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Lodine
CLINICAL PHARMACOLOGY
Lodine
Pharmacodynamics
Lodine is a nonsteroidal anti-inflammatory drug (NSAID) that exhibits anti-inflammatory, analgesic, and antipyretic activities in animal models. The mechanism of action of Lodine, like that of other NSAIDs, is not completely understood, but may be related to prostaglandin synthetase inhibition.
Lodine 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 Lodine 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 either the tablet or capsule formulation is at least 80%. Etodolac does not undergo significant first-pass metabolism following oral administration. Mean (± 1 SD) peak plasma concentrations (Cmax) range from approximately 14 ± 4 to 37 ± 9 µg/mL after 200 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 Lodine 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 Lodine in Normal Healthy Adults and Various Special Populations
| 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) |
Renal Impairment (46-73) (n=10) |
Hepatic Impairment (34-60) (n=9) |
|
| Dialysis On | Dialysis Off | |||||||
| Tmax, 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%) |
| OralClearance, 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%) |
| †% Coefficient of variation *Age Range (years) NA = not available |
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Distribution
Generic Name: Etodolac
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