Etodolac Dosage

Medically reviewed by Drugs.com. Last updated on Oct 24, 2024.

Usual Adult Dose for Osteoarthritis

Immediate Release:

• Starting dose: 300 mg orally 2 to 3 times a day OR 400 to 500 mg orally twice a day
• For long-term use: 600 mg/day may be sufficient
• Maximum dose: 1000 mg/day

Extended Release:

• Starting dose: 400 to 1000 mg orally once a day

Comments:

• In chronic conditions, a therapeutic response is sometimes seen within 1 week of therapy, but most often is observed by 2 weeks.
• Immediate Release:
• Doses greater than 1000 mg/day have not been adequately studied.
• After achieving a satisfactory response, the patient's dose should be reviewed and adjusted as needed.
• Extended Release: The lowest effective dose should be used.

Uses:

• Immediate release: For acute and long-term use in the management of signs/symptoms of osteoarthritis and rheumatoid arthritis
• Extended release: For relief of the signs/symptoms of osteoarthritis and rheumatoid arthritis

Usual Adult Dose for Rheumatoid Arthritis

Immediate Release:

• Starting dose: 300 mg orally 2 to 3 times a day OR 400 to 500 mg orally twice a day
• For long-term use: 600 mg/day may be sufficient
• Maximum dose: 1000 mg/day

Extended Release:

• Starting dose: 400 to 1000 mg orally once a day

Comments:

• In chronic conditions, a therapeutic response is sometimes seen within 1 week of therapy, but most often is observed by 2 weeks.
• Immediate Release:
• Doses greater than 1000 mg/day have not been adequately studied.
• After achieving a satisfactory response, the patient's dose should be reviewed and adjusted as needed.
• Extended Release: The lowest effective dose should be used.

Uses:

• Immediate release: For acute and long-term use in the management of signs/symptoms of osteoarthritis and rheumatoid arthritis
• Extended release: For relief of the signs/symptoms of osteoarthritis and rheumatoid arthritis

Usual Adult Dose for Pain

Immediate Release: 200 to 400 mg orally every 6 to 8 hours
Maximum dose: 1000 mg/day

Comments:

• Doses greater than 1000 mg/day have not been adequately studied.

Use: For the management of acute pain

Usual Pediatric Dose for Juvenile Rheumatoid Arthritis

Extended Release:
6 to 16 years:

• Weight 20 to 30 kg: 400 mg orally once a day
• Weight 31 to 45 kg: 600 mg orally once a day
• Weight 46 to 60 kg: 800 mg orally once a day
• Weight greater than 60 kg: 1000 mg orally once a day

Use: For relief of signs/symptoms of rheumatoid arthritis

Renal Dose Adjustments

Mild to Moderate Renal Dysfunction: No adjustment recommended; caution recommended.

Severe Renal Dysfunction:

• Immediate release: No adjustment recommended; caution recommended.
• Extended release: Data not available

Advanced Renal Disease: Not recommended; if therapy must be started, close monitoring of renal function is recommended.

Comments:

• The pharmacokinetics of this drug after administration of the extended-release formulation have not been studied in subjects with renal dysfunction.
• This drug should be used with caution in patients with mild to moderate renal dysfunction; this drug may further decrease renal function in some patients.

Liver Dose Adjustments

Acute and chronic liver diseases: No adjustment recommended

If clinical signs/symptoms consistent with liver disease develop, systemic manifestations (e.g., eosinophilia, rash) occur, or abnormal liver tests persist/worsen during therapy: This drug should be discontinued.

Comments:

• The pharmacokinetics of this drug after administration of the extended-release formulation have not been studied in subjects with liver dysfunction.
• Clearance of this drug is dependent on liver function and could be reduced in patients with severe liver failure.

Dose Adjustments

Older adult patients (65 years and older):

• No dosage adjustment is generally needed based on pharmacokinetics.
• These patients may be more sensitive to antiprostaglandin effects than younger patients.
• Dosage adjustment of the extended-release formulation may be needed.
• Caution is recommended when treating these patients.
• Also when increasing the dose of the immediate-release formulation

Patients with recent myocardial infarction: Avoid use unless the benefits are expected to outweigh the risk of recurrent cardiovascular thrombotic events.

Patients with severe heart failure: Avoid use unless the benefits are expected to outweigh the risk of worsening heart failure.

Precautions

US BOXED WARNINGS:

• CARDIOVASCULAR THROMBOTIC EVENTS: NSAIDs cause an increased risk of serious cardiovascular thrombotic events (including myocardial infarction and stroke), which can be fatal; this risk may occur early in therapy and may increase with duration of use. This drug is contraindicated in the setting of coronary artery bypass graft (CABG) surgery.
• GASTROINTESTINAL (GI) RISK: NSAIDs cause an increased risk of serious GI side effects (including bleeding, ulceration, and perforation of stomach or intestines), which can be fatal; such events can occur at any time during use and without warning symptoms. Older adult patients are at greater risk for serious GI events.

CONTRAINDICATIONS:

• Hypersensitivity to the active component or any of the ingredients
• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
• In the setting of CABG surgery

Immediate release: Safety and efficacy have not been established in patients younger than 18 years.
Extended release: Safety and efficacy have not been established in patients younger than 6 years.

Consult WARNINGS section for additional precautions.

Dialysis

Hemodialysis:

• Immediate release: No adjustment recommended
• Extended release: Data not available

Comments:

• Hemodialysis does not significantly remove this drug from the blood.

Other Comments

Administration advice:

• Carefully consider potential benefits and risks of this drug and other treatment options before deciding to use this drug.
• Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
• After the response to initial therapy has been observed, adjust the dose and frequency as appropriate per the individual patient's needs.

Storage requirements:

• Store at 20C to 25C (68F to 77F)
• Immediate release:
• Capsules: Protect from moisture.
• Tablets: Store in original container until ready to use; dispense in light-resistant container.
• Extended release: Protect from excessive heat and humidity.

Monitoring:

• Cardiovascular: Blood pressure (during initiation and throughout therapy); for signs of cardiac ischemia in patients with recent myocardial infarction; for signs of worsening heart failure in patients with severe heart failure
• Gastrointestinal: For signs/symptoms of GI bleeding
• General: Chemistry profile in patients on long-term therapy (periodically)
• Hematologic: CBC in patients on long-term therapy (periodically)
• Renal: Renal function in older adult patients

Patient advice:

• Read the US FDA-approved patient labeling (Medication Guide).
• Be alert for symptoms of cardiovascular thrombotic events (including chest pain, shortness of breath, slurring of speech); report any of these symptoms to your health care provider immediately.
• Be alert for signs/symptoms of GI ulcerations and bleeding; seek medical advice if any indicative signs/symptoms (including epigastric pain, dyspepsia, melena, hematemesis) are observed. This follow-up is important.
• Discontinue this drug immediately if any type of rash or fever develops; contact your health care provider as soon as possible.
• Be alert for symptoms of congestive heart failure (including shortness of breath, unexplained weight gain, edema); contact your health care provider if such symptoms occur.
• Discontinue therapy and seek immediate medical therapy if signs/symptoms of hepatotoxicity (e.g., nausea, fatigue, lethargy, pruritus, jaundice, right upper quadrant tenderness, influenza-like symptoms) occur.
• Seek immediate emergency help if signs of an anaphylactic reaction (e.g., difficulty breathing, swelling of face/throat) occur.
• Discontinue this drug at the first appearance of skin rash or any other sign of hypersensitivity.
• If pregnant, avoid use of this and other NSAIDs starting at 30 weeks gestation.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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