Conventional capsules and tablets and extended-release tablets of etodolac are used for anti-inflammatory and analgesic effects in the acute and chronic symptomatic treatment of osteoarthritis and rheumatoid arthritis. Extended-release tablets of etodolac also are used for the symptomatic treatment of juvenile rheumatoid arthritis in pediatric patients 6-16 years of age. Conventional capsules and tablets of etodolac also are used for the relief of pain. Extended-release tablets of etodolac are not recommended for the management of acute pain.
The potential benefits and risks of etodolac therapy as well as alternative therapies should be considered prior to initiating etodolac therapy. The lowest possible effective dosage and shortest duration of therapy consistent with treatment goals of the patient should be employed.
Patients should be advised that etodolac, like other NSAIAs, is not free of potential adverse effects, including some that can cause discomfort, and that more serious effects (e.g., myocardial infarction, stroke, GI bleeding), which may require hospitalization and may even be fatal, also can occur. NSAIAs, including selective cyclooxygenase-2 (COX-2) inhibitors and prototypical NSAIAs, increase the risk of serious adverse cardiovascular thrombotic events, including myocardial infarction and stroke, in patients with or without cardiovascular disease or risk factors for cardiovascular disease. Available data suggest that the increase in risk may occur early (within the first weeks) following initiation of therapy and may increase with higher dosages and longer durations of use. Use of NSAIAs also is associated with an increased risk of heart failure. The risk of potentially serious adverse GI effects also should be considered in patients receiving etodolac, particularly in patients receiving chronic therapy with the drug. NSAIAs are contraindicated in the setting of coronary artery bypass graft (CABG) surgery. Patients should be advised to read the medication guide for NSAIAs that is provided to the patient each time the drug is dispensed.