Lodine (Etodolac) and Ibuprofen: Which Is Better for Arthritis Pain?

Ibuprofen and etodolac are two types of non-steroidal anti-inflammatory drugs (NSAIDs) used to treat arthritis pain. Being of the same pharmaceutical class, there's much that they have in common. Both reduce inflammation and pain sensation, easing the severity of symptoms. That said, there are also a number of crucial differences.

Etodolac, a prescription-only generic drug previously sold under the discontinued brand name Lodine, is typically only indicated for osteoarthritis and rheumatoid arthritis. Ibuprofen is available in numerous over-the-counter (OTC) and prescribed forms and takes on a wider range of pain, including arthritis.

As with any medication, it's important to be careful when using etodolac and ibuprofen, as they can interact with other drugs or supplements. In particular, the chances of adverse effects increase if these two drugs—or any two NSAIDs—are taken together. It's important to understand how to use these drugs safely.

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How Etodolac and Ibuprofen Are Similar

Like all NSAIDs, both etodolac and ibuprofen prevent the activity of enzymes called cyclooxygenases (COX), which help your body produce prostaglandins. These hormone-like chemicals are essential for pain and swelling in the body, so inhibiting their activity eases symptoms. Each is often prescribed for rheumatoid arthritis and osteoarthritis.

Since etodolac and ibuprofen function in this way, their side effects are also similar. While there are more for etodolac, common side effects of both include:

Constipation
Diarrhea
Gas and/or bloating
Dizziness
Nervousness
Ringing in the ears

Not only that, severe side-effects for these drugs, which include allergic reactions such as breathing difficulties, facial swelling, and hives, among others, are also identical.

How Etodolac and Ibuprofen Are Different

Though there are similarities between these NSAIDs, there are also a number of key differences. Here's a quick breakdown:

Availability: Ibuprofen, sold under a wide range of names, including Motrin, Advil, Midol, and others, comes in both over-the-counter and prescribed formulations. In contrast, etodolac is only available with a prescription in faster-acting and more slow-release forms.
Indications: While some healthcare providers may prescribe etodolac for other painful conditions, it's approved only for the management of osteoarthritis and rheumatoid arthritis. Ibuprofen is indicated for a wider range of conditions, including everything from headache, menstrual pain, toothaches, and others.
Half-lives: Etodolac has a much longer half-life—the time it takes for half of the substance to be metabolized—of six to eight hours, which means people will need fewer pills to manage pain and other symptoms. Ibuprofen, in contrast, gets to this point between one and three hours.
Typical dosages: For arthritis, etodolac doses range from 300 milligrams two to three times a day, to one 400- to 1,000-milligram tablet daily. Higher and more frequent doses of ibuprofen achieve the same effect: 400 to 800 milligrams three to four times a day.

Safe populations: While both of these drugs are considered generally safe for adults, forms of ibuprofen are safe for those as young as 6 months old. Etodolac, however, isn't recommended for those under 6 years old.

Which Is Better for Treating Arthritis Pain? 

What makes arthritic conditions difficult is that there is no outright cure for them. Treatment of these conditions is a matter of long-term management of symptoms, of which ibuprofen and etodolac may both play a part. But it's important ask: Is one better than the other?

The answer is a little complicated, though etodolac seems to have an edge. A formative, double-blind study conducted in 1997 directly comparing the two for rheumatoid arthritis found them to be equally effective for the first two months, with ibuprofen showing less efficacy over the long run. For up to three years of therapy, etodolac offered better management of symptoms.

However, it should also be noted that ibuprofen has consistently been found to be among the safest of NSAIDs, and certainly safer than etodolac. Especially in moderate doses, it's been shown to lead to relatively few adverse events. No doubt, this is why this medication is so widespread and has such a long history.

Is It Safe to Take Ibuprofen With Etodolac? 

Whenever you're prescribed a medication, it's important to be aware of what, if any, other drugs, supplements, or herbs you can safely take at the same time. This is especially important when managing chronic conditions like arthritis, as you may need to take medications for a long period of time.

When taking any NSAID, using another one at the same time significantly increases the chance of adverse side effects. This would certainly be the case if you tried to mix ibuprofen and etodolac, which is why the Food and Drug Administration (FDA) specifically warns against doing so.

If you're taking prescription or over-the-counter medications for your arthritis and still struggling with pain and inflammation, be sure to let your healthcare provider know. The management of chronic conditions often requires a multifaceted approach.

NSAID Warnings

The use of NSAIDs, though common and widespread, comes with risks. Most significantly, according to the FDA, there is a chance that this class of drugs can lead to heart attack and stroke in the following cases:

Duration of use: Healthcare providers have documented cardiovascular effects within two weeks of starting NSAIDs, and this risk rises with prolonged use.
Higher doses: Chances of stroke and heart attack also grow with higher concentrations and dosages of NSAIDs.
Present conditions: NSAIDs have been found to increase the risk of adverse cardiovascular events even in those with no history of heart problems. Those with heart disease or other issues have a higher likelihood of developing these severe reactions.

In addition, NSAIDs can also affect gastrointestinal health, leading to intestinal bleeding, stomach ulcers, and perforation of ulcers. The risk of any of these occurring rises with age, and prompt medical attention is necessary if they arise.

Finally, the use of ibuprofen, etodolac, or other NSAIDs may also lead to:

Skin reactions: Rashes and other skin conditions may be signs of adverse reactions.
Liver damage: Taking medications like ibuprofen or etodolac can also damage the liver, leading to jaundice (yellowing of skin and eyes), liver failure, fatigue, nausea, flu-like symptoms, and others.
Heart failure: Use can also cause insufficient heart-pumping activity, leading to swelling, shortness of breath, and sudden weight gain.
Fetal toxicity: NSAIDs like ibuprofen and etodolac may also be problematic in pregnancy after 30 weeks. Those who take them after 20 weeks need to be carefully monitored to ensure safety.

When to Call Your Healthcare Provider

Some side-effects of NSAID use are so dangerous as to constitute medical emergencies. If you experience any of the following, call for help as soon as you can:

Breathing difficulties
Rapid heartbeat
Chest pain
Swelling in the abdomen, hands, feet, ankles, and legs
Skin rashes, blisters, hives
Fever and chills
Jaundice (yellowing of skin and eyes)
Abdominal pain
Loss of appetite
Cloudy urine
Pain while urinating
Sudden weight gain

A Word From Verywell

Managing osteoarthritis or rheumatoid arthritis is challenging, but you're far from alone if you experience these conditions. As common and widespread as these conditions are, it's important to remember that there are many effective means of managing them, of which ibuprofen and etodolac both have their utility.

If you take these NSAIDs—or any other medication—it's absolutely essential to understand how they work and how to use them safely. The secret weapon against arthritis is something we all have: knowledge.

The more you know about your condition and your approach to treatment, the better off you'll be. Never hesitate to ask your healthcare provider about your options.

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