Etodolac

ETODOLAC- etodolac tablet, coated
PD-Rx Pharmaceuticals, Inc.

Rx Only

Cardiovascular Thrombotic Events

  • Nonsteroidal anti-inflammatory drugs (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 treatment and may increase with duration of use (see WARNINGS and PRECAUTIONS).
  • Etodolac tablets are contraindicated in the setting of coronary artery bypass graft (CABG) surgery (see CONTRAINDICATIONS and WARNINGS).

Gastrointestinal Risk

  • NSAIDs cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal (GI) events (see WARNINGS).

DESCRIPTION

Etodolac tablets, USP are a member of the pyranocarboxylic acid group of nonsteroidal anti-inflammatory drugs (NSAIDs). Each tablet contains etodolac, USP for oral administration. Etodolac, USP is a racemic mixture of [+]S and [-]R-enantiomers. Etodolac, USP is a white crystalline compound, insoluble in water but soluble in alcohols, chloroform, dimethyl sulfoxide, and aqueous polyethylene glycol.

The chemical name is (±) 1,8-diethyl-1,3,4,9-tetrahydropyrano-[3,4-b]indole-1-acetic acid. The molecular weight of the base is 287.37. It has a pKa of 4.65 and an n-octanol:water partition coefficient of 11.4 at pH 7.4. The molecular formula for etodolac is C 17 H 21 NO 3 and it has the following structural formula:

Chemical-Structure

Each tablet, for oral administration contains 400 mg and 500 mg of etodolac, USP. In addition, each tablet contains the following inactive ingredients: lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol, povidone, sodium starch glycolate (potato), talc and titanium dioxide.

CLINICAL PHARMACOLOGY

Pharmacodynamics

Etodolac is a nonsteroidal anti-inflammatory drug (NSAID) that exhibits anti-inflammatory, analgesic, and antipyretic activities in animal models. The mechanism of action of etodolac, like that of other NSAIDs, is not completely understood, but may be related to the prostaglandin synthetase inhibition.

Etodolac is a racemic mixture of [-]R- and [+]S-etodolac. As with other NSAIDs, it has been demonstrated in animals that the [+]S-form is biologically active. Both enantiomers are stable and there is no [-]R to [+]S conversion in vivo.

Pharmacokinetics

Absorption

The systemic bioavailability of etodolac from etodolac tablets is 100% as compared to solution and at least 80% as determined from mass balance studies. Etodolac is well absorbed and had a relative bioavailability of 100% when 200 mg capsules were compared with a solution of etodolac. Based on mass balance studies, the systemic availability of etodolac from the tablet is at least 80%. Etodolac does not undergo significant first-pass metabolism following oral administration. Mean (± 1 SD) peak plasma concentrations (C max ) range from approximately 14 ± 4 mcg/mL to 37 ± 9 mcg/mL after 200 mg to 600 mg single doses and are reached in 80 ± 30 minutes (see Table 1 for summary of pharmacokinetic parameters). The dose-proportionality based on the area under the plasma concentration-time curve (AUC) is linear following doses up to 600 mg every 12 hours. Peak concentrations are dose proportional for both total and free etodolac following doses up to 400 mg every 12 hours, but following a 600 mg dose, the peak is about 20% higher than predicted on the basis of lower doses. The extent of absorption of etodolac is not affected when etodolac is administered after a meal. Food intake, however, reduces the peak concentration reached by approximately one-half and increases the time to peak concentration by 1.4 to 3.8 hours.

Table 1: Mean (CV%) * Pharmacokinetic Parameters of Etodolac in Normal Healthy Adults and Various Special Populations
*
%Coefficient of variation
Age Range (years)

PK

Parameters

Normal

Healthy

Adults

(18-65)

(n=179)

Healthy

Males (18-65)

(n=176)

Healthy

Females

(27-65)

(n=3)

Elderly

(>65)

(70-84)

Hemodialysis

(24-65)

(n=9)

Dialysis Dialysis

On Off

Renal Impairment

(46-73)

(n=10)

Hepatic

Impairment

(34-60)

(n=9)

T max, h

1.4

(61%) *

1.4

(60%)

1.7

(60%)

1.2

(43%)

1.7

(88%)

0.9

(67%)

2.1

(46%)

1.1

(15%)

Oral

Clearance,

mL/h/kg

(CL/F)

49.1

(33%)

49.4

(33%)

35.7

(28%)

45.7

(27%)

NA

NA

58.3

(19%)

42.0

(43%)

Apparent

Volume of

Distribution,

mL/kg (Vd/F)

393

(29%)

394

(29%)

300

(8%)

414

(38%)

NA

NA

NA

NA

Terminal

Half-Life, h

6.4

(22%)

6.4

(22%)

7.9

(35%)

6.5

(24%)

5.1

(22%)

7.5

(34%)

NA

5.7

(24%)

NA = not available

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