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Inhibition of prostaglandin synthesis and COX-2 selectivityAll non-steroidal anti-inflammatory drugsNSAIDshave been shown to inhibit the formation of prostaglandinsIt is this action which is responsible both for their therapeutic effects and some of their side-effectsThe inhibition of prostaglandin synthesis observed with etodolac differs from that of other NSAIDsIn an animal model at an established anti-inflammatory dosecytoprotective PGE concentration in the gastric mucosa have been shown to be reduced to a lesser degree and for a shorter period than other NSAIDsThis finding is consistent with subsequent in-vitro studies which have found etodolac to be selective for induced cyclo-oxygenase 2COX-2associated with inflammationover COX-1cytoprotective

Oedemahypertension and cardiac failurehave been reported in association with NSAID treatmentClinical trial and epidemiological data suggest that use of some NSAIDsparticularly at high doses and in long term treatmentmay be associated with an increased risk of arterial thrombotic eventsfor example myocardial infarction or strokesee section 4.4

Etodolac is a member of the pyranocarboxylic acid class of NSAIDsIn vitro data suggest that etodolac is not COX-2 selective in dogsHowever in vivo data are conflictingwith evidence suggesting that platelet thromboxane and gastric prostaglandin PGE 1 were not inhibited by etodolac in dogs at recommended therapeutic dosesThus it is difficult to definitively state whether or not etodolac is COX-1 sparing in vivoEtodolac is approved as an oral formulation for use in managing pain and inflammation associated with canine OAClinically it has been shown to improve rear limb function in dogs with chronic OAAdverse events are primarily seen in the GI tracthoweverkeratoconjunctivitis sicca has also been associated with etodolac administration.

Osteoarthritisimmediate and extended-release formsrheumatoid arthritisimmediate and extended-release formsjuvenile rheumatoid arthritisextended-release formshort-term painimmediate release form)

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no information is available from controlled clinical studies regarding the use of etodolac in patients with advanced renal disease.

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