glucosamine (Cosamin, Osteo-Bi-Flex)
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Uses
- osteoarthritis[7] (also see GAIT study)
- often used in combination with chondroitin sulfate
- not effective[15][17]*
- rheumatoid arthritis[14]
- may lower risk for cardiovascular events[18]
* on list of medications to avoid[17]
Contraindications
- shellfish allergy (made from oyster & crab shells)[5]
- diabetes NOT a contraindication[6]
- NOT useful for chronic low back pain & degenerative lumbar osteoarthritis[11]
- NOT useful for hip osteoarthritis alone or in combination with chondroitin[12][16]
Dosage
Pharmacokinetics
- takes 4-8 weeks to relieve pain
Adverse effects
- hyperglycemia[5]; no increase in HgbA1c[6]
- hypercholesterolemia[4]
- hypertension[4]
- GI upset: nausea, diarrhea, heartburn[14]
- anorexia
- insomnia
- pruritus & pain
- peripheral edema
- tachycardia
- not harmful[12]
Drug interactions
- may increase INR in some patients on warfarin[8]
- may reduce effectiveness of hypoglycemic agents[14]
Laboratory
Mechanism of action
- possibly stimulates formation & repair of cartilage
- may reduce joint pain in osteoarthritis
- may slow the progression of osteoarthritis[3]
- no benefit of glucosamine or chondroitin for attenuating joint space narrowing[9]
- not much benefit in GAIT trial
- increases insulin resistance in animal studies[6]
- may have antiplatelet effects[8]
More general terms
More specific terms
- glucosamine-2,6-sulfate
- glucosamine-2-sulfate (N-sulfoglucosamine, GlcNS)
- glucosamine-6-phosphate (Robison ester)
- N-acetylglucosamine (GlcNAc)
Additional terms
Component of
- cholecalciferol/chondroitin sulfate/glucosamine
- calcium carbonate/cholecalferol/chondroitin sulfate/glucosamine
- glucosamine/methylsulfonylmethane
- chondroitin sulfate/glucosamine
- chondroitin sulfate/glucosamine/methylsulfonylmethane
- Flexium
References
- ↑ Prescriber's Letter 6(10):58, Oct, 1999
- ↑ Prescriber's Letter 8(2):7, Feb, 2001
- ↑ Jump up to: 3.0 3.1 Journal Watch 21(6):47, 2001 Reginster et al Lancet 357:251, 2001 McAlidon Lancet 357:247, 2001
- ↑ Jump up to: 4.0 4.1 4.2 Prescriber's Letter 8(11):64 2001
- ↑ Jump up to: 5.0 5.1 5.2 Prescriber's Letter 10(5):27 2003
- ↑ Jump up to: 6.0 6.1 6.2 6.3 6.4 Prescriber's Letter 10(9):49 2003
- ↑ Jump up to: 7.0 7.1 Prescriber's Letter 13(1): 2006 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=220102&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Jump up to: 8.0 8.1 8.2 Prescriber's Letter 15(6): 2008 Glucosamine/Chondroitin and Warfarin Interaction Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=240613&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Jump up to: 9.0 9.1 Sawitzke AD et al. The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: A report from the Glucosamine/chondroitin Arthritis Intervention Trial. Arthritis Rheum 2008 Oct; 58:3183. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18821708
- ↑ Prescriber's Letter 15(11): 2008 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=241111&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Jump up to: 11.0 11.1 Wilkens P et al Effect of Glucosamine on Pain-Related Disability in Patients With Chronic Low Back Pain and Degenerative Lumbar Osteoarthritis JAMA. 2010;304(1):45-52. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/20606150 <Internet> http://jama.ama-assn.org/cgi/content/full/304/1/45
- ↑ Jump up to: 12.0 12.1 12.2 Wandel S et al Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis BMJ 2010; 341:c4675 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/20847017 <Internet> http://www.bmj.com/content/341/bmj.c4675
- ↑ Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society
- ↑ Jump up to: 14.0 14.1 14.2 14.3 Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
- ↑ Jump up to: 15.0 15.1 Kwoh CK et al. Effect of oral glucosamine on joint structure in individuals with chronic knee pain: A randomized, placebo-controlled clinical trial. Arthritis Rheumatol 2014 Apr; 66:930 - <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24616448 <Internet> http://onlinelibrary.wiley.com/doi/10.1002/art.38314/abstract
- ↑ Jump up to: 16.0 16.1 Fransen M et al. Glucosamine and chondroitin for knee osteoarthritis: A double-blind randomised placebo-controlled clinical trial evaluating single and combination regimens. Ann Rheum Dis 2015 May; 74:851 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24395557 <Internet> http://ard.bmj.com/content/74/5/851
- ↑ Jump up to: 17.0 17.1 17.2 Therapeutics Letter #108. Therapeutics Initiative Drugs to Avoid. http://www.ti.ubc.ca/2018/01/04/108-drugs-avoid/
- ↑ Jump up to: 18.0 18.1 Ma H, Li X, Sun D et al Association of habitual glucosamine use with risk of cardiovascular disease: prospective study in UK Biobank. BMJ 2019;365:l1628 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31088786 Free Article https://www.bmj.com/content/365/bmj.l1628
Zheng J, Hukportie DN, Zhang Y et al Association Between Glucosamine Use and the Risk of Incident Heart Failure. The UK Biobank Cohort Study and Mendelian Randomization Analysis. Mayo Clinic Proceedings. 2023. July 7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37422736 https://www.mayoclinicproceedings.org/article/S0025-6196(23)00199-4/fulltext