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.

See also:

Further information

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

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