuretic effect)
Precautions: Patients taking etodolac should be monitored for signs and symptoms of gastrointestinal bleeding, renal impairment, and liver toxicity. Etodolac should be used with caution in elderly patients, who may be more susceptible to adverse effects. Long-term use should be under medical supervision.