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Side effects from glucosamine and chondroitin: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

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Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

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Glucosamine – Mayo Clinic

Overview

Glucosamine is a natural compound found in cartilage — the tough tissue that cushions joints.

In supplement form, glucosamine is harvested from shells of shellfish or made in a lab. There are several forms of glucosamine, including glucosamine sulfate, glucosamine hydrochloride and N-acetyl glucosamine. These supplements aren’t considered interchangeable.

People use glucosamine sulfate orally to treat a painful condition caused by the inflammation, breakdown and eventual loss of cartilage (osteoarthritis).

Evidence

Research on glucosamine use for specific conditions shows:

  • Osteoarthritis. Oral use of glucosamine sulfate might provide some pain relief for people with osteoarthritis of the knee. Some research shows that it may also help slow knee joint degeneration associated with osteoarthritis. More studies are needed to determine the benefits of glucosamine sulfate supplements for osteoarthritis of the hip, spine or hand.
  • Rheumatoid arthritis. Early research suggests that oral use of glucosamine hydrochloride might reduce pain related to rheumatoid arthritis. However, researchers didn’t see an improvement in inflammation or the number of painful or swollen joints.

When considering glucosamine, read product labels carefully to make sure you choose the correct form. There’s less clinical evidence to support the use of N-acetyl glucosamine in treating osteoarthritis, and more research is needed to confirm its benefits.

Our take

Generally safe

Glucosamine sulfate might provide some pain relief for people with osteoarthritis. The supplement appears to be safe and might be a helpful option for people who can’t take nonsteroidal anti-inflammatory drugs (NSAIDs). While study results are mixed, glucosamine sulfate might be worth a try.

Safety and side effects

When taken in appropriate amounts, glucosamine sulfate appears to be safe. Oral use of glucosamine sulfate can cause:

  • Nausea
  • Heartburn
  • Diarrhea
  • Constipation

Other side effects may include:

  • Drowsiness
  • Skin reactions
  • Headache

Because glucosamine products might be derived from the shells of shellfish, there is concern that the supplement could cause an allergic reaction in people with shellfish allergies.

Glucosamine might worsen asthma.

There’s some concern that glucosamine might raise eye pressure. If you have glaucoma, talk to your doctor before taking glucosamine supplements.

Interactions

Possible interactions include:

  • Acetaminophen (Tylenol, others). Taking glucosamine sulfate and acetaminophen together might reduce the effectiveness of both the supplement and medication.
  • Warfarin (Jantoven). Taking glucosamine alone or in combination with the supplement chondroitin might increase the effects of the anticoagulant warfarin. This can increase your risk of bleeding.

Nov. 12, 2020

Show references

  1. Glucosamine and chondroitin for osteoarthritis pain. Arthritis Foundation. https://www.arthritis.org/health-wellness/treatment/complementary-therapies/supplements-and-vitamins/glucosamine-chondroitin-osteoarthritis-pain. Accessed Oct. 24, 2020.
  2. N-acetyl glucosamine (NAG). Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Oct. 24, 2020.
  3. Osteoarthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/osteoarthritis. Accessed Oct. 24, 2020.
  4. Glucosamine sulfate. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Oct. 24, 2020.
  5. Pizzorono JE, et al., eds. Glucosamine. In: Textbook of Natural Medicine. 5th ed. Elsevier, 2021. https://www.clinicalkey.com. Accessed Oct. 24, 2020.
  6. Vasiliadis HS, et al. Glucosamine and chondroitin for the treatment of osteoarthritis. World Journal of Orthopedics. 2017; doi:10.5312/wjo.v8.i1.1.
  7. Glucosamine hydrochloride. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Oct. 24, 2020.
  8. Rubin BR, et al. Oral polymeric N-acetyl-D-glucosamine and osteoarthritis. Journal of the American Osteopathic Association. 2001; https://jaoa.org/article.aspx?articleid=2092565. Accessed Oct. 28, 2020.


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The Side Effects of Glucosamine and Chondroitin Sulfate

Two popular dietary supplements, glucosamine sulfate and chondroitin sulfate, are often used as natural remedies for osteoarthritis. There is some evidence both supplements can help control osteoarthritis by protecting against the breakdown of cartilage.

While any associated side effects are generally mild, as with all medications and supplements, there are risks with their use. It is important to be aware of these and to discuss the use of any supplement with your physician.

While management of osteoarthritis is the most common use of glucosamine sulfate and chondroitin sulfate, there is some evidence each also aids in the treatment of a variety of conditions. For example, glucosamine is touted as a natural remedy for interstitial cystitis, temporomandibular joint disorder, and glaucoma.

Meanwhile, chondroitin sulfate is purported to treat cataracts, dry eye syndrome, high cholesterol, and urinary tract infections.

Side Effects of Glucosamine

A compound found naturally in your body, glucosamine is also available in the shells of shrimp, lobsters, and other shellfish. Although many dietary supplements contain glucosamine sourced from shellfish, some products contain synthetic forms of this compound.

Since glucosamine supplements may be made from shellfish, people with allergies to shellfish should avoid glucosamine unless it has been confirmed that it is a non-shellfish source. The source of glucosamine is not required to be printed on the label, so it may require a phone call to the manufacturer.

Here are some of the other side effects most commonly associated with glucosamine:

  • Bloating
  • Constipation
  • Diarrhea
  • Gas
  • Heartburn
  • Indigestion
  • Nausea
  • Stomach upset

In rare cases, use of glucosamine may cause such side effects as drowsiness, skin reactions, vomiting, headache, elevated blood pressure and heart rate, and palpitations.

Taking glucosamine with food may help reduce the occurrence of digestive issues associated with glucosamine.

Side Effects of Chondroitin Sulfate

Chondroitin sulfate is naturally present in the cartilage surrounding your joints. The chondroitin sulfate found in dietary supplements is usually produced from animal sources, such as cow cartilage, and thus is not suitable for those with vegetarian or vegan diets.

Mild stomach pain and nausea are the two side effects most frequently caused by chondroitin sulfate. Chondroitin sulfate may also trigger the following side effects:

  • Constipation
  • Diarrhea
  • hair loss
  • Irregular heartbeat
  • Wwelling of the eyelids or legs

Safety

According to the National Institutes of Health (NIH), both glucosamine and chondroitin sulfate are likely safe for most adults. However, the NIH cautions that the safety of using glucosamine and/or chondroitin sulfate while pregnant or breastfeeding is unknown.

There’s some concern that the use of glucosamine may aggravate such conditions as asthma, diabetes, high blood pressure, and high cholesterol. The use of chondroitin sulfate, meanwhile, may have harmful effects in people with asthma, blood clotting disorders, or prostate cancer.

Since glucosamine may affect your blood sugar levels and interfere with blood sugar control during surgery, it’s important to avoid the use of glucosamine for at least two weeks prior to undergoing a scheduled surgery.

There is conflicting evidence suggesting that glucosamine, in doses used to treat osteoarthritis, may increase insulin and/or hemoglobin A1C (a test that measures how well blood sugar has been controlled during the previous three months) levels in people with diabetes or insulin resistance.

Glucosamine and chondroitin sulfate may interact with a number of medicines, including blood-thinning drugs like Coumadin (warfarin), Plavix (clopidogrel), or Ticlid (ticlopidine) and supplements such as garlic, ginkgo, vitamin E, or red clover. Glucosamine may also interact with certain medications used during chemotherapy.

If you’re currently taking medication, make sure to consult your physician before using glucosamine or chondroitin sulfate.

Alternatives

So far, research on the effects of glucosamine and chondroitin sulfate in osteoarthritis patients has produced conflicting results. However, there’s some evidence that glucosamine and chondroitin sulfate may help alleviate pain, ease stiffness, reduce swelling, and improve function in people with osteoarthritis.

Other natural remedies that show promise in the treatment of osteoarthritis include white willow bark, Pycnogenol, avocado/soybean unsaponifiables, omega-3 fatty acids, and bromelain.

It should be noted that, like glucosamine and chondroitin sulfate, each of the above remedies is associated with a range of side effects.

The Truth About Glucosamine and Chondroitin Sulfate

We, at Orthopedic Associates, pride ourselves in providing our patients the best possible care. As a component to this quality medical attention, we would like to provide you with the information that may assist you in managing your health. A common question we are asked is, “Would it help me to take Glucosamine and Chondroitin Sulfate?” Hopefully, after reading this brochure you will increase your understanding of this particular supplement and its relevance to you.

Glucosamine and chondroitin sulfate are nutritional supplements and are not subject to the same rigorous regulations required for prescription and non-prescription drugs. Therefore, if you decide to take any supplements, you do so at your own risk.

The information provided in this brochure does not replace the advice and guidance given by your doctor. If you have any questions about this supplement, please ask your physician.

What is Glucosamine and Chondroitin Sulfate?

Glucosamine sulfate and chondroitin sulfate are naturally occurring substances found in the connective tissues of the body, including the cartilage that covers the ends of bones in the joints.
Glucosamine sulfate functions are the primary building block for proteoglycans, large molecules in cartilage that give it viscoelastic (buffering) properties. When taken orally, glucosamine sulfate is absorbed readily into the system and can be traced to cartilage as soon as four hours after consumption.

Similar to non-steroidal anti-inflammatory drugs, glucosamine sulfate has been shown to have unique anti-inflammatory effects. Additionally, in some laboratory tests, the glucosamine supplement demonstrated a protective effect on the cartilage as well. These studies suggest that glucosamine sulfate may inhibit the breakdown of cartilage associated with osteoarthritis and may have the potential to help build-up cartilage.

Glucosamine hydrochloride, another form of glucosamine, is available as a nutritional supplement and is considered to be as effective as the sulfate form although there are fewer completed studies to review. This hydrochloride form of glucosamine is more available for absorption into the body; therefore, a smaller dose delivers an equivalent amount in the system.

Chondroitin sulfate is a larger molecule also found in cartilage. Chondroitin sulfate has been studied much less extensively, but early results show that it also seems to work as an anti-inflammatory and reduces pain. Some laboratory studies suggest that chondroitin sulfate may slow cartilage breakdown associated with osteoarthritis and even stimulate cartilage growth.

Who Should Take Glucosamine/Chondroitin Sulfate?

Many patients who suffer from osteoarthritis may benefit from the positive effects of taking this supplement. The painful symptoms of osteoarthritis may appear when cartilage becomes worn, and exposed bones begin to rub together. Conventional medicine does not yet have a proven treatment to stop or slow the progression of osteoarthritis. Traditional medical treatment includes drug therapy to control the pain associated with osteoarthritis. These treatments are sometimes disappointing for physicians and patients because medications may not provide complete relief and can have unwanted side effects. Some of these patients may be candidates for nutritional supplements like glucosamine and chondroitin sulfate.

How Do I Take These Supplements?

  • Typical dosage is 1500mg for glucosamine sulfate and 1200mg for chondroitin sulfate, taken once daily. For body weight less than 100 lbs, the dose is generally reduced to 1000mg for glucosamine sulfate and 800mg for chondroitin sulfate.
  • Duration of treatment has not yet been determined.
  • Reported improvement (e.g. reduction in painful symptoms) varies from three weeks to as much as eight weeks.
  • Some studies have shown continued improvement of symptoms after oral intake was stopped.
  • Generally, if there is no pain reduction after two months, there is little chance of improvement.
  • Patients should keep a diary of their symptoms when treatment begins to better judge any changes in pain level or joint movement, and this information should be shared with their physician.

What are the side effects of taking Glucosamine and Chondroitin Sulfate?

Preliminary studies show glucosamine sulfate and chondroitin sulfate to be safe and well tolerated. Common side effects may include:

  • Nausea
  • Diarrhea
  • Gastrointestinal upset

These side effects are reported in a small portion of patients. However, even substances that are found naturally in the body can have unpredictable results when taken in higher than normal quantities and in different formulations. This is particularly true with patients who are taking multiple medications or who have other diagnosed illness. For example:

  • Studies suggest that glucosamine sulfate may increase insulin resistance. For this reason, diabetic patients should use glucosamine sulfate with caution and only under medical supervision.
  • Patients on blood thinners (anticoagulants) should use chondroitin sulfate only after discussing and receiving approval from their physician.

Safe Use of Glucosamine and Chondroitin Sulfate Supplements

Patients should always consult a health professional before changing their diet or taking any over-the-counter drugs or nutritional supplements (also known as dietary supplements or natural supplements).

Only patients who have been diagnosed with osteoarthritis by a health professional and have had other possible causes for their back pain ruled out are candidates for glucosamine and chondroitin sulfate supplements. Patients should inform their physician of any other medications they are taking and of their medical history before taking any type of dietary supplement.

See Osteoarthritis Complete Treatment Guide

Glucosamine and Chondroitin Sulfate Side Effects

In general, glucosamine and chondroitin sulfate nutritional supplements appear to be quite safe. The most common side effects occur that have been reported are gastrointestinal in nature, such as upset stomach, nausea, heartburn, and diarrhea. Taking glucosamine and/or chondroitin sulfate with food seems to reduce the incidence of the above side effects.

To date, no significant side effects have been reported, although long-term studies on the safety of glucosamine and chondroitin sulfate supplements still need to be completed.

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Glucosamine and Chondroitin Sulfate Contraindications and Warnings

It is known that the following groups of patients should only take the supplements under close medical supervision or should avoid them altogether:

  • Diabetic patients should only use glucosamine sulfate supplements under close medical supervision, as some studies suggest that glucosamine sulfate may increase insulin resistance.
  • Patients who are allergic to shellfish should consult their physician before taking glucosamine sulfate supplements. However, an allergy to shellfish does not usually pose a limitation for taking glucosamine sulfate, as glucosamine sulfate is extracted from chitin, a carbohydrate, whereas shellfish allergies are most often caused by a protein.1
  • Children, as well as women who are pregnant and/or nursing, or who could become pregnant. There is currently not enough research available to determine whether or not taking glucosamine and chondroitin sulfate supplements has negative effects on young children or fetuses.1
  • Patients taking blood-thinning medications or daily aspirin should not take chondroitin sulfate, as it may contribute to bleeding.1

Patients who have any adverse reactions or unusual side effects to glucosamine and/or chondroitin sulfate supplements should discontinue use immediately and consult their physician.

In This Article:

Dosage for Glucosamine and Chondroitin Sulfate Dietary Supplements

The generally accepted daily dosages for the nutritional supplements are the following:

Supplement name Patients weighing less than 100 lbs Patients weighing more than 100 lbs
Glucosamine sulfate 1,000 mg 1,500 mg
Chondroitin sulfate 800 mg 1,200 mg

Patients who are obese or who weigh over 200 pounds should discuss proper dosage with their physician, as they may need to take higher levels of glucosamine and chondroitin sulfate. Both types of dietary supplements are available in capsule form over-the-counter (without a prescription). Glucosamine and chondroitin sulfate dietary supplements are often sold in combination formulas, and some patients find this easier to take.

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Nutritional/Dietary Supplements Are Not Regulated

Finally, it is important to reiterate that both glucosamine sulfate and chondroitin sulfate nutritional supplements are not subject to the same strict regulations and FDA oversight as are other types of medications, so both the quality and the content/ingredients of the supplement capsule may vary between brands.

Therefore, patients need to be especially diligent about researching and using high quality brands. It is advisable for patients to talk to their physician and/or pharmacist about specific brands.

Glucosamine and Chondroitin Sulfate May Help with Optimal Pain Relief

It is certain that further research on glucosamine and chondroitin sulfate is still needed. However, the lack of more effective traditional medical treatments for osteoarthritis and the low incidence of side effects from glucosamine and chondroitin sulfate present the nutritional supplements as a viable treatment alternative for some patients with osteoarthritis.

Combined with other osteoarthritis treatments (as deemed appropriate by a physician), taking glucosamine and chondroitin sulfate dietary supplements may help some patients attain optimal levels of relief from osteoarthritis-related joint pain.

As more information becomes available, it is important for all patients to follow the recommended guidelines for taking glucosamine and chondroitin sulfate nutritional supplements (as well as other types of dietary supplements) and to remain under supervision of a physician throughout the duration of treatment.

References

  • 1.Arthritis Foundation. “Alternative therapies: glucosamine and chondroitin sulfate.” 2004.

Glucosamine & Chondroitin with MSM Uses, Side Effects & Warnings

Generic name: chondroitin, glucosamine, and methylsulfonylmethane (MSM) (kon DROI tin, gloo KOSE a meen, and METH il sul FON il METH ane)
Brand name: Glucosamine & Chondroitin with MSM, Glucosamine Chondroitin Advanced, Osteo Bi-Flex Advanced, Osteo Bi-Flex Plus MSM
Drug class: Nutraceutical products

Medically reviewed by Drugs.com on June 7, 2021. Written by Cerner Multum.

What is Glucosamine & Chondroitin with?

Chondroitin is a naturally occurring substance formed of sugar chains. Chondroitin is believed to help the body maintain fluid and flexibility in the joints.

Glucosamine is a naturally occurring substance that is believed to help develop and renew cartilage (the hard connective tissue mainly located on bones near joints in the body), and keep it lubricated for better joint movement and flexibility.

Methylsulfonylmethane (MSM) is a naturally occurring form of sulfur that helps support muscles and tendons in the body.

Chondroitin, glucosamine, and MSM is a combination medicine that has been used in alternative medicine as a possibly effective aid in treating osteoarthritis, muscle damage caused by exercise, and other inflammatory joint disorders.

It is not certain whether chondroitin, glucosamine, and MSM is effective in treating any medical condition. Medicinal use of this product has not been approved by the FDA. This product should not be used in place of medication prescribed for you by your doctor.

Chondroitin, glucosamine, and MSM is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Chondroitin, glucosamine, and MSM may also be used for purposes not listed in this product guide.

Warnings

Follow all directions on the product label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Before taking this medicine

You should not use this product if you are allergic to chondroitin, glucosamine, or methylsulfonylmethane.

Ask a doctor, pharmacist, herbalist, or other healthcare provider if it is safe for you to use this product if you have:

It is not known whether chondroitin, glucosamine, and MSM will harm an unborn baby. Do not use this product without medical advice if you are pregnant.

It is not known whether chondroitin, glucosamine, and MSM passes into breast milk or if it could harm a nursing baby. Do not use this product without medical advice if you are breast-feeding a baby.

Do not give any herbal/health supplement to a child without medical advice.

How should I take chondroitin, glucosamine, and MSM?

When considering the use of herbal supplements, seek the advice of your doctor. You may also consider consulting a practitioner who is trained in the use of herbal/health supplements.

If you choose to use chondroitin, glucosamine, and MSM, use it as directed on the package or as directed by your doctor, pharmacist, or other healthcare provider. Do not use more of this product than is recommended on the label.

It may take up several weeks before your symptoms improve. Call your doctor if the condition you are treating with chondroitin, glucosamine, and MSM does not improve after a few weeks of treatment, or if your condition gets worse while using this product.

Glucosamine may increase the glucose (sugar) levels in your blood. If you have diabetes, you may need to check your blood sugar more often while taking this medication. You may also need to adjust your insulin dosage. If you need surgery, you may need to stop taking chondroitin, glucosamine, and MSM at least 2 weeks ahead of time. Do not change your dose or medication schedule without advice from your doctor.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking chondroitin, glucosamine, and MSM?

Avoid taking chitosan (usually marketed as a weight-loss product) while you are taking chondroitin, glucosamine, and MSM. Chitosan can make it harder for your body to absorb chondroitin.

Chondroitin, glucosamine, and MSM side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Common side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect chondroitin, glucosamine, and MSM?

Do not take this product without medical advice if you are using any of the following medications:

This list is not complete. Other drugs may interact with chondroitin, glucosamine, and MSM, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this product guide.

Does Chondroitin/glucosamine/methylsulfonylmethane interact with my other drugs?

Enter other medications to view a detailed report.

More about chondroitin / glucosamine / methylsulfonylmethane

Consumer resources

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Related treatment guides

Further information

  • Consult with a licensed healthcare professional before using any herbal/health supplement. Whether you are treated by a medical doctor or a practitioner trained in the use of natural medicines/supplements, make sure all your healthcare providers know about all of your medical conditions and treatments.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Copyright 1996-2021 Cerner Multum, Inc. Version: 3.03.

Glucosamine | Uses, side-effects | Versus Arthritis

A review article of 18 trials investigating the effectiveness of glucosamine sulphate in treating osteoarthritis was published in 2005. A further four trials published since 2007 evaluated the effect of glucosamine sulphate in the treatment of hip and knee osteoarthritis. A second review article compared the clinical effectiveness and safety of glucosamine sulphate with those of non-steroidal anti-inflammatory drugs (NSAIDs).

Review article (2005)

The number of participants in the RCTs included in this article ranged from 30 to 319. The trials lasted from three weeks to three years.

  • Seven trials out of 13 which compared glucosamine sulphate to a placebo found that the glucosamine sulphate was significantly better than the placebo in relieving pain.
  • In all 13 RCTs, the number and severity of side-effects reported by participants who were given glucosamine sulphate weren’t significantly different from those reported by participants who got the placebo.
  • Three trials out of five found that glucosamine sulphate was significantly better than the placebo in improving problems associated with walking and other daily activities.
  • No trials found that glucosamine sulphate was significantly effective, as compared to a placebo, in improving all the main osteoarthritis-related symptoms (pain, disability and joint stiffness).
  • Trials that used one company’s (Rotta Pharm) supplement showed a positive effect for pain and function while those that used other brands didn’t.
  • Trials that used the best methods to make sure participants didn’t know which treatment they were getting didn’t show significant benefits in pain relief and improved physical function in those who received glucosamine sulphate.

Trial 1

The first trial involved 222 people over two years. The supplement didn’t show any beneficial effects, compared to a placebo, in relieving pain and improving function.

Trial 2

In this six-month trial, which included 318 participants, glucosamine had a clear significant benefit over a placebo and an even stronger effect than paracetamol in improving both pain and function.

Trial 3‡

The 64 participants with osteoarthritis of the knee in this study received either 500 mg glucosamine sulphate three times a day or 400 mg vitamin E made from palm oil once a day for six months. Both groups improved in pain and function, but there was no difference between them.

Trial 4

60 participants with primary osteoarthritis in either one or both knees were randomised to receive a 1500 mg sachet of glucosamine sulphate or a placebo. After 12 weeks, there were no improvements in the placebo group but those who received glucosamine reported significant improvements in resting and moving pain, overall pain, stiffness and function. The improvements in these final three measures lasted for 20 weeks. In the treatment group, reported side-effects were heartburn and an all-over itch.

Review article

This review article summarised results of four trials:

  • Two trials out of three found that glucosamine sulphate was significantly more effective than NSAIDs in reducing pain, while the third found that both treatments had similar effects.
  • One trial out of two found that glucosamine sulphate was significantly better than NSAIDs in improving physical function, while the second trial found that both medications had similar effects.
  • Three trials out of four found that the number and severity of side-effects reported by participants taking glucosamine sulphate were significantly less than those reported by participants who were given NSAIDs.

‡ A trial of low quality. Results of this trial were given a lower weighting when we came to our conclusion about the compound.

Glucosamine-Maximum instructions for use: indications, contraindications, side effects – description Glucosamin-Maximum Tablets (53125)

Glucosamine and chondroitin are chondroprotectors with proven efficacy, proven in numerous open independent studies (conducted in the USA, Europe and Russia) … As a result of the action of the combination of glucosamine and chondroitin, the mobility of the joints improves, the effectiveness of the main therapy increases, the need for the use of painkillers and anti-inflammatory drugs decreases, and the quality of life of patients suffering from diseases of the musculoskeletal system improves.

Glucosamine and chondroitin are natural components of the articular cartilage, necessary for the normal synthesis of the connective tissue of the cartilage and helping to prevent the processes of cartilage destruction. The mechanisms of action of glucosamine and chondroitin are similar.

The ability of glucosamine to provide support and treatment of joints is due to the fact that it is a starting substance for the synthesis of a number of joint tissues (in particular, proteoglycans and collagen, which together provide the elasticity of the cartilage and its resistance to external influences).Glucosamine is also the basis for hyaluronic acid, which is essential for the formation of joints. Glucosamine has a moderate anti-inflammatory effect, protects damaged cartilage from destruction caused by pain relievers and hormonal drugs, neutralizes the aggressive effects of inflammatory enzymes that destroy cartilage tissue, and normalizes calcium deposition in bone tissue.

Chondroitin Sulfate provides an additional substrate for healthy joint matrix formation and proteoglycan synthesis.Chondroitin sulfate increases the synthesis and maintains the viscosity of the synovial fluid, prevents the compression of connective tissue and plays the role of a kind of lubrication of the articular surfaces, providing flexibility and elasticity of the joints. It inhibits the process of degeneration of cartilage tissue, suppressing the activity of those enzymes that break down cartilage, and resists the action of free radicals.

The interaction of these two components, which are part of the dietary supplement Glucosamine-Maximum, and the high content of the active substance provide a pronounced and lasting beneficial effect on the joints and the spine.

The constant intake of Glucosamine-Maximum helps to reduce the intensity of inflammatory processes in the joints, reduce pain, restore joints, cartilage and bone tissue.

Glucosamine-Maximum is recommended at the first signs of impaired activity of the musculoskeletal system, as well as for those at risk, for the prevention of diseases, helping to maintain flexibility of the joints and prevent their premature aging.

The active ingredients of the dietary supplement Glucosamine-Maximum are of natural origin and are well tolerated.

Glucosamine-Maximum is produced in Russia in compliance with all requirements for the production of biologically active food supplements. The functional orientation of its action is confirmed by the System of voluntary certification of dietary supplements for food.

Glucosamine-Maximum is a reliable basis for constructive prevention of diseases of the musculoskeletal system and an essential component of the daily diet of people suffering from diseases of the joints and spine.

Application of Glucosamine-Maximum in a dose of 1 tab./ day helps to provide the body with substances necessary for the normal functioning of the joints. The daily intake (1 tab.) Contains 750 mg of glucosamine hydrochloride (89% of the intake in terms of glucosamine) and 250 mg of chondroitin sulfate (42% of the adequate intake). The percentage of the adequate level of consumption is indicated in accordance with the Unified Sanitary-Epidemiological and Hygienic Requirements for Goods Subject to Sanitary-Epidemiological Supervision (Control).

instructions for use, analogs, articles »Drug Handbook

Stimulates the restoration of cartilage tissue.Chondroitin sulfate and glucosamine are involved in the formation of connective tissue, helping to prevent the destruction of cartilage. The use of exogenous glucosamine stimulates the formation of the cartilage matrix and protects the cartilage from chemical damage. Glucosamine as a sulfate salt is a precursor to hexosamine, and the sulfate anion is needed for the production of glycosaminoglycans. Another possible property of glucosamine is protection against metabolic destruction of damaged cartilage, which is caused by glucocorticosteroids and non-steroidal anti-inflammatory drugs, as well as the presence of its own moderate anti-inflammatory effect.Chondroitin sulfate is an additional substrate for the synthesis of healthy cartilage matrix, whether it is supplied to the body as separate components or as an intact form. Enhances the synthesis of proteoglycans, hyaluronon and collagen type 2, protects hyaluronon from degradation by enzymes (the activity of the hyaluronidase enzyme is suppressed) and from the negative effects of free radicals; maintains the viscosity of the joint fluid, enhances cartilage repair and reduces the activity of enzymes involved in cartilage breakdown (hyaluronidase, elastase).During the treatment of osteoarthritis, it reduces the manifestation of the disease, and also reduces the need for taking non-steroidal anti-inflammatory drugs. The bioavailability of glucosamine when taken orally is 25% (due to the effects of “first pass” through the liver). Distributed in tissues: maximum concentrations are found in articular cartilage, kidneys and liver. Approximately 30% of the dose taken persists for a long time in muscle and bone tissues. It is mainly excreted unchanged in urine, a little in feces.The half-life is 68 hours. When taken orally 0.8 grams (or 0.4 grams 2 times a day) chondroitin sulfate content in plasma increases during the day. The absolute bioavailability is 12%. About 20 and 10% of the dose taken is absorbed as low molecular weight and high molecular weight derivatives, respectively. The apparent volume of distribution is approximately 0.44 ml / g. During desulfurization processes, it undergoes metabolism. It is excreted in the urine. The half-life is 310 minutes.

instructions for use, analogs, composition, indications

Pharmacodynamics
Glucosamine
Mechanism of Action
Glucosamine hydrochloride is a salt of the amino monosaccharide glucosamine, which is an endogenous component and a preferred substrate for the synthesis of glycosaminoglycans and proteoglycans of articular cartilage and synovial fluid.Glucosamine hydrochloride inhibits the activity of interleukin-1 beta and other inflammatory mediators.
Clinical efficacy and tolerability
The safety and efficacy of glucosamine hydrochloride has been confirmed in clinical trials with a treatment duration of up to three years. Short- and medium-term clinical studies have shown that the effectiveness of glucosamine hydrochloride in relation to the symptoms of osteoarthritis is noted after 2-3 weeks of its use.However, unlike non-steroidal anti-inflammatory drugs (NSAIDs), glucosamine hydrochloride has a long-lasting effect that lasts from six months to three years.
Clinical studies with daily intake of glucosamine hydrochloride for a period of up to three years have shown a gradual improvement in the symptoms of the disease and a slowdown in structural changes in the joint, as demonstrated by conventional radiography.
Glucosamine hydrochloride has been shown to be well tolerated during short and long term treatments.
Evidence of drug efficacy was demonstrated when it was used for three months, with a residual effect for two months after discontinuation. The safety and effectiveness of the drug have also been confirmed in clinical trials for up to three years. Continuous treatment for more than three years cannot be recommended, as there is no safety data for glucosamine supplementation for more than three years.
Chondrothin sulfate
Chondroitin sulfate is a high molecular weight mucopolysaccharide.It is the main component of proteaglycans, which together with collagen fibers make up the cartilage matrix.
Pharmacokinetics
Glucosamine
Absorption
After oral administration of 14C-labeled glucosamine, it is rapidly and almost completely absorbed, and about 90% of the radioactive label is recorded in the systemic circulation. The absolute bioavailability of glucosamine in humans after oral administration was 44%, taking into account the first passage.After a daily oral intake of 1500 mg of glucosamine hydrochloride by healthy volunteers under fasting conditions, the maximum plasma concentrations in a stationary state (C max , CC ) averaged 3 hours (T max ) about 1602 ± 426 ng / ml. At steady-state, the AUC was 14564 ± 4138 ng ∙ h / ml. It is not known whether food intake has a significant effect on oral bioavailability. The pharmacokinetics of glucosamine is linear in the dose range of 750-1500 mg, with deviations from linearity at a dose of 3000 mg due to lower bioavailability.There are no gender differences in absorption and bioavailability of glucosamine. The pharmacokinetics of glucosamine were similar in healthy volunteers and patients with knee osteoarthritis.
Distribution
After oral absorption, glucosamine is distributed in various vascular compartments, including synovial fluid, with an apparent volume of distribution 37 times higher than the total volume of fluid in humans. Glucosamine does not bind to plasma proteins. Therefore, it is extremely unlikely that glucosamine is capable of drug interactions when taken together with other drugs that strongly bind to blood plasma proteins.
Metabolism
The metabolic profile of glucosamine has not been studied, since, being an endogenous substance, it is used as a “building material” for the biosynthesis of articular cartilage components. Glucosamine is mainly metabolized by conversion to hexosamine, regardless of the cytochrome system. It does not act as an inhibitor or inducer of human CYP450 isoenzymes, including CYP 3A4, 1A2, 2E1, 2C9 and 2D6.00. There is no clinically significant interaction of glucosamine with other drugs that could be realized by inhibiting and / or inducing human CYP450 isoforms.
Excretion
In humans, the half-life of glucosamine from plasma is 15 hours. After oral administration of 14C-labeled glucosamine, excretion in urine was 10 ± 9%, with feces – 11.3 ± 0.1% of the administered dose. The average excretion of unchanged glucosamine after oral administration in humans is about 1% of the administered dose, which suggests that the kidneys and liver do not play a significant role in the elimination of glucosamine, its metabolites and / or its degradation products.
Pharmacokinetics in various categories of patients
In patients with renal and hepatic insufficiency
Studies of the pharmacokinetics of glucosamine in patients with renal or hepatic insufficiency have not been conducted. These studies were considered inappropriate due to the insignificant contribution of the liver and kidneys to the metabolic process, degradation and excretion of glucosamine. Therefore, given the favorable safety profile and good tolerability of glucosamine, no dose adjustment is required in patients with renal or hepatic insufficiency.
Children and adolescents
Studies of the pharmacokinetics of glucosamine in children and adolescents have not been conducted.
Elderly patients
Pharmacokinetic studies in elderly patients have not been conducted, however, in clinical trials of the efficacy and safety of glucosamine, mainly elderly patients were included. It has been shown that in this category of patients there is no need for dose adjustment.
Chondrothin sulfate
Pharmacokinetics have not been studied.

The frequency of adverse reactions indicated below was determined using the following note: very often (≥ 1/10), often (≥ 1/100 to
General profile of adverse events
The most common adverse reactions associated with oral glucosamine and chondroitin sulfate are nausea, abdominal pain, indigestion, flatulence, constipation, and diarrhea.These side reactions were usually mild and transient. In the following table, adverse reactions were grouped based on the MedDRA classification.

Class of systems or organs Very often
≥ 1/100
Often
≥ 1/100 to <1/10
Uncommon
≥ 1/1000 to <1/100
Rarely
≥ 1/10000
up to <1/1000
Very rare
<1/10000
Unknown *
From the immune system Allergic reactions **
On the part of metabolism and nutrition Inadequate glycemic control in diabetes
Mental disorders Insomnia
From the nervous system Headache
Drowsiness
Dizziness
On the part of the organ of vision Visual impairment
From the side of the heart Arrhythmias, including tachycardia
From the vascular system Tides
From the respiratory system, chest and mediastinum Asthma / worsening of asthma
From the gastrointestinal tract Diarrhea
Constipation
Nausea
Flatulence
Abdominal pain
Dyspepsia
Vomiting
On the part of the skin, subcutaneous tissue Erythema
Itching
Rash
Angioedema
Hives
From the liver and biliary tract Increased levels of “liver” enzymes in the blood and jaundice ***
General violations Fatigue Edema / peripheral edema
On the part of laboratory and physiological parameters Increased liver enzymes, blood glucose levels, increased blood pressure, fluctuations in INR

* Frequency cannot be estimated from available data.
** Prone patients may develop severe allergic reactions to glucosamine.
*** Cases of increased liver enzymes and the development of jaundice have been reported, but a causal relationship with glucosamine intake has not been established.
Cases of hypercholesterolemia have been reported, but a causal relationship with glucosamine intake has not been established.
Reported Suspected Adverse Reactions
Medical professionals are encouraged to send information about any suspected adverse reactions and drug ineffectiveness to the address: Republican Unitary Enterprise “Center for Examination of Tests in Health Care”, Tovarishchekiy per., 2a, 220037, Republic of Belarus, e-mail: [email protected]

Glucosamine for people in the body – what is it and what is it for, norms

Types of glucosamine

Glucosamine is produced in the form of two salts – glucosamine sulfate and glucosamine hydrochloride, which differ slightly in their properties and effectiveness.

Glucosamine sulfate and chloride break down in the stomach to form glucosamine and salt. Glucosamine, isolated from both the sulfate and hydrochloride forms, practically does not differ in chemical properties and clinical effect.

How does glucosamine work in the body?

Active glucosamine from the intestine enters the blood vessels and then into the cartilage. Its main task is to maintain the function of chondrocytes. Chondrocytes are special cells that work like mini-factories.They produce the building blocks for cartilage: collagen, hyaluronic acid, chondroitin sulfate and other important substances.

Therefore, the addition of glucosamine to the diet helps to activate our internal “building factories” that repair cartilage connections, thereby relieving us of joint pain.

Is glucosamine proven to be beneficial in humans?

The first studies of glucosamine were carried out in the 80s of the last century in Italy. In the course of clinical studies, it was found that with prolonged use of glucosamine inside, it reduced pain and improved joint movement, slowed down the progression of osteoarthritis.Most of the patients noticed a significant reduction in pain after just one month of taking glucosamine. The results were confirmed in the study of X-ray images of patients after a course of glucosamine intake: a slowdown in the destruction of the joint was noted. Subsequent experiments confirmed the data obtained and even showed an increase in the effect when combined with glucosamine and chondroitin.

In addition, it should be mentioned that glucosamine is recommended by the European Society for the Clinical and Economic Aspects of Osteoporosis and Osteoarthritis as the first line of therapy for osteoarthritis and other degenerative joint diseases due to its ability to control pain and slow the development of structural changes in the joints.

At the same time, glucosamine with another chondroprotective substance, chondroitin sulfate, has shown particularly high efficiency in osteoarthritis. The effectiveness of the combined use of these substances has been well studied in various comparative studies. It has been shown that in terms of effectiveness against the symptoms of osteoarthritis – pain, dysfunction of the joint – the combination of glucosamine and chondroitin, when used systematically, is not inferior to the most modern non-steroidal anti-inflammatory drugs and at the same time has a positive effect on the structure of joint tissues.In this case, one should take into account the doses of glucosamine and chondroitin, which were used in the largest foreign studies and are currently considered sufficient or therapeutic. For example, a therapeutic daily dose of glucosamine (1500 mg) and chondroitin (1200 mg) is contained in 3 capsules of the Teraflex preparation and is therefore recommended for the first 3 weeks of treatment.

Indications for use

Glucosamine has proven to be effective and irreplaceable in the treatment of many joint diseases.It is actively used for osteochondrosis, arthrosis, arthritis and other diseases. It should only be remembered that the effects of glucosamine, as well as chondroitin sulfate, develop gradually. Therefore, the main indications for use are various manifestations of osteoarthritis:

  • Pain
  • Restraint
  • Crunch (characteristic sound when bending the limbs)
  • Swelling in the area of ​​the joints
  • Bone outgrowths (in case of advanced form of osteoarthritis)

Treatment or prevention?

Based on the above, we can conclude that glucosamine can be used not only for the treatment of joint diseases, but also for the prevention of further progression of cartilage destruction.In order to contain dystrophic changes, the agent is prescribed when the first signs of the disease appear, as a rule, to athletes and people over 40, since it is these groups that are most susceptible to the development of joint diseases. Glucosamine has established itself as an excellent substance in terms of its efficacy and safety profile, which has been popular for several decades.

The effectiveness of taking glucosamine to maintain joint health has been proven in combination with chondroitin.The combination of these substances contributes to the restoration of cartilage tissue, increases the resistance of the cartilage to destruction and helps to reduce pain 1 .

This combination is presented in the Teraflex and Teraflex Advance line of drugs, which helps to reduce pain due to the presence of ibuprofen (non-steroidal anti-inflammatory drug) in the composition, and the combination of glucosamine and chondroitin simultaneously begins to stimulate the renewal of cartilage tissue.

Glucosamine and chondroitin: content in Teraflex

Chondroitin and glucosamine are formed in cartilage tissue in sufficient quantities, but usually only in a young and healthy body.With age, chondrocytes become less active and produce less and less of these substances necessary for the joint. As a result, dystrophic processes begin in the cartilage: it loses its strength, elasticity, and absorbs worse. The amount of synovial fluid decreases – the heads of the joint no longer move so easily relative to each other, the nutrition of the joints is disrupted. Then there is a crunch, clicking, unpleasant sensations with sudden and awkward movements, increased loads.

Intra-articular fluid provides the cartilage with useful substances: if it is not enough, the tissues “starve”.This further exacerbates the degeneration process. However, at first it is reversible: with a sufficient amount of glucosamine and chondroitin, the cartilage could be restored, but the deficiency of these substances dooms a person to a gradual deterioration in the condition of the joints. Against the background of the destruction of cartilage tissue, arthrosis and osteoarthritis develop, accompanied by pain, inflammation. With the progression of the disease, deformities and significant limitation of movements in the joints are possible.

If there is a shortage of glucosamine and chondroitin in the body, it is necessary to ensure their supply from the outside.For example, with food: jellied meat, aspic, various jellies contain chondroitin, and our distant ancestors received it by eating cartilage and veins of animals. And yet, the amount of the necessary substance in food is not so great, and it is impossible to constantly eat the listed products. Therefore, drugs are usually used as their source.

Preparations for joint health

The group of joint diseases is very extensive: it includes inflammatory (arthritis, bursitis, synovitis) and degenerative (arthrosis, chondrosis), the consequences of various injuries.Their specificity is such that an isolated pathological process of one type is rarely found, more often they proceed in parallel, in some cases one even becomes the cause of the other.
For example:

  • against the background of dystrophic processes, inflammatory processes often develop – this is how osteoarthritis is formed;
  • a joint weakened by dystrophic processes is easier to injure;
  • the trauma suffered can trigger the process of cartilage degeneration or provoke inflammation;
  • Acute inflammation (arthritis, bursitis) rarely passes without a trace – the nutrition of the cartilage is seriously impaired, which causes degenerative changes and chronic inflammatory processes.

Because of the blurred boundaries of each disease, they are often grouped together into a single group called “arthropathies”. Of course, if possible, a specific diagnosis is made – this is important for proper treatment. Therapy for rheumatoid arthritis and, for example, chlamydial arthritis, will be different. But with any arthropathy, it is important to restore the cartilage tissue. In some diseases, its destruction is the main cause, in others it is a consequence, but it always suffers. For this purpose, chondroprotectors are prescribed, which usually include glucosamine and chondroitin.

Chondroprotectors need to be taken in long courses (from 3 months to six months or more) – it is necessary to form a sufficient supply of substances necessary for cartilage so that recovery processes begin in it. There are practically no side effects with drugs in this group. Therefore, chondroprotectors are taken not only for severe joint problems, but also to avoid them in the transition to a more severe stage 1 .

For treatment, it is better to choose not biologically active supplements, but full-fledged drugs that have passed all the necessary studies, where they have confirmed their effectiveness and safety.It is also worth paying attention to the composition: the complex of glucosamine and chondroitin is more effective than each component separately 2 . As an example of a combined preparation, one can name “Teraflex”, which contains glucosamine and chondroitin sulfate, which enhance the action of each other 2 .

90,000 Does Glucosamine Work?

benefits, dosage and side effects

2020-10-01 19:55:23
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