Lodine


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Related to Lodine: etodolac, Norflex, iodine, Lodine xl

etodolac

(ee-toe-doe-lak) ,

Lodine

(trade name),

Lodine XL

(trade name)

Classification

Therapeutic: antirheumatics
Pharmacologic: pyranocarboxylic acid
Pregnancy Category: C

Indications

Osteoarthritis.Rheumatoid arthritis.Mild to moderate pain (not XL tablets).

Action

Inhibits prostaglandin synthesis.
Also has uricosuric action.

Therapeutic effects

Suppression of inflammation.
Decreased severity of pain.

Pharmacokinetics

Absorption: Well absorbed after oral administration.
Distribution: Widely distributed.
Protein Binding: >99%.
Metabolism and Excretion: Mostly metabolized by the liver; <1% excreted unchanged in urine.
Half-life: 6–7 hr (single dose); 7.3 hr (chronic dosing).

Time/action profile (analgesic effect)

ROUTEONSETPEAKDURATION
PO (analgesic)0.5 hr1–2 hr4–12 hr
PO (anti-inflammatory) days–wkunknown 6–12 hr†
†Up to 24 hr as XL (extended-release) tablet

Contraindications/Precautions

Contraindicated in: Hypersensitivity;Active GI bleeding or ulcer disease;Cross-sensitivity may exist with other NSAIDs, including aspirin; Obstetric: Use during second half of pregnancy can result in premature closure of ductus arteriosis.
Use Cautiously in: Cardiovascular disease or risk factors for cardiovascular disease (may ↑ risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, especially with prolonged use)Renal or hepatic disease;History of ulcer disease; Lactation: Limited information available; use other safer NSAID; Pediatric: Safety not established; Geriatric: ↑ risk of GI bleeding.

Adverse Reactions/Side Effects

Central nervous system

  • depression
  • dizziness
  • drowsiness
  • insomnia
  • malaise
  • nervousness
  • syncope
  • weakness

Ear, Eye, Nose, Throat

  • blurred vision
  • photophobia
  • tinnitus

Respiratory

  • asthma

Cardiovascular

  • chf (life-threatening)
  • edema
  • hypertension
  • palpitations

Gastrointestinal

  • gi bleeding (life-threatening)
  • dyspepsia (most frequent)
  • abdominal pain
  • constipation
  • diarrhea
  • drug-induced hepatitis
  • dry mouth
  • flatulence
  • gastritis
  • nausea
  • stomatitis
  • thirst
  • vomiting

Genitourinary

  • dysuria
  • renal failure
  • urinary frequency

Dermatologic

  • exfoliative dermatitis (life-threatening)
  • stevens-johnson syndrome (life-threatening)
  • toxic epidermal necrolysis (life-threatening)
  • ecchymoses
  • flushing
  • hyperpigmentation
  • pruritus
  • rashes
  • sweating

Hematologic

  • anemia
  • prolonged bleeding time
  • thrombocytopenia

Miscellaneous

  • allergic reactions including anaphylaxis (life-threatening)
  • angioedema (life-threatening)
  • chills
  • fever

Interactions

Drug-Drug interaction

Concurrent use with aspirin may ↓ effectiveness.↑ adverse GI effects with aspirin, other NSAIDs, potassium supplements, corticosteroids, antiplatelet agents, or alcohol.Chronic use with acetaminophen may ↑ risk of adverse renal reactions.May ↓ effectiveness of diuretic or antihypertensive therapy.May ↑ serum lithium levels and ↑ risk of toxicity.↑ risk of toxicity from methotrexate.↑ risk of bleeding with cefotetan, cefoperazone, valproic acid, thrombolytics, antiplatelet agents, or anticoagulants.↑ risk of adverse hematologic reactions with antineoplastics or radiation therapy.May ↑ the risk of nephrotoxicity from cyclosporine.↑ risk of bleeding with arnica, chamomile, clove, dong quai, fever few, garlic, ginko, and Panax ginseng.

Route/Dosage

Oral (Adults) Analgesia—200–400 mg q 6–8 hr (not to exceed 1200 mg/day). Osteoarthritis/rheumatoid arthritis—300 mg 2–3 times daily, 400 mg twice daily, or 500 mg twice daily; may also be given as 400–1200 mg once daily as XL tablets.

Availability (generic available)

Capsules: 200 mg, 300 mg
Tablets: 400 mg, 500 mg
Extended-release tablets (XL): 400 mg, 500 mg, 600 mg

Nursing implications

Nursing assessment

  • Patients who have asthma, aspirin-induced allergy, and nasal polyps are at increased risk for developing hypersensitivity reactions. Monitor for rhinitis, asthma, and urticaria.
  • Assess for rash periodically during therapy. May cause Stevens-Johnson syndrome. Discontinue therapy if severe or if accompanied with fever, general malaise, fatigue, muscle or joint aches, blisters, oral lesions, conjunctivitis, hepatitis, and/or eosinophilia.
  • Osteoarthritis/Rheumatoid Arthritis: Assess pain and range of movement before and 1–2 hr after administration.
  • Pain: Assess location, duration, and intensity of the pain before and 60 min after administration.
  • Lab Test Considerations: May cause ↓ hemoglobin, hematocrit, leukocyte, and platelet counts.
    • Monitor liver function tests within 8 wk of initiating etodolac therapy and periodically during therapy. May cause ↑ serum alkaline phosphatase, LDH, AST, and ALT concentrations.
    • Monitor BUN, serum creatinine, and electrolytes periodically during therapy. May cause ↑ BUN, serum creatinine, and electrolyte concentrations and ↓ urine electrolyte concentrations.
    • May cause ↓ serum and ↑ urine uric acid concentrations.

Potential Nursing Diagnoses

Acute pain (Indications)
Impaired physical mobility (Indications)

Implementation

  • Do not confuse Lodine (etodolac) with codeine or iodine.
    • Administration in higher-than-recommended doses does not provide increased effectiveness but may cause increased side effects.
  • Use lowest effective dose for shortest period of time.
  • Oral: For rapid initial effect, administer 30 min before or 2 hr after meals. May be administered with food, milk, or antacids containing aluminum or magnesium to decrease GI irritation.
    • Do not break, crush, or chew extended-release tablets.

Patient/Family Teaching

  • Advise patients to take etodolac with a full glass of water and to remain in an upright position for 15–30 min after administration.
  • Instruct patient to take medication as directed. Take missed doses as soon as possible within 1–2 hr if taking twice/day, or unless almost time for next dose if taking more than twice/day. Do not double doses.
  • Etodolac may occasionally cause drowsiness or dizziness. Advise patient to avoid driving or other activities requiring alertness until response to the medication is known.
  • Caution patient to avoid the concurrent use of alcohol, aspirin, acetaminophen, NSAIDs, or other OTC medications without consultation with health care professional.
  • Advise patient to inform health care professional of medication regimen before treatment or surgery.
  • Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, black stools, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain) occurs.

Evaluation/Desired Outcomes

  • Decreased severity of pain.
  • Improved joint mobility. Patients who do not respond to one NSAID may respond to another. May require 2 wk or more for maximum anti-inflammatory effects.

Lodine

(lō′dēn′)
A trademark for the drug etodolac.

Lodine®

Rheumatology A formulation of etodolac for managing osteoarthritis, rheumatoid arthritis. See Osteoarthritis, Rheumatoid arthritis.

Lodine

A brand name for ETODOLAC.
References in periodicals archive ?
The members have now spoken and there is no use now getting into any kind of sour grapes," said Lodine.
The first in a class of NSAIDs known as the pyranocarboxylic acids, Lodine has potent analgesic and anti-inflammatory properties and has a favorable gastrointestinal tolerability profile.
Clinical trials have established that Lodine XL is effective in managing the pain and inflammation associated with osteoarthritis and rheumatoid arthritis.
Today's FDA decision granting marketing clearance to Lodine XL follows closely on the heels of two other recent FDA decisions regarding Lodine (etodolac tablets and capsules): marketing clearance of a 500 mg dosage strength, as well as a new indication for the treatment of rheumatoid arthritis (RA).
The agreement includes Lodine SR, a patent protected once-a-day formulation of this prescription nonsteroidal anti-inflammatory drug (NSAID).
But Gore, the master of many policy details, mangled the facts, and late last week his aides could not say with certainty that Shiloh or Margaret Ann Aitcheson actually takes the brand-name drug, Lodine, that Gore said they do.
Robinson had found a congressional study that cited exactly the same prices for human and animal prescriptions of Lodine as those cited by Gore.
Many drug manufacturers admit in product labels that they do not know how the drugs work--take, for example, the labels as shown in the Physicans' Desk Reference (Thomson 2007) for the following widely used drugs: Ativan, Effexor, Fluothane, Inderal, Lodine, Neurontin, and Risperdal.
His efforts resulted in 20 NCEs being advanced into development, 12 INDs and 4 NDAs (including Efexor, Lodine, Durapro & Oruvail).
by adding two years to its patent for the arthritis drug Lodine was withdrawn Friday after Sen.
Etopan XL, a prescription product, is the first approved UK generic alternative to Lodine SR Tablets 600 mg, which is marketed in the UK by Shire Pharmaceuticals.
Irrigants tested at various concentrations were: Sodium Hypochlorite (NaOCL); Chlorhexidine (CHX); lodine Potassium-lodide (IKI); Betadine Scrub (BDS); Calcium Hydroxide (CaO[H.