This sheet is about exposure to etodolac in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider.
What is etodolac?
Etodolac is a medication that has been used to treat pain and inflammation in conditions such as osteoarthritis and rheumatoid arthritis. It belongs to the class of medications called non-steroidal anti-inflammatory drugs (NSAIDs). A brand name for etodolac is Lodine®.
MotherToBaby has a fact sheet on rheumatoid arthritis here: https://mothertobaby.org/fact-sheets/rheumatoid-arthritis/.
The U.S. Food and Drug Administration (FDA) recommends not using NSAIDs after week 20 of pregnancy, unless specifically recommended by your healthcare provider.
I take etodolac. Can it make it harder for me to get pregnant?
Some studies suggest that using etodolac or other NSAIDs might make it harder to get pregnant. This might be more likely when NSAIDs are used often or over a long period of time.
Does taking etodolac increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if etodolac can increase the chance of miscarriage. A few studies have reported a higher chance of miscarriage when other NSAIDs (not etodolac) were used in pregnancy. However, the reasons why women in the studies were taking NSAIDs (such as medical conditions, infections, or pain from miscarriages that were already happening) might have contributed to the higher chance of miscarriage. As there can be many causes of miscarriage, it is hard to know if a medication, the medical condition being treated, or other factors are the cause of a miscarriage.
Does taking etodolac increase the chance of birth defects?
Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like etodolac, might increase the chance of birth defects in a pregnancy.
A study of over 5,000 pregnancies did not report an increased chance of birth defects when any NSAID (including etodolac) was used during the first trimester of pregnancy.
Does taking etodolac in pregnancy increase the chance of other pregnancy-related problems?
Etodolac is generally not recommended for use after week 20 of pregnancy. Etodolac should only be used under a healthcare provider’s supervision, particularly in the 2nd and 3rd trimesters. Your healthcare providers can closely watch your pregnancy if you need to use etodolac after week 20.
Some reports suggest that using NSAIDs (like etodolac) after 20 weeks of pregnancy may affect the fetal kidneys and lower the amount of amniotic fluid (the fluid around the fetus in the womb). Having too little amniotic fluid (called oligohydramnios) can lead to poor lung development and stiff joints in the fetus, or the need for early delivery. In rare cases, it can cause stillbirth.
One study suggested that the use of some NSAIDs in the 1st half of pregnancy (first 20 weeks) might also affect the fetal kidneys and amount of amniotic fluid. The researchers did not report which NSAIDs were included in their study.
Using etodolac during the 3rd trimester (28 to 40 weeks of pregnancy) might cause premature closure of the ductus arteriosus. This means that a blood vessel in the fetal heart closes too early. This blood vessel normally stays open to help carry oxygen to the body while the fetus is still in the womb, and it closes at birth when the baby starts to breathe. If the vessel closes too soon (before birth), it can cause high blood pressure in the fetal lungs (called pulmonary hypertension).
Some studies looking at NSAID medications as a group suggest that using NSAIDs can increase the chance of other pregnancy-related problems, including preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth. Other studies have not reported these findings. Some of the conditions that NSAIDs are used to treat can also increase the chances of these problems. That makes it hard to know if the medication, the condition being treated, or other factors are increasing the chance of these outcomes.
Does taking etodolac in pregnancy affect future behavior or learning for the child?
It is not known if etodolac can increase the chance of behavior or learning issues for the child.
What screenings or tests are available to see if my pregnancy has birth defects or other issues?
Prenatal ultrasounds can be used screen for some pregnancy-related problems, such as oligohydramnios and problems with the fetal kidneys. Fetal echocardiogram (a test to look at blood flow in the heart) can be used to identify premature closure of the ductus arteriosus. Ultrasound can also be used to monitor the growth of the pregnancy. Talk with your healthcare provider about any prenatal screenings or testing that are available to you. There are no tests available during pregnancy that can tell how much effect there could be on future behavior or learning.
Breastfeeding while taking etodolac:
There is no information on the use of etodolac during breastfeeding. Be sure to talk to your healthcare provider about all your breastfeeding questions.
If a man takes etodolac, could it affect fertility or increase the chance of birth defects?
It is not known if etodolac could affect men’s fertility (ability to get a partner pregnant). Studies have not been done to see if etodolac could increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
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