Etodolac
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| Systematic (IUPAC) name | |
|---|---|
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(RS)-2-(1,8-Diethyl-4,9-dihydro-3H-pyrano[3,4-b]indol-1-yl)acetic acid | |
| Clinical data | |
| Pregnancy category |
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| Routes of administration | oral |
| Legal status | |
| Legal status | |
| Pharmacokinetic data | |
| Protein binding | 100% |
| Metabolism | liver |
| Biological half-life | 7.3 ± 4.0 hours |
| Excretion | renal |
| Identifiers | |
| CAS Number | 41340-25-4 |
| ATC code | M01AB08 (WHO) |
| PubChem | CID 3308 |
| Chemical data | |
| Formula | C17H21NO3 |
| Molar mass | 287.35 g/mol[[Script error: No such module "String".]] |
| Script error: No such module "collapsible list". | |
| Physical data | |
| Melting point | 145 to 148 °C (293 to 298 °F) |
| Solubility in water | 3.92e-02 mg/mL [ALOGPS] mg/mL (20 °C) |
| (verify) | |
Etodolac: Etodolac belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Other members of this class include aspirin, ibuprofen (Motrin, Advil, Nuprin, etc.), naproxen (Aleve, Naprosyn), indomethacin (Indocin), nabumetone (Relafen) and numerous others. These drugs are used for the management of mild to moderate pain, fever, and inflammation. They work by reducing the levels of prostaglandins, which are chemicals that are responsible for pain and the fever and tenderness that occur with inflammation. Etodolac blocks the enzyme that makes prostaglandins (cyclooxygenase), resulting in lower concentrations of prostaglandins. As a consequence, inflammation, pain and fever are reduced. The FDA approved etodolac in January 1991.[1]
Post-marketing studies demonstrated that etodolac inhibition of cyclooxygenase is somewhat COX-2 selective [2] similar to celecoxib and other "COX-2 inhibitors." Unlike rofecoxib, both etodolac and celecoxib can fully inhibit COX-1 and are designated as having "preferential selectivity" toward COX-2. Interestingly, the (inactive against COX) r-enantiomer of etodolac inhibits beta-catenin levels in hepatoma cells. [3]
Contents
Preparations
Etodolac is manufactured by Shire under the trade name Lodine SR[4] and by Meda Pharmaceuticals under the name Eccoxolac [5]. Non-propriety etodolac is also available [6]
Indications
Etodolac is licensed for the treatment of inflammation and pain caused by osteoarthritis and rheumatoid arthritis [7].
Dosing
Capsules: 200 and 300 mg; Tablets: 400 and 500 mg; Extended Release: 400, 500 and 600 mg. The maximum recommeded daily dosage of etodolac is 1000 mg. However, some patients have been found to benefit from daily dosage of 1200 mg. Daily dosages of Etodolac exceeding 1200 mg have not been evaluated. [1]
Interactions
Etodolac should be avoided by patients with a history of asthma attacks, hives, or other allergic reactions to aspirin or other NSAIDs. Rare but severe allergic reactions have been reported in such individuals. It also should be avoided by patients with peptic ulcer disease or poor kidney function, since this medication can irritate both conditions. Etodolac is generally used with caution in patients taking blood thinning medications (anticoagulants), such as warfarin (Coumadin), because of increased risk of bleeding. Patients taking lithium can develop toxic blood lithium levels. Additionally, Etodolac has been found to interact with certain anti-depressant medications, such as sertraline or fluoxetine, can increase risks of stroke, heart attack, and other cardiovascular conditions. Patients also taking ciclosporin (Sandimmune) can develop kidney toxicity. Use in children has not been adequately studied. Etodolac is not habit-forming. NSAIDs should be discontinued prior to elective surgery because of a mild interference with clotting that is characteristic of this group of medicines. Etodolac is best discontinued at least four days in advance of the procedure.
Persons who have more than 3 alcoholic beverages per day are at increased risk of developing stomach ulcers when taking etodolac or other NSAIDs.
Pregnancy and Nursing
Etodolac is generally avoided during pregnancy and nursing. NSAIDs may cause adverse cardiovascular effects in the fetus during pregnancy. [1]
Side Effects
Etodolac may cause side effects, or adverse drug reactions. Tell your doctor if any of these symptoms are severe or do not go away:
Constipation, diarrhea, gas or bloating, vomiting, headache, dizziness, ringing in the ears, runny nose, sore throat, blurred vision.
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately. Do not take any more etodolac until you speak to your doctor:
Unexplained weight gain, swelling of the eyes, face, lips, tongue, throat, hands, feet, ankles, or lower legs, fever or chills, blisters, rash, itching, hives, hoarseness, difficulty breathing or swallowing, yellowing of the skin or eyes, excessive tiredness, unusual bleeding or bruising, lack of energy, loss of appetite, pain in the upper right part of the stomach, flu-like symptoms, pale skin, fast heartbeat, cloudy, discolored, or bloody urine, difficult or painful urination, back pain.
Etodolac may cause other side effects.
References
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| 40x40px | Wikimedia Commons has media related to [[commons:Category:{{#property:P373}}|Etodolac]]. |
es:Etodolaco it:Etodolac pt:Etodolaco tr:Etodolak
vi:Etodolac- ↑ 1.0 1.1 1.2 http://www.medicinenet.com/etodolac/article.htm
- ↑ http://www.pnas.org/content/96/13/7563.short
- ↑ http://www.ncbi.nlm.nih.gov/pubmed/17275129
- ↑ Summary of Product Characteristics Lodine SR
- ↑ Summary of Product Characteristics Eccoxolac
- ↑ BNF 55: Etodolac preparations
- ↑ BNF 55 - Etodolac
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- 2Fix
- Non-steroidal anti-inflammatory drugs
- Pyranoindoles
