Etodolac
NSAIDs
Nonsteroidal anti-inflammatory drugs (NSAIDs)Pregnancy: avoid
Avoid from week 20: from about 20 weeks NSAIDs can reduce amniotic fluid through their effect on the fetal kidney, and from about 30 weeks they can close the fetal ductus…
An NSAID for arthritis and acute pain. Only its S-enantiomer is active; it can give false-positive urine bilirubin and ketone tests.
Quick facts
- Group
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Target
- Cyclooxygenase 1 and 2 (COX-1/COX-2)
- Used for
- Osteoarthritis · Rheumatoid arthritis · Acute pain
- Key effects
- Dyspepsia · Diarrhoea · Dizziness and headache
- Monitor
- Blood pressure · Signs of gastrointestinal bleeding
- ATC
- M01AB08
No doses: the clinician sets them by the current guideline.
Mechanism of action
Etodolac inhibits prostaglandin synthesis by cyclooxygenase, with a preference for COX-2 at usual doses. It is a racemic mixture in which the S form carries the activity; the two forms do not interconvert in the body.
- The S-enantiomer inhibits cyclooxygenase
- Fewer prostaglandins in the inflamed joint
- Less pain and stiffness
Indications
- Osteoarthritis Knee Osteoarthritis →
- Rheumatoid arthritis Rheumatoid arthritis →
- Acute pain
Adverse effects
Common
- Dyspepsia, abdominal pain and heartburn
- Diarrhoea, flatulence and nausea
- Dizziness and headache
- Rash, itching and tinnitus
Contraindications
- Asthma, hives or allergic-type reactions after aspirin or another NSAID
- Pain around coronary artery bypass graft (CABG) surgery
- Hypersensitivity to etodolac
Key interactions
- Warfarin, antiplatelets, SSRIs and SNRIs
- More bleeding, mainly in the gut
- Cyclosporine, digoxin, lithium and methotrexate
- Slower elimination and more toxicity of these drugs
- Phenylbutazone
- More free etodolac; not combined
What is monitored
- Blood pressure, swelling and signs of heart failure
- Signs of gastrointestinal bleeding (black stools, vomiting blood, anaemia)
- Kidney function, potassium, liver tests and blood count in long-term use
- Interpret urine bilirubin and ketone dipsticks with care (false positives)
Administration and safety
- Given by mouth at the lowest effective dose for the shortest time
- Not recommended in advanced kidney disease
Pregnancy and breastfeeding
Avoid from week 20: from about 20 weeks NSAIDs can reduce amniotic fluid through their effect on the fetal kidney, and from about 30 weeks they can close the fetal ductus arteriosus too early.
Nursing care
- Ask about ulcers, bleeding, kidney or heart disease and aspirin-sensitive asthma before the first dose
- Check blood pressure and fluid status during treatment
- Teach to report black stools, vomiting blood, chest pain, weakness on one side or rash
- Teach to avoid taking another NSAID at the same time, including over-the-counter ones
Pharmacokinetics
- Absorption
- Well absorbed by mouth
- Distribution
- More than 99% bound to plasma proteins, mainly albumin
- Metabolism
- Extensive in the liver to hydroxylated products and glucuronides
- Half-life
- About 6 hours
Test yourself
Think of the answer, then tap the question to see it.
Which enantiomer of etodolac is active?
The S-enantiomer.
Which urine tests can etodolac falsely make positive?
Bilirubin and ketone tests.
Which drug raises free etodolac and is not combined with it?
Phenylbutazone.
Connections
← Back to the class: Nonsteroidal anti-inflammatory drugs (NSAIDs)
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: DailyMed - ETODOLAC capsule (DailyMed (U.S. National Library of Medicine), 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.