Glucosamine

From Anvita Health Wiki

Contents 1 More Specific Terms 2 Uses 3 Contraindications 4 Dosage 5 Pharmacokinetics 6 Adverse-effects 7 Drug-interactions 8 Mechanism-of-action 9 More General Terms 10 Additional Terms 11 Internet Database 12 References

More Specific Terms

• glucosamine-2,6-sulfate
• glucosamine-2-sulfate (N-sulfoglucosamine, GlcNS)
• glucosamine-6-phosphate (Robison ester)
• N-acetylglucosamine (GlcNAc)

Uses

• osteoarthritis [7] (also see GAIT study)

• often used in combination with chondroitin sulfate

• rheumatoid arthritis [14]

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]

Dosage

• 1500* mg PO QD to 1 g PO BID
  

• * 1500 mg QD for diabetics [6]

Pharmacokinetics

• takes 4-8 weeks to relieve pain

Adverse-effects

• hyperglycemia [5]; no increase in HgbA1c [6]
• hypercholesterolemia [4]
• hypertension [4]
• GI upset [14]
• anorexia [14]
• insomnia [14]
• pruritis & pain [14]
• peripheral edema [14]
• tachycardia [14]
• not harmful [12]

Drug-interactions

• may increase INR in some patients on warfarin [8]
  
• drug interaction(s) of warfarin with glucosamine

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

• hexosamine
• metabolic agent (metabolic modifier)

Additional Terms

• NIH Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT)

Internet Database

Kegg: [1]
PubChem: 441477

References

1. Prescriber's Letter 6(10):58, Oct, 1999
2. Prescriber's Letter 8(2):7, Feb, 2001
3. Journal Watch 21(6):47, 2001 Reginster et al Lancet 357:251, 2001 McAlidon Lancet 357:247, 2001
4. Prescriber's Letter 8(11):64 2001
5. Prescriber's Letter 10(5):27 2003
6. Prescriber's Letter 10(9):49 2003
7. Prescriber's Letter 13(1): 2006 Detail-Document#: [2] (subscription needed) [3]
8. Prescriber's Letter 15(6): 2008 Glucosamine/Chondroitin and Warfarin Interaction Detail-Document#: [4] (subscription needed) [5]
9. 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: [6]
10. Prescriber's Letter 15(11): 2008 Detail-Document#: [7] (subscription needed) [8]
11. 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: [9] <Internet> [10]
12. 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: [11] <Internet> [12]
13. Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society

glucosamine (Cosamin, Osteo-Bi-Flex)