Lonine
Lonine Uses, Dosage, Side Effects, Food Interaction and all others data.
Lonine is a non-steroidal anti-inflammatory drug (NSAID). It inhibits the formation of prostaglandins. The inhibition of prostaglandin synthesis observed with Lonine differs from that of other NSAIDs. Studies in human cell models have confirmed that Lonine is selective for the inhibition of COX-2. Experiments have shown Lonine to have marked anti-inflammatory activity, being more potent than several clinically established NSAIDs.
Lonine is an anti-inflammatory agent with analgesic and antipyretic properties. It is used to treat osteoarthritis, rheumatoid arthritis and control acute pain. The therapeutic effects of etodolac are achieved via inhibition of the synthesis of prostaglandins involved in fever, pain, swelling and inflammation. Lonine is administered as a racemate. As with other NSAIDs, the S-form has been shown to be active while the R-form is inactive. Both enantiomers are stable and there is no evidence of R- to S- conversion in vivo.
Trade Name | Lonine |
Availability | Prescription only |
Generic | Etodolac |
Etodolac Other Names | Etodolac, Étodolac, Etodolaco, Etodolacum, Etodolic acid, Etodolsäure |
Related Drugs | Humira, Buprenex, aspirin, prednisone, ibuprofen, acetaminophen, tramadol, meloxicam, naproxen, Tylenol |
Type | |
Formula | C17H21NO3 |
Weight | Average: 287.3535 Monoisotopic: 287.152143543 |
Protein binding | > 99% bound, primarily to albumin |
Groups | Approved, Investigational, Vet approved |
Therapeutic Class | Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs) |
Manufacturer | |
Available Country | Greece, Taiwan |
Last Updated: | September 19, 2023 at 7:00 am |
![Lonine Lonine](https://www.medicinesfaq.com/media/png/lonine.png)
Uses
Carefully consider the potential benefits and risks of etodolac capsules and other treatment options before deciding to use etodolac capsules. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.Lonine are used:1. For acute and long-term use in the management of signs and symptoms of the following:
- Osteoarthritis
- Rheumatoid arthritis
2. For the management of acute pain
Lonine is also used to associated treatment for these conditions: Chronic Back Pain, Extra-Articular Rheumatism, Juvenile Idiopathic Arthritis (JIA), Muscle Spasms, Nonspecific Pain Post Traumatic Injury, Osteoarthritis (OA), Pain, Acute, Postoperative pain, Rheumatoid Arthritis, Spinal Disorders
How Lonine works
Similar to other NSAIDs, the anti-inflammatory effects of etodolac result from inhibition of the enzyme cycooxygenase (COX). This decreases the synthesis of peripheral prostaglandins involved in mediating inflammation. Lonine binds to the upper portion of the COX enzyme active site and prevents its substrate, arachidonic acid, from entering the active site. Lonine was previously thought to be a non-selective COX inhibitor, but it is now known to be 5 – 50 times more selective for COX-2 than COX-1. Antipyresis may occur by central action on the hypothalamus, resulting in peripheral dilation, increased cutaneous blood flow, and subsequent heat loss.
Dosage
Lonine dosage
Carefully consider the potential benefits and risks of Lonine and other treatment options before deciding to use Lonine capsules. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
After observing the response to initial therapy with Lonine capsules, the dose and frequency should be adjusted to suit an individual patient's needs.
Dosage adjustment of Lonine is generally not required in patients with mild to moderate renal impairment. Lonine should be used with caution in such patients, because, as with otherNSAIDs, they may further decrease renal function in some patients with impaired renal function.
Analgesia: The recommended total daily dose of Lonine for acute pain is up to 1000 mg, given as 200 to 400 mg every 6 to 8 hours. Doses of Lonine greater than 1000 mg/day have not been adequately evaluated in well-controlled clinical trials.
Osteoarthritis and Rheumatoid Arthritis: The recommended starting dose is 300 mg b.i.d., t.i.d., or 400 mg b.i.d., or 500 mgb.i.d.A lower dose of 600 mg/day may suffice for long-term administration. Physicians should be aware that doses above 1000 mg/day have not been adequately evaluated in well-controlled clinical trials.
In chronic conditions, a therapeutic response to therapy with Lonine is sometimes seen within one week of therapy, but most often is observed by two weeks. After a satisfactory response has been achieved, the patient's dose should be reviewed and adjusted as required.
Side Effects
The common side effects of Lonine involve the gastrointestinal system. It can cause abdominal pain, constipation, diarrhea, dyspepsia, flatulence, heartburn, nausea, GI ulcers, vomiting. Other events including abnormal renal function, anemia, dizziness, edema, elevated liver enzymes, headaches, increased bleeding time, pruritis, rashes, tinnitus etc.
Toxicity
Selective COX-2 inhibitors have been associated with increased risk of serious cardiovascular events (e.g. myocardial infarction, stroke) in some patients. Current data is insufficient to assess the cardiovascular risk of etodolac. Lonine may increase blood pressure and/or cause fluid retention and edema. Risk of GI toxicity including bleeding, ulceration and perforation. Risk of direct renal injury, including renal papillary necrosis. Anaphylactoid and serious skin reactions (e.g. exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis) have been reported. Common adverse events include abdominal pain, constipation, diarrhea, dyspepsia, flatulence, GI bleeding, GI perforation, nausea, peptic ulcer, vomiting, renal function abnormalities, anemia, dizziness, edema, liver function test abnormalities, headache, prolonged bleeding time, pruritus, rash, tinnitus. Symptoms of overdose include lethargy, drowsiness, nausea, vomiting, and epigastric pain.
Precaution
Lonine should be given with caution in patients with severe hepatic reactions, pre-existing asthma, fluid retention, hypertension or heart failure. If clinical sings and symptoms consistent with liver disease develop, or if systemic manifestations occur (e.g. eosinophilia, rash etc.), it should be discontinued.
Interaction
Since Lonine is extensively protein-bound, it may be necessary to modify the dosage of other highly protein-bound drugs. The concomitant administration of Warfarin and Lonine should not require a dosage adjustment of either drug, however it has rarely led to prolonged prothrombin times, therefore caution should be exercised when Lonine is administered with Warfarin. Concomitant use of Ciclosporin, Methotrexate, Digoxin, or Lithium with NSAIDs may cause an increase in serum levels of these compounds and associated toxicities. Care should also be taken in patients treated with any of the following drugs as interactions have been reported in some patients: Anti-hypertensives, Mifepristone, other Analgesics, Corticosteroids and Quinolone Antibiotics.
Food Interaction
- Avoid alcohol.
- Take with food. Food reduces irritation.
Lonine Alcohol interaction
[Moderate] GENERALLY AVOID:
The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss.
The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.
Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.
Lonine Hypertension interaction
[Major] Fluid retention and edema have been reported in association with the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
Therapy with NSAIDs should be administered cautiously in patients with preexisting fluid retention, hypertension, or a history of heart failure.
Blood pressure and cardiovascular status should be monitored closely during the initiation of NSAID treatment and throughout the course of therapy.
Hypertension interaction[Moderate] Nonsteroidal anti-inflammatory drugs (NSAIDs), including topicals, can lead to new onset of hypertension or worsening of preexisting hypertension, either of which can contribute to the increased incidence of cardiovascular events.
NSAIDs should be used with caution in patients with hypertension.
Blood pressure should be monitored closely during the initiation of NSAID therapy and throughout the course of therapy.
Lonine Drug Interaction
Moderate: aspirin, aspirin, duloxetine, duloxetine, omega-3 polyunsaturated fatty acids, omega-3 polyunsaturated fatty acidsUnknown: cyclobenzaprine, cyclobenzaprine, pregabalin, pregabalin, acetaminophen / hydrocodone, acetaminophen / hydrocodone, cyanocobalamin, cyanocobalamin, ascorbic acid, ascorbic acid, cholecalciferol, cholecalciferol, cetirizine, cetirizine
Lonine Disease Interaction
Major: asthma, fluid retention, GI toxicity, rash, renal toxicities, thrombosisModerate: anemia, heart failure, hepatotoxicity, hyperkalemia, hypertension, platelet aggregation inhibition
Volume of Distribution
- 390 mL/kg
Elimination Route
Based on mass balance studies, the systemic bioavailability of etodolac from either the tablet or capsule formulation is at least 80%.
Half Life
Terminal t1/2, 7.3 ± 4.0 hours. Distribution t1/2, 0.71 ± 0.50 hours
Clearance
- Oral cl=49.1 mL/h/kg [Normal healthy adults]
- Oral cl=49.4 mL/h/kg [Healthy males (18-65 years)]
- Oral cl=35.7 mL/h/kg [Healthy females (27-65 years)]
- Oral cl=45.7 mL/h/kg [Eldery (>65 years)]
- Oral cl=58.3 mL/h/kg [Renal impairement (46-73 years)]
- Oral cl=42.0 mL/h/kg [Hepatic impairement (34-60 years)]
Elimination Route
It is not known whether etodolac is excreted in human milk; however, based on its physical-chemical properties, excretion into breast milk is expected. Lonine is extensively metabolized in the liver. The hydroxylated-etodolac metabolites undergo further glucuronidation followed by renal excretion and partial elimination in the feces (16% of dose). Approximately 1% of a etodolac dose is excreted unchanged in the urine with 72% of the dose excreted into urine as parent drug plus metabolite.
Pregnancy & Breastfeeding use
Pregnancy: There are no adequate and well-controlled studies in pregnant women. It should be use in pregnancy only if the potential benefit justifies the potential risk to the fetus.
Lactation: It is not known whether Lonine is excreted in human milk. A decision should be made whether to discontinue nursing or to discontinue the drug taking into account the importance of the drug to the mother.
Contraindication
Lonine is contraindicated in patients with known hypersensitivity to Lonine. Lonine should not be given to patients who have experienced asthma, urticaria or other allergic-type reactions after taking Aspirin or other NSAIDs.
Acute Overdose
Symptoms following acute NSAID overdose are usually limited to lethargy, drowsiness, nausea, vomiting, and epigastric pain which are generally reversible with supportive care.
Storage Condition
Store at a cool and dry place protected from light & moisture. Keep out of reach of children.
Innovators Monograph
You find simplified version here Lonine
Lonine contains Etodolac see full prescribing information from innovator Lonine Monograph, Lonine MSDS, Lonine FDA label
FAQ
What is Lonine used for?
Lonine is a nonsteroidal anti-inflammatory drug (NSAID) used to treat mild to moderate pain, and helps to relieve symptoms of arthritis (eg, osteoarthritis and rheumatoid arthritis), including inflammation, swelling, stiffness, and joint pain.
How safe is Lonine?
Lonine may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using etodolac, especially in older adults.
How does Lonine work?
Lonine works by stopping the body's production of a substance that causes pain, fever, and inflammation.
What are the common side effects of Lonine?
Common side effects of Lonine are include:
- Belching
- bloody or black, tarry stools
- blurred vision
- body aches or pain
- chest pain
- cloudy urine
- constipation
- cough or hoarseness
- decrease in urine output or decrease in urine-concentrating ability
- diarrhea
- dizziness
- dryness or soreness of throat
- feeling of indigestion
- fever or chills
- headache
- increased bleeding time
- itching, skin rash
- loss of appetite
- lower back or side pain
- nausea and vomiting
- nervousness
- pain in the chest below the breastbone
- painful or difficult urination
- pale skin
- pounding in the ears
- runny nose
- slow or fast heartbeat
- stomach bloating, burning, cramping, or pain
- swelling
- tender, swollen glands in neck
- trouble in swallowing
- trouble breathing
- unusual bleeding or bruising
- unusual tiredness or weakness
- voice changes
- vomiting of blood or material that looks like coffee grounds
- weight loss
Is Lonine safe during pregnancy?
If you are pregnant, you should not take Lonine unless your doctor tells you to.
Is Lonine safe during breastfeeding?
Use should be avoided. The effects in the nursing infant are unknown. Since no information is available regarding use of this drug during breastfeeding, other agent may be preferred, especially while nursing a newborn or preterm infant.
Can I drink alcohol with Lonine?
Do not drink alcohol while taking Lonine. Alcohol can increase your risk of stomach bleeding caused by Lonine. Call your doctor at once if you have symptoms of bleeding in your stomach or intestines.
Can I drink alcohol with Lonine?
Do not drive, use machinery, or do anything that needs alertness until you can do it safely.
How many time can I take Lonine daily?
To treat arthritis, the tablet and capsule are usually taken two to three times a day and the extended-release tablet is usually taken once a day.
How often can I take Lonine?
Adults, 200 to 400 milligrams (mg) every 6 to 8 hours.
How long does Lonine take to work?
Peak plasma concentrations of etodolac are reached within 50 to 110 minutes after oral administration, and the peak analgesic effect occurs between one to two hours following a dose.
What is the half-life of Lonine?
The effects of etodolac usually last six to eight hours. The elimination half-life of etodolac is between 6 and 8 hours in plasma, and is similar for both enantiomers.
How long can I take Lonine?
For safe and effective use of this medicine, do not take more of it, do not take it more often, and do not take it for a longer time than ordered by your doctor.
Who should not take Lonine?
Do not take Lonine around or after 20 weeks of pregnancy, unless you are told to do so by your doctor. talk to your doctor about the risks and benefits of taking etodolac if you are 75 years of age or older. Do not take this medication for a longer period of time or at a higher dose than recommended by your doctor.
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
What happens if I overdose?
Seek emergency medical attention. Overdose symptoms may include drowsiness, vomiting, stomach pain, or stomach bleeding.
What happen If I stop taking Lonine?
It comes with risks if you don't take it as prescribed by your doctor. If you stop or miss doses: If you stop taking this medication, miss doses, or don't take it on schedule, you may experience more pain caused by your condition.
Can Lonine affect my liver?
Lonine has been linked to rare instances of clinically apparent drug induced liver disease.
Can Lonine affect my heart?
Lonine can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).
Can Lonine affect my kidneys?
The results suggest that Lonine does not affect renal function in normal individuals, nor does it exacerbate underlying renal insufficiency when administered to patients with mild to moderate renal impairment.