Etodolac

How it works

It inhibits cyclo-oxygenase enzymes, reducing prostaglandin synthesis and thereby producing anti-inflammatory, analgesic and antipyretic effects.

Prescribing in practice

• Like other NSAIDs it carries gastrointestinal bleeding, ulceration, cardiovascular and renal risks, so use the lowest effective dose for the shortest time and consider gastroprotection in at-risk patients.
• Avoid in active peptic ulceration, severe heart failure and significant renal impairment, and use cautiously in older people.
• It can interact with anticoagulants, antihypertensives, diuretics and other NSAIDs, increasing bleeding and renal risk.

Monitoring

Monitor renal function, blood pressure and for gastrointestinal symptoms, particularly with prolonged use or in higher-risk patients.

Counselling the patient

• Take with or after food and report black stools, vomiting blood or severe indigestion.
• Avoid combining with other anti-inflammatory painkillers such as ibuprofen.
• Seek advice if you have swelling, breathlessness or reduced urine output.

Evidence & guidelines

MHRA and NICE advice on NSAID cardiovascular and gastrointestinal safety applies to etodolac, supporting cautious, time-limited use at the lowest effective dose.